Foa_Content_of_CDC-RFA-DP22-2201 Final.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH

PROMOTION

Tribal Practices for Wellness in Indian Country

CDC-RFA-DP22-2201

03/16/2022

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- DP22-2201. 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:

Tribal Practices for Wellness in Indian Country 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-DP22-2201

E. Assistance Listings Number:

93.762 F. Dates:

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

N/A

2. Due Date for Applications:

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

03/16/2022 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Information Call January 11, 2022 2:30 p.m. - 4:00 p.m. EST 1-888-390-3412 Passcode: 9195563

If you have questions about this funding opportunity, you can submit them to TPWIC2201@cdc.gov. All questions must be submitted no later than Friday, March 11, 2022. Our goal is to respond to questions within 2 working days and we will post them on the TPWIC DP22-2201 FAQ page. CDC cannot answer questions about eligibility other than refer you to the Additional Information on Eligibility page of the NOFO. CDC cannot discuss your proposed activities with you or answer questions about your proposed activities other than refer you to the Strategies and Activities section of the NOFO.

You can find the NOFO, the script from the information call, and links to the FAQs on the NOFO webpage.

G. Executive Summary:

1. Summary Paragraph This funding opportunity supports tribal practices that build resiliency and connections to community, family, and culture among American Indians/Alaska Natives (AI/AN). Social connectedness is a social determinant of health (SDoH) and is a significant factor in mental, emotional, and physical health. Cultural connectedness is a critical element in overall wellness, identity, and sense of belonging, particularly in Native communities. A high degree of social and cultural connectedness can increase the likelihood of individuals engaging in positive health behaviors that ultimately improve health outcomes for chronic diseases. Recipients will implement tribal wellness practices that were identified by tribal health leaders who were convened by CDC in 2016 and from lessons learned from the previous Tribal Practices for Wellness in Indian Country cooperative agreement, CDC-RFA-DP18-1812PPHF18. Up to 18 federally recognized AI/AN tribes, villages, or tribal organizations serving a single tribe or native village will be funded, with no more than 2 awards to tribes/villages and tribal organizations within a single Indian Health Service (IHS) Area. In addition, up to 12 Urban Indian Organizations will be funded to address the same strategies for that portion of their population that is AI/AN.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

https://www.grants.gov/ mailto:TPWIC2201@cdc.gov.

https://www.cdc.gov/healthytribes/tpwic/funding-opportunities/TPWIC-NOFO-2201-faqs.htm https://www.cdc.gov/healthytribes/tpwic/funding-opportunities/TPWIC-NOFO-2201.htm

$22,183,200

e. Average One Year Award Amount:

$150,000 Subject to availability of funding, including both direct and indirect costs.

f. Total Period of Performance Length:

g. Estimated Award Date:

June 29, 2022

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 The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) has prioritized five key social determinants of health (SDoH) for the next 3 – 5 years. This NOFO is intended to address one of those five SDoH, social connectedness, as it focuses on tribal practices that build resiliency and connections to community, family, and culture among American Indians/Alaska Natives (AI/AN). This NOFO will focus on cultural connectedness as a component of social connectedness. Cultural connectedness and cultural practices are essential determinants of health that impact wellbeing and healthy living in AI/AN communities. Social connectedness is a significant determinant of mental, emotional, and physical health and serves as a key factor in protecting, improving, and maintaining individual and community well-being.

Many American Indian and Alaska Native (AI/AN) communities (including those in urban settings) maintain strong traditions to sustain, enhance, or reintroduce cultural wellness practices specific to the location, history, and traditions of their people. Practicing traditional ways, speaking one’s native language, having connections to family and community, and fostering intergenerational relationships have been associated with healthy living (DeCou, 2013). Similar findings have been shown in Native adults; feeling connected to community and culture and speaking a traditional language can positively impact wellbeing (Hodge, 2012). These cultural practices may also strengthen cultural identity; studies have shown those associated with a stronger sense of identify have a more balanced and positive mental health (Hodge, 2012).

