Foa_Content_of_CDC-RFA-IP21-2108.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES

Partnering with National Organizations to Support Community-Based Organizations to Increase Vaccination Coverage Across Different Racial and Ethnic Adult Populations Currently

Experiencing Disparities

CDC-RFA-IP21-2108

03/29/2021

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- IP21-2108. 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:

Partnering with National Organizations to Support Community-Based Organizations to Increase Vaccination Coverage Across Different Racial and Ethnic Adult Populations Currently Experiencing 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)).

New-Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-IP21-2108

E. Assistance Listings Number:

93.185 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

F. Dates:

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

N/A

2. Due Date for Applications:

03/29/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Potential applicants may participate in a conference call for information on this NOFO. The conference call will be conducted by the Immunization Services Division. The call will be held:

March 22, 2021, 11:30am – 12:30pm ET. Please use this link to access the call:

Join Zoom Meeting;

(US: +1 669 254 5252 or +1 646 828 7666 or +1 669 216 1590 or +1 551 285 1373);

Meeting ID: 160 622 9049;

Passcode: =7?aRBDU; Passcode (dial-in): 87320987;

International numbers

G. Executive Summary:

1. Summary Paragraph CDC seeks to build the evidence base of effective interventions to improve vaccination coverage and identify and implement strategies to reduce racial and/or ethnic disparities in adult vaccination coverage.

This NOFO’s goal is to support efforts to increase influenza and COVID-19 vaccination coverage for adults in racial and/or ethnic populations experiencing disparities in the United States. This NOFO has three parts. All national recipients are responsible for Part A activities and are expected to monitor, evaluate, and support community-based organizations’ (CBOs) implementations of Part C activities. Only 1-2 national recipients will also implement Part B activities.

a. Eligible Applicants:

Single

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 200,000,000

e. Average One Year Award Amount:

$ 10,000,000

f. Total Period of Performance Length:

https://www.grants.gov/ https://cdc.zoomgov.com/j/1606229049?pwd=aVcyTS90RWw4NnhmYVpGSmpZeWpVdz09&from=addon https://cdc.zoomgov.com/u/aGi1k0x8z

g. Estimated Award Date:

April 09, 2021

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 Vaccination is considered one of the most important public health achievements of the twentieth century and continues to offer great promise. Vaccines save lives and improve the quality of life by preventing serious infectious diseases and their consequences. However, the benefits of vaccination are not realized equally across the population of the United States. Data shows that adult vaccination coverage remains low nationally and significant racial and ethnic disparities exist. The groups experiencing disparities are also disproportionately affected by COVID-19, at risk for serious illness from COVID-19, and/or at high risk for complications from influenza infection.

This NOFO’s goal is to support efforts to increase influenza and COVID-19 vaccination coverage for adults in racial and/or ethnic populations experiencing disparities in the United States. This NOFO has three parts:

Part A: National Recipients

1. Select approximately 50-100 CBOs, mostly from affiliations and network, to partner with and implement Part C activities at the community level

2. Coordinate, evaluate, and provide technical assistance to funded CBOs

3. Facilitate CBOs’ connection and contributions to the resources and evidence base

4. Provide progress reports to CDC

Part B: 1-2 National Recipients

1. Coordinate activities for CBOs and organizations participating in the broader Reducing Racial and Ethnic Disparities in Adult Immunization Program to share knowledge and expertise

2. Manage materials created by CBOs and organizations participating in the broader Program

Part C: Community-Based Organizations

1. Equip influential messengers by providing trainings and materials

2. Increase vaccination opportunities and enhance provider partnerships

3. Establish partnerships with state and local health departments

b. Statutory Authorities

This program is authorized under Sections 317 and 317(k)(2) of the Public Health Service Act (42 U.S.C. Sections 247b and 247b(k)(2)), as amended.

c. Healthy People 2030 This NOFO relates to two Healthy People 2030 topic areas: social determinants of health (https://health.gov/healthypeople/objectives-and-data/social-determinants-health) and infectious disease (https://health.gov/healthypeople/objective-and-data/browse-objectives/infectious-desease).