Efforts to keep community members engaged in these traditional practices are critical to address the higher rates of chronic disease among AI/AN populations compared with other racial and ethnic groups in the United States. Based on tribal leader input, it is anticipated that lifestyle interventions that incorporate native history and culture will be effective in reducing chronic disease risk factors, and over time, reduce morbidity and mortality due to heart disease, stroke, cancer, and diabetes.

https://www.cdc.gov/chronicdisease/programs-impact/sdoh.htm

Recipients will implement tribal wellness practices that were identified by tribal health leaders and from lessons learned from the previous cooperative agreement, Tribal Practices for Wellness in Indian Country (CDC-RFA-DP18-1812PPHF18). Evaluation for this NOFO will focus on how program strategies lead to increased sense of cultural connectedness among participants, increased physical activity, and increased healthy traditional foods in diets.

This NOFO complements the Good Health and Wellness in Indian Country (CDC-RFA-DP19- 1903) program, which focuses on obesity prevention, commercial tobacco use prevention, and prevention and control of diabetes, high blood pressure, and high blood cholesterol.

References:

Christopher R. DeCou, Monica C. Skewes & Ellen D. S. López (2013) Traditional living and cultural ways as protective factors against suicide: perceptions of Alaska Native university students, International Journal of Circumpolar Health, 72:1, DOI: 10.3402/ijch.v72i0.20968

Hodge, FS, Nandy K. Predictors of wellness in American Indians. J Health Care for Poor and Underserved, 2011: 22(3), DOI: 10, 1353/hpu.2011.0093.IDS: 787B1 Predictors of wellness and American Indians - PubMed (nih.gov)

b. Statutory Authorities Section 301(a) of the Public Health Service Act, 42 U.S.C. 241(a).

c. Healthy People 2030 Diabetes - Healthy People 2030 | health.gov; Heart Disease and Stroke - Healthy People 2030 | health.gov; Cancer - Healthy People 2030 | health.gov; Overweight and Obesity - Healthy People 2030 | health.gov; Oral Conditions - Healthy People 2030 | health.gov; Nutrition and Healthy Eating - Healthy People 2030 | health.gov; Physical Activity - Healthy People 2030 | health.gov;

Tobacco Use - Healthy People 2030 | health.gov; Health Care Access and Quality - Healthy People 2030 | health.gov; Social and Community Context - Healthy People 2030 | health.gov

d. Other National Public Health Priorities and Strategies The Surgeon General’s Call to Action to Support Breastfeeding Best Practices for Comprehensive Tobacco Control Programs – 2014 Native Diabetes Wellness Program Dietary Guidelines for Americans, 2020-2025 Active People, Healthy Nation

e. Relevant Work Good Health and Wellness in Indian Country (CDC-RFA-DP19-1903) Tribal Practices for Wellness in Indian Country (CDC-RFA-DP18-1812PPHF18) Using Traditional Foods and Sustainable Ecological Approaches to Promote Health and Prevent Diabetes in American Indian and Alaska Native Communities Social Determinants of Health | CDC

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

https://doi.org/10.3402/ijch.v72i0.20968 https://pubmed.ncbi.nlm.nih.gov/21841279/ https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke https://health.gov/healthypeople/objectives-and-data/browse-objectives/cancer https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-objectives/oral-conditions https://health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-eating https://health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-eating https://health.gov/healthypeople/objectives-and-data/browse-objectives/physical-activity https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://health.gov/healthypeople/objectives-and-data/browse-objectives/social-and-community-context http://www.surgeongeneral.gov/library/calls/breastfeeding/index.html https://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm https://www.cdc.gov/diabetes/ndwp/index.html https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials https://www.cdc.gov/physicalactivity/activepeoplehealthynation/index.html https://www.cdc.gov/healthytribes/ghwic.htm https://www.cdc.gov/healthytribes/tribalpractices.htm https://www.cdc.gov/diabetes/ndwp/traditional-foods/ https://www.cdc.gov/diabetes/ndwp/traditional-foods/ https://www.cdc.gov/chronicdisease/programs-impact/sdoh.htm

Logic Model: Tribal Practices for Wellness in Indian Country, CDC-RFA-DP22-2201

Strategies Short-Term Outcomes

Intermediate Outcomes

Long-Term Outcomes

Strategy 1: Family and community activities that connect cultural teachings to health and wellness

Strategy 2: Seasonal cultural and traditional practices that support health and wellness

Strategy 3: Social and cultural activities that promote community wellness

Strategy 4:

Intergenerational learning opportunities that support wellness and resilience

Strategy 5: Cultural teachings and practices about traditional healthy foods to promote health, sustenance, and sustainability

Strategy 6:

Traditional and contemporary physical activities that strengthen wellbeing

Increased number of people participating in opportunities for cultural teachings and practices that promote health and wellness

Increased sense of cultural connectedness (All Strategies)

Increased sense of social connectedness (All strategies)

Increased consumption of healthy traditional foods and/or increased physical activity (traditional or contemporary) (Strategies 5 and/or 6)

Increased resilience and use of cultural practices to reduce diabetes, heart disease, stroke, and cancer

Reduced morbidity/mortality due to diabetes, heart disease, stroke, and cancer

Increased sense of mental and emotional wellbeing among community members

The Tribal Practices for Wellness in Indian Country Logic Model (see above) provides a framework to use throughout program planning, implementation, and evaluation. Tribal health leaders identified the 6 strategies in the Logic Model based on tribal practices that connect community members to culture and keep them well. The short-term outcome applies to all strategies and activities and should connect and contribute to achieving the intermediate outcomes in the Logic Model. Applicants are required to report on the bolded outcomes for each of their 3 proposed strategies and activities. All recipients will report on the first two bolded intermediate outcomes (cultural connectedness and social connectedness). Recipients who choose Strategy 5 or 6 will be required to report on the third bolded intermediate outcome (healthy foods/physical activity). The bolded intermediate outcomes are expected to be achieved by the end of the 5-year period of performance.

i. Purpose American Indians and Alaska Natives have higher rates of chronic disease than other racial and ethnic groups in the United States. This NOFO supports the implementation of tribal practices to build resiliency and connections to community, family, and culture, which over time, can reduce risk factors for chronic disease. The long-term goals are to increase resilience and use of cultural practices to reduce morbidity/mortality due to diabetes, heart disease, stroke, and cancer, and increase mental and emotional wellbeing among community members.

ii. Outcomes Intermediate Outcomes

Increased sense of cultural connectedness (All Strategies) Increased sense of social connectedness (All Strategies) Increased consumption of healthy traditional foods and/or increased physical activity

(traditional or contemporary) (Strategy 5 and/or 6)

iii. Strategies and Activities Applicants are required to select 3 strategies from the strategies listed below and in the Logic Model, and propose at least 1 activity for each selected strategy. The applicant should also describe their “community served,” which could be a tribe, a community primarily comprised of AI/ANs, or the specific AI/AN population served. All strategies and activities are to be implemented with and within the community served. All outcomes listed in the Outcomes section above and in the Logic Model are xpected to be achieved within the community served over the course of the 5-year period of performance.

Strategy 1: Family and community activities that connect cultural teachings to health and wellness Activities:

Implement family-centered community activities and events working with community members and partners that teach, build upon, celebrate, and strengthen cultural and traditional practices and teachings.

Establish or develop health education Native language activities that promote and connect community health and Native language.

Implement a culturally based, community-chosen activity that supports Strategy 1.

Strategy 2: Seasonal cultural and traditional practices that support health and wellness Activities:

Establish an annual community calendar of seasonal cultural and traditional events, celebrations and activities that support and reinforce healthy practices.

Support implementation of one or more seasonal and traditional cultural events, celebrations, traditional harvest, or activities and engage community members and partners to make the event even healthier.

Implement a culturally based, community-chosen activity that supports Strategy 2.

Strategy 3: Social and cultural activities that promote community wellness

Establish and/or strengthen community social and cultural activities focused on sharing cultural knowledge and practices, honoring the future through our people and youth especially teachings of historical events for mental and emotional wellbeing.

Implement social and/or Tribal cultural activities incorporating opportunities to learn about traditional healthy food, physical activities, and lifestyle practices to enhance mental and emotional wellbeing.