A goal of Healthy People 2030 is to eliminate health disparities and achieve health equity (https://health.gov/healthypeople/about/healthy-people-2030-framework). This NOFO addresses the following vaccination objectives:

Increase the proportion of persons who are vaccinated annually against seasonal influenza

Increase the proportion of adults age 19 years or older who get recommended vaccines

d. Other National Public Health Priorities and Strategies This NOFO supports CDC’s COVID-19 Response Health Equity Strategy (https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/cdc-strategy.html), including the goals of:

Reduced COVID-19-related health disparities Ensured equity in nationwide distribution and administration of future COVID-19 vaccines Implemented evidence-based policies, systems, and environmental strategies to mitigate social and health inequities related to COVID-19 Reduced COVID-19 associated stigma and implicit bias Expanded cultural responsiveness and application of health equity principle among an increasingly diverse COVID-19 responder workforce

The Approach section outlines suggested activities to achieve the goals listed above.

e. Relevant Work This NOFO builds on a supplement to CDC’s Racial and Ethnic Approaches to Community Health (REACH) program, which funds REACH recipients to implement activities aiming to increase COVID-19 vaccination coverage and influenza vaccination coverage among racial and ethnic groups experiencing disparities in the United States. Additionally, this NOFO will fund recipient organizations and affiliated CBOs to implement work similar to another CDC NOFO that funds minority-led national organizations and their local branches/chapters/affiliates (https://www.grants.gov/web/grants/search-grants.html?keywords=CDC-RFA-IP21-2106).

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

CDC-RFA-IP21-2108 Logic Model: Partnering with National Organizations to Support Community-Based Organizations to Increase Vaccination Coverage Across Different Racial and Ethnic Adult Populations Currently Experiencing Disparities https://health.gov/healthypeople/about/healthy-people-2030-framework https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/cdc-strategy.html https://www.grants.gov/web/grants/search-grants.html?keywords=CDC-RFA-IP21-2106

Bold indicates period of performance outcome

Strategy and Activities

Outputs Short-Term Outcomes

Long-Term Outcomes

Part A

1) Select approximately 50- 100 CBOs, mostly from affiliations and network, to partner with and implement Part C activities at the community level

2) Coordinate, evaluate, and provide technical assistance to funded CBOs

3) Facilitate CBOs’ connection and contributions to the resources and evidence base

4) Provide progress reports to

CDC

Part B

1) Coordinate activities for CBOs and organizations participating in the broader program to share knowledge and expertise

2)Manage materials created by CBOs and organizations

Part A

- Established criteria for an impactful influential messenger

- Education and communications campaigns

Part B

- Identification of evidence-based practices or resources

- Messaging and communications strategies

Part C

- User-tested and culturally appropriate messages, visual assets, and other communications materials

- Recruitment campaigns and training for influencers

- Educational modules, events, webinars, and convenings

- MoU and partnership agreements with

All Parts

- Increased range of trusted community voices supporting vaccine education and delivery

- Increased availability of community or population-specific messages

- Increased number and diversity of vaccination opportunities in communities currently experiencing disparities

- Increased number and range of partnerships or collaborative activities between providers and community organizations

- Increased number and range of health care providers recommending influenza vaccines (and COVID-19 vaccines, when appropriate) to patients

- Increased number and range of health

All Parts

- Increased acceptance of influenza and COVID-19 vaccine among populations disproportionately affected by influenza and COVID-19 and/or at greater risk for lower vaccination coverage (i.e., persons who are African American, American Indian/Alaska Native, Asian American, Hispanic or Latinx American, Native Hawaiian/Other Pacific Islander)

- Increased access to immunization services among populations and/or communities experiencing disparities participating in the broader program

Part C

1) Equip influential messengers by providing tailored information, trainings, and materials designed to reach priority populations

2) Increase vaccination opportunities and enhance provider partnerships

3) Establish partnerships with state and local health departments providers and community organizations

- Mobile vaccination clinics and activities care organizations implementing accountability processes and/or practical guidance to improve equity in vaccine administration

i. Purpose CDC seeks to build the evidence base of effective interventions to improve vaccination coverage and to identify and implement strategies to reduce racial and/or ethnic disparities in adult vaccination coverage.