Implement a culturally based, community-chosen activity that supports Strategy 3.

Strategy 4: Intergenerational learning opportunities that support wellbeing and resilience

Establish or strengthen opportunities to encourage two way sharing and connect youth, adults, and elders to share knowledge about food, language, ceremonies, stories, places, technology, crafts, and play.

Establish or strengthen opportunities for adults and elders to pass on Tribal, cultural, and other knowledge to children and young people, and to other adults and elders.

Establish and strengthen intergenerational programs that address historical trauma and that promote and enhance healing and resilience.

Implement a culturally based, community-chosen activity that supports Strategy 4.

Strategy 5: Cultural teachings and practices about traditional healthy foods to promote health, sustenance, and sustainability Activities:

Establish or strengthen sustainable programs to gather, raise, harvest, produce or preserve traditional healthy foods, and provide those foods and beverages to individuals, families, schools, institutions, and others.

Partner with Tribal, Inter-Tribal, governmental, and non-governmental entities to produce and promote traditional diets, including foods and drinks to sustain health.

Implement a culturally based, community-chosen activity that supports Strategy 5.

Strategy 6: Traditional and contemporary physical activities that strengthen wellbeing

Enhance, strengthen, or increase opportunities and supports for traditional and contemporary physical activity at schools, work sites, cultural and community events, and other venues.

Enhance, strengthen, or increase traditional knowledge and history that supports traditional and contemporary physical activities at home, in school, worksites, cultural, and community events.

Build traditional or contemporary physical activity into Strategies 1 to 5, above.

Implement a culturally based, community-chosen activity that supports Strategy 6.

In addition to the strategies and activities listed above and in the Logic Model, recipients must also:

Develop a Partnership Plan by the end of year one that proposes at least one external partner to help achieve at least one of the chosen intermediate outcomes. External partners could include other departments within the Tribe or Urban Indian Organization;

other tribal programs operating within the community, such as the Federally Recognized Tribal Extension Program, Tribal school or college, or other partners that share a desire to achieve a similar outcome as the program. CDC will work with recipients in Year 1 to help identify partners, if needed, and develop the Partnership Plan. Recipients will work to develop and strengthen this partnership throughout the period of performance.

Develop a Program Advisory Group by the end of year 1 that will provide guidance on program implementation and continual feedback on activities, success, and challenges.

Recipients will identify members of the Advisory Group, which could include Tribal leaders, elders, youth, persons impacted by the program, other partners interested in the outcomes of the program, and subject matter experts. CDC will work with recipients in year 1 to help identify processes for developing and sustaining a Program Advisory Group. The Program Advisory Group should be active by the beginning of year 2.

Participate in the TPWIC Community of Practice (CoP) facilitated by CDC and Evaluation/Technical Assistance (TA) partners. The CoP will consist of monthly virtual meetings and trainings facilitated by Indigenous Evaluation/TA partners to convene recipients to share ideas, successes, and challenges, exchange lessons learned, and establish best practices.

Participate in important meetings related to the cooperative agreement. Applicant budgets should include travel funds sufficient for the Project Director or designee to attend one recipient kick-off meeting in the first year.

1. Collaborations

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

Collaboration with programs funded by CDC is encouraged, particularly those that are working to reduce risk factors associated with diabetes, heart disease, stroke, cancer, and obesity, including recipients of CDC-RFA-DP19-1903 Good Health and Wellness in Indian Country.

National initiatives, guidelines, and policies have been identified from The Community Guide;

CDC’s Division of Nutrition, Physical Activity, and Obesity; Division of Diabetes Translation;

Division for Heart Disease and Stroke Prevention; Division of Cancer Prevention and Control, and the Office on Smoking and Health that may complement and build upon effective, culturally based strategies and activities. Examples of other CDC programs that may provide collaboration opportunities to support achievement of NOFO outcomes include the National Native Network for Tobacco Control, the WISEWOMAN (Well-Integrated Screening and Evaluation for http://www.cdc.gov/healthytribes/ghwic.htm https://www.cdc.gov/tobacco/stateandcommunity/tobacco_control_programs/coop-agreement/index.html https://www.cdc.gov/tobacco/stateandcommunity/tobacco_control_programs/coop-agreement/index.html https://www.cdc.gov/wisewoman/index.htm

WOMen Across the Nation) program, Racial and Ethnic Approaches to Community Health (REACH), and the High Obesity Program.

Recipients will be required to collaborate with relevant programs based on community needs.

b. With organizations not funded by CDC:

Applicants should describe their plans to collaborate with the following entities, as appropriate based on strategies selected, to address the requirements of this NOFO:

Tribal departments of health Tribal culture departments and language programs Tribal behavioral health departments Tribal schools and/or local school systems Other federally funded tribal programs, such as USDA Federally-Recognized Tribal

Extension Programs, Food Distribution on Indian Reservations, and Supplemental Nutrition Assistance (SNAP Ed) Programs, SAMHSA Native Connections Programs, and Administration for Native Americans Language Preservation Programs.

2. Target Populations American Indians and Alaska Natives

a. Health Disparities American Indians and Alaska Natives (AI/ANs) have higher rates of chronic disease than other racial and ethnic groups in the United States. Tribal Practices for Wellness in Indian Country supports the implementation of tribal practices to build resiliency and connections to community, family, and culture, which over time, can reduce risk factors for chronic disease among AI/ANs.

The long-term goals of this NOFO are to increase resiliency and cultural connectedness to reduce morbidity and mortality due to heart disease, stroke, cancer, and diabetes within AI/AN communities.

iv. Funding Strategy Up to 18 federally recognized AI/AN tribes/villages or tribal organizations serving a single tribe/village will be funded under this NOFO to address the identified strategies. No more than 2 awards to tribes/villages/tribal organizations will be made within a single I.H.S. Area. In addition, up to 12 Urban Indian Organizations will also be funded under this NOFO to address the same strategies for that portion of their population that is American Indian and Alaska Native.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Evaluation and Performance Measurement help demonstrate achievement of program outcomes and build a stronger evidence base for specific program interventions. Evaluation and performance measurement can also determine whether program strategies are scalable and effective at reaching the target or intended populations.

Throughout the five-year project period, CDC, with the assistance of Indigenous Evaluation/ Technical Assistance (TA) partners, will work individually and collectively with recipients to https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm https://www.cdc.gov/nccdphp/dnpao/state-local-programs/hop-1809/high-obesity-program-1809.html https://nifa.usda.gov/program/federally-recognized-tribes-extension-grant-program https://nifa.usda.gov/program/federally-recognized-tribes-extension-grant-program https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations https://www.fns.usda.gov/snap/snap-ed https://www.fns.usda.gov/snap/snap-ed https://www.samhsa.gov/native-connections https://www.acf.hhs.gov/ana/current-grantees https://www.ihs.gov/sites/urban/themes/responsive2017/display_objects/documents/staff/IHS_UIO_ED-CEO_Directory.pdf answer the following evaluation questions based on the program Logic Model and activities.

Both process and outcome evaluation will seek to answer the following questions:

1. To what extent did recipient communities demonstrate an increased sense of cultural connectedness?

2. To what extent did recipient communities demonstrate an increased sense of social connectedness?

3. To what extent did recipient communities demonstrate increased consumption of healthy traditional foods?

4. To what extent did recipient communities demonstrate increased physical activity (traditional or contemporary)?

To answer these questions, a two-pronged evaluation approach will be used. Recipients will be required to: 1) report yearly on performance measures using the Performance Progress and Monitoring (PPMR) report, https://www.cdc.gov/grants/documents/Performance-Progress-and- Monitoring-Report-PPMR.pdf.); and 2) develop and implement recipient-led evaluations with support from CDC and Indigenous Evaluation/TA partners as appropriate. Performance measure reporting must be limited to data collection.

Recipients will be responsible for gathering data for their chosen short-term measures and the intermediate measures that correspond to their chosen strategies. With these measures, the recipients will track the implementation and the achievement of the intended short-term outcomes and intermediate outcomes. For recipient-led evaluations, CDC and Indigenous Evaluation/TA partners will be available to provide technical assistance, where appropriate.