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

Increased range of trusted community voices supporting vaccine education and delivery Increased availability of community or population-specific messages Increased number and diversity of vaccination opportunities in communities experiencing disparities Increased number and range of partnerships or collaborative activities between providers and community organizations Increased number and range of health care providers recommending influenza and

COVID-19 vaccines to patients

Recipients will track progress toward these outcomes and communicate them back to CDC through data collection and periodic reporting requirements, as discussed further in the Evaluation and Performance Measurement section.

iii. Strategies and Activities

All national recipients are responsible for focus areas in Part A and are expected to monitor, evaluate, and support the implementation of community-based organizations’ activities that are outlined in Part C. Only 1-2 of the national recipients that receive Part A funding will also implement focus areas in Part B.

Part A: National Recipients (Required for All Recipients)

In order to achieve the short- and long-term outcomes as outlined in the Project Approach, national recipients will partner with, monitor, support, and evaluate CBOs who will execute grassroots outreach activities. During the performance period, the recipient(s) are expected to identify CBOs to partner with, provide technical assistance to funded CBOs, and produce formative assessments of CBOs’ influenza and COVID-19 activities for reporting to CDC.

This involves addressing the following focus areas:

1. Select approximately 50-100 CBOs, mostly from affiliations and network, to partner with and implement Part C activities at the community level: Build a national network of organizations to undertake the community level work outlined in part C by identifying and funding qualified entities.

Conduct outreach to affiliates and networks to identify community-based organizations with the credibility, connections, and ingenuity to implement vaccination-related activities to the priority race/ethnic communities experiencing disparities

Create a streamlined and transparent solicitation, application, and selection process for CBOs in consultation with other recipient organizations and CDC, who will be responsible for validating partnership funding strategy for proposed CBOs

The process for CBO funding should minimize the burden on CBOs (e.g., short application forms, clear selection criteria)

The recipients for this NOFO should work together to reduce possible duplication or confusion for CBOs who may apply for partnership opportunities

2. Coordinate, evaluate, and provide technical assistance to funded CBOs: National recipients will be accountable for the outcomes of the program. In order to provide adequate oversight and support to CBOs, national recipients are expected to provide technical assistance and other needed support for CBOs and their activities.

Examples of technical assistance include holding coaching calls with funded local entities, facilitating peer-to-peer learning opportunities (i.e., informational webinars with subject matter experts) among CBOs, and sharing programmatic updates from

CDC

3. Facilitate CBOs’ connection and contributions to the resources and evidence base:

Connect and advise CBOs on how to utilize and contribute to the peer-to-peer network of resources, events, and materials as well as Data-Informed Technical Assistance (described in “Collaborations” and “CDC Program Support to Recipients” sections)

4. Provide progress reports to CDC: Share monthly, quarterly, and annual progress reports with CDC on CBO activities, events and overall impact.

Part B: 1-2 National Recipient Organizations

During the performance period, 1-2 recipients that receive Part A funding will also implement additional cross-program activities, serving all recipients and CBO affiliates involved in the program and other related funding programs.

1. Coordinate activities for CBOs and organizations participating in the broader program to share knowledge and expertise: Coordinate learning activities for all CDC-funded entities and other participating organizations involved in the overarching program (e.g., work with the Association of Immunization Managers to make office hours with immunization subject matter experts available to all recipients and CBOs)

2. Manage materials created by CBOs and organizations participating in broader program: Work with all recipient organizations to collate, adapt, assess, and protocolize materials which appear to be promising, including highlighting these materials and making them available for use by any national recipient or CBO participating in the program

Part C: Community-Based Organizations (Required for All CBOs)

During the performance period, recipient(s) are expected to commit 75% of the total Part A funding to identified CBOs to implement COVID-19 vaccination-related activities and influenza vaccination-related activities. CDC will provide the grant allocation in a lump sum to the recipient(s). The recipient(s) will then establish a national network of organizations funded to perform the activities listed below. Each CBO’s funding allocation should be based on their proposed scope of work and be outlined in each recipient’s partnership strategy shared with CDC. CBOs should undertake work in at least one of the following focus areas in order to receive funding from a recipient:

1. Equip influential messengers by providing tailored, information, trainings, and materials designed to reach priority populations: Educate and empower “trusted voices” in the community to support vaccine education and delivery

2. Increase vaccination opportunities and enhance provider partnerships: Build partnerships between vaccination providers (e.g., pharmacies) to increase the number, range, and diversity of opportunities for vaccination

3. Establish partnerships with state and local health departments: Collaborate with state and/or local health departments – and state immunization programs, as applicable – to build upon existing public health messages, information, and partnerships in the focus areas C1 and C2

Focus Area Activities Implementation will focus on improving influenza vaccination coverage and COVID-19 vaccination coverage among adults in racial and ethnic groups experiencing disparities in the United States.