Applicants should consider their selected or proposed short-term outcomes (from the logic model), and for each, develop a short-term measure that will show whether the anticipated change took place. CDC will work with recipients to finalize short-term (1 year) performance measures in the first year of the program.

Applicants should consider their selected strategies, activities, and short-term outcomes, and include the corresponding intermediate measures to examine over the course of their 5-year project. CDC, in collaboration with Indigenous Evaluation/TA partners, will work with recipients to finalize performance measures within the first 12 months after award.

Intermediate measures:

Number of people reporting an increased sense of cultural connectedness Number of people reporting an increased sense of social connectedness For Strategies 1, 2, and/or 3: Number of people participating in opportunities for cultural teachings and practices that promote health and wellness For Strategy 4: Number of people participating in programs that provide intergenerational opportunities that focus on health and wellbeing For Strategy 5 and/or 6: Number of people including healthy traditional foods in their diets and/or number of people reporting an increase in physical activity (traditional or contemporary)

ii. Applicant Evaluation and Performance Measurement Plan https://www.cdc.gov/grants/already-have-grant/Reporting.html https://www.cdc.gov/grants/already-have-grant/Reporting.html https://www.cdc.gov/grants/documents/Performance-Progress-and-Monitoring-Report-PPMR.pdf https://www.cdc.gov/grants/documents/Performance-Progress-and-Monitoring-Report-PPMR.pdf

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.

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 Applicants must describe their organizational capacity to carry out the activities, strategies, and evaluation requirements as outlined in the NOFO. CDC anticipates that all applicants will demonstrate capacity to carry out the activities and evaluation over the five-year period of performance. Specifically, applicants should provide a description of the following:

Experience working directly with the proposed community served, which could be a tribe, community primarily comprised of AI/ANs, or the specific AI/AN population served) in activities that relate to the logic model strategies.

Experience implementing the selected strategies or similar strategies and describe previous success in collaborating with the community served.

Adequate staffing plan to carry out the project (including a project management structure, defined staff roles and responsibilities, position descriptions for vacant positions, CVs/resumes for current staff assigned to the project, and an organizational https://www.cdc.gov/grants/additional-requirements/ar-25.html chart). Position descriptions, CVs/Resumes, and an organizational chart should be included in your application. Name the files, Position Descriptions, CVs/Resumes, and Organizational Chart and upload them as PDF documents under other attachments/mandatory other attachments.

o Applicants must identify a Program Director for the project; however, this person does not have to be dedicated to this position for 100% time.

o Though a trained evaluator contributing to the program is an asset, applicants do not need to identify and provide funding for a trained evaluator. However, applicants must identify a staff person or contractor as having the responsibility to work with CDC and the Indigenous Evaluation/TA providers.

Capability to manage required procurement efforts, including the ability to write and award subcontracts in accordance with 45 C.F.R. 75, as applicable.

Applicants must also:

Demonstrate the capacity to complete all activities proposed.

Demonstrate the ability to engage with community members to implement cultural teachings that promote health and wellness.

d. Work Plan The following template is provided as an example work plan. If the applicant chooses another format, all information in the template must be provided.

Applicants should provide a detailed work plan for the first year of the project and a high-level description of the proposed activities for years 2 – 5 in the project narrative. Reminder:

Applicants should also include the following in their work plan, as described in the Strategies and Activities section of this NOFO:

Partnership Plan Program Advisory Group TPWIC Community of Practice

Strategy:

Intermediate (5-year) Outcome:

Activity

Person(s) Responsible

Timeline/Due Date

Short-term (1-year) Outcome

Short-term Performance Measure

Partners (if applicable)

1.

Briefly describe how the activity will lead to the intermediate (5-year) outcome:

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

In a cooperative agreement, CDC and recipients share responsibility for successfully implementing the award and meeting identified outcomes. The following are potential areas of substantial involvement. Beyond monthly calls, site visits, and regular performance and financial monitoring during the period of performance, CDC will provide the following additional activities to support recipients:

1. Facilitating sharing and lessons learned through an ongoing TPWIC Community of Practice in collaboration with Evaluation/Technical Assistance partners;

2. Providing technical assistance to understand and implement the cooperative agreement requirements and meet program outcomes;

3. Providing guidance to improve the work plans and evaluation strategies;

4. Documenting progress, including doing so in a culturally appropriate way;

5. Providing technical assistance for evaluation and performance measures through collaboration with Evaluation/Technical Assistance partners;

6. Supporting opportunities to network, improve communication and coordination; and

7. Participating in important meetings related to the cooperative agreement.

Throughout the five-year period of performance, technical assistance may be provided to recipients individually or collectively.

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

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$4,436,640

5. Total Period of Performance Funding:

$22,183,200 This amount is subject to the availability of funds.

Estimated Total Funding:

$22,183,200

6. Total Period of Performance Length:

year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$150,000 Per Budget Period

Subject to availability of funding, including both direct and indirect costs.

9. Award Ceiling:

$150,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor:

$100,000 Per Budget Period

Subject to availability of funding, including both direct and indirect costs.

11. Estimated Award Date:

June 29, 2022

12. Budget Period Length:

12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is not available through this NOFO.

If you are successful and receive a Notice of Award, in accepting the award, you agree that the award and any activities thereunder are subject to all provisions of 45 CFR part 75, currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

C. Eligibility Information

1. Eligible Applicants Eligibility Category:

00 (State governments)

01 (County governments)

02 (City or township governments)

04 (Special district governments)

06 (Public and State controlled institutions of higher education)

05 (Independent school districts)

07 (Native American tribal governments (Federally recognized))

08 (Public housing authorities/Indian housing authorities)

11 (Native American tribal organizations (other than Federally recognized tribal governments))

12 (Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education)

13 (Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education)

20 (Private institutions of higher education)

22 (For profit organizations other than small businesses)

23 (Small businesses)

99 (Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled "Additional Information on Eligibility")

25 (Others (see text field entitled "Additional Information on Eligibility" for clarification))

Additional Eligibility Category:

Government Organizations:

American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations

American Indian or Alaska native tribally designated organizations

2. Additional Information on Eligibility This Notice of Funding Opportunity Announcement will support any of the 574 Federally recognized American Indian Tribes/Alaska Native (AI/AN) Villages, any of the 41 Urban Indian Organizations (UIO) that have a current Title V Indian Health Care Improvement Act contract with the Indian Health Service, or any Tribal Organization, as defined in this NOFO, that is applying on behalf of a single American Indian tribe/Alaska Native village. Recipients must have the critical understanding or experience of working in AI/AN communities and sovereign tribal governments where cultural sensitivity, an awareness of history, and establishing trust are critical for success.

Tribal Organizations applying on behalf of a single tribe/village must submit with their application a letter of support signed by the tribe/village leadership, which may vary by tribe/village, and may include the Tribal/Village Council, President, or other designated executive leader. The signed letter of support from the tribe/village leadership must:

1. Be on the Tribal/Village letterhead,

2. Specifically mention the name of the applicant (Tribal Organization) applying on behalf of the Tribe/Village,

3. Specifically state that the Tribe/Village approves of the applicant (Tribal Organization) applying on their behalf,

4. Specifically indicate that the Tribe/Village intends to fully participate in the CDC-RFA-

DP22-2201, Tribal Practices for Wellness in Indian Country funding opportunity with the applicant (Tribal Organization), and

5. Include the name, title, and signature of the tribal leader.

This letter of support should be titled “Tribal Support Letter” and uploaded as a "other attachments/mandatory other attachments" with the application at www.grants.gov. Failure to provide this letter of support will deem the application as nonresponsive and it will receive no further review.

CDC will consider any application requesting to serve multiple tribes as nonresponsive and it will receive no further review.