All national recipients are expected to undertake activities for the four focus areas in part

A.

1-2 national recipient(s) will also undertake activities for the two focus areas in part B. All funded CBO affiliates are expected to undertake activities for the three focus areas in part C.

The following list includes examples of possible activities but is not exhaustive of all permissible activities:

Focus Area Potential Activities Part A: Recipient(s) select CBOs to partner with to implement Part C activities, provide technical assistance to CBOs, and produce formative assessments of CBOs’ influenza and COVID-19 activities for reporting to CDC Select approximately 50-100 CBOs, mostly from affiliations and network, to partner with and implement Part C activities at the community level:

Create a streamlined solicitation, application, and selection process for CBOs and verify funding for proposed CBOs.

- Conduct outreach to affiliates and networks to identify community-based organizations with the credibility, connections and ingenuity to implement vaccination-related activities to the priority race/ethnic communities experiencing disparities.

- Establish a national network of funded organizations that will work collaboratively and in partnership with the recipient, to perform the activities outlined in part C.

- Develop and issue a streamlined request for proposals in consultation with CDC that incentivizes CBOs to apply and takes into account CBOs’ capacity to respond to solicitations

- Work with CDC to develop selection criteria, which should consider the CBO’s administrative capacity to manage the award and implement focus areas and activities in part C, as well as public health need in the population or areas the CBO serves

- Review solicitations, select CBOs to partner with, and submit the following information to

CDC:

o The name(s) of the organization(s) and staff responsible for responding to the program opportunity o A brief (1-2 sentence) description of the organization’s mission and reach, including the population it intends to serve

Focus Area Potential Activities o A summary of how the CBO meets the selection criteria o A brief description of the CBO’s intended activities for one year of funding o The planned award amount

- Initiate and manage legal and administrative processes to deliver funding to selected CBOs after CDC’s verification

Coordinate, evaluate, and provide technical assistance to funded CBOs:

Provide technical assistance and other needed support for CBOs and their activities

- Regularly convene project managers from each CBO to discuss project goals and progress, address challenges, and identify and mitigate risks

- Provide other technical assistance related to CBOs’ activities (part C), including but not limited to:

o Sharing lessons learned and aligning on best practices with other CBOs (e.g., communications development, message-testing, partnership-building)

- Providing one-on-one coaching and technical assistance, which includes, but is not limited to, the following: checking in on progress, addressing challenges, identifying successes that can be shared with other recipients and CBOs, identifying support needs that may require subject matter expertise from across the program, and providing guidance on how to report on and evaluate program activities

- Facilitate regular (at least every two weeks) program updates to CBOs with, or on behalf of, CDC and the recipient

- Ensure CBOs are carrying out part C focus areas

- Connect CBOs to cross-program learning opportunities

Facilitate CBOs’ connection and contributions to the resources and evidence base: Connect and advise CBOs on how to connect and contribute to the peer-to-peer network of resources, events, and materials as well as Data-

- Connect CBOs to cross-program learning opportunities, Data-Informed Technical Assistance, and CDC’s State and Community Health Media Center and advise them on how to

Informed Technical Assistance (described in “Collaborations” and “CDC Program Support to Recipients” sections) access, modify, and repurpose materials for their own use

- Collaborate with CBOs to develop new materials or resources, as needed, based on observed common challenges and practices associated with influenza and COVID-19 (when appropriate) vaccination activities

- Contribute to, and use, Data-Informed Technical Assistance services and products to help CBOs tailor their activities

Provide progress reports to CDC:

Share monthly, quarterly, and annual progress reports with CDC on CBO activities and impact

- Submit monthly, quarterly, and annual