CDC would not meet the intent of the original establishment of the program budget line and the direction given in House Report 114-699 in FY17, and subsequently reaffirmed and funded in the FY18, FY19, FY20, and FY21 Appropriation bills for CDC to fund “Good Health and Wellness in Indian Country” programs. Most recently, the committee was clear in FY19 (House Report 115-862) that the program funds are to be awarded to Tribes and Tribal organizations, https://www.federalregister.gov/documents/2021/01/29/2021-01606/indian-entities-recognized-by-and-eligible-to-receive-services-from-the-united-states-bureau-of https://www.federalregister.gov/documents/2021/01/29/2021-01606/indian-entities-recognized-by-and-eligible-to-receive-services-from-the-united-states-bureau-of https://www.ihs.gov/sites/urban/themes/responsive2017/display_objects/documents/staff/IHS_UIO_ED-CEO_Directory.pdf https://www.ihs.gov/sites/urban/themes/responsive2017/display_objects/documents/staff/IHS_UIO_ED-CEO_Directory.pdf http://www.grants.gov also referred to as AI/AN communities (which is clearly understood by the committee and tribal communities to be only Tribes and Tribal organizations): “The Good Health initiative supports efforts by American Indian and Alaska Native communities to implement holistic and culturally-adapted approaches to reduce tobacco use, improve physical activity and nutrition, and increase health literacy.” The language in FY20 (House Report 116-62) and continued level funding for this budget line and recommended an increase in FY21 (House Report 116-450): “The Committee’s recommended level includes an increase of $2,000,000 for Good Health and Wellness in Indian Country.”

3. Justification for Less than Maximum Competition N/A

4. Cost Sharing or Matching Cost Sharing / Matching Requirement:

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.

5. Maintenance of Effort Maintenance of effort is not required for this program.

D. Application and Submission Information

1. Required Registrations An organization must be registered at the three following locations before it can submit an application for funding at www.grants.gov.

In preparation for the federal government’s April 4, 2022 transition to the Unique Entity Identifier (UEI) from the Data Universal Numbering System (DUNS), applicants must include a UEI in applications (SF-424, field 8c) due on or after January 25, 2022. The UEI is generated as part of SAM.gov registration. Current SAM.gov registrants have already been assigned their UEI and can view it in SAM.gov and grants.gov. Entities registering in SAM.gov prior to April 4, 2022 must still obtain a DUNS number before registering in SAM.gov registration. Additional information is available at: https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update, SAM.gov, https://www.grants.gov/forms/sf-424-family.html and https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/.

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number to register in SAM.gov prior to April 4, 2022. A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B).

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll https://www.grants.gov/ https://sam.gov/content/home https://sam.gov/content/home https://sam.gov/content/home https://grants.gov https://sam.gov/content/home https://sam.gov/content/home https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update https://sam.gov/content/home https://www.grants.gov/forms/sf-424-family.html https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/ https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/ free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS number will be provided at no charge.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their DUNS numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number and a Unique Entity Identifier (UEI). All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC.

If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at SAM.gov and the SAM.gov Knowledge Base.

c. Grants.gov:

The first step in submitting an application online is registering your organization at www.grants.gov, the official HHS E-grant Web site. Registration information is located at the "Applicant Registration" option at www.grants.gov.

All applicant organizations must register at www.grants.gov. The one-time registration process usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

Step System Requirements Duration Follow Up

Data Universal Number System

(DUNS)

(Required until April 4, 2022)

1. Click on http:// fedgov.dnb.com/ webform

2. Select Begin DUNS search/request process

3. Select your country or territory and follow the instructions to obtain your DUNS 9-digit #

4. Request appropriate staff member(s) to obtain DUNS number, verify & update information under DUNS number

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call 1-866-705-

2 System for Award

1. Retrieve organizations DUNS number (required until April 4, 2022)

3-5 Business Days but up to 2 weeks and must be renewed once a year

For SAM Customer Service Contact https://fs http://fedgov.dnb.com/webform/displayHomePage.do https://sam.gov/content/home https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dgsa_kb_view2%26kb_id%3Df66d8e6cdb76d4100d73f81d0f9619c6&data=04%7C01%7Ccshifflett%40dminc.com%7C8eee7a2adab549a3b3c008d925e9a364%7Cdb7ac9ef779d46e59bca00509580ad6b%7C0%7C0%7C637582507851821018%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=UrR%2B%2FM2wWF2fZG05Z8O6JS2C3FXXSl%2F7B3%2FB45XHRrg%3D&reserved=0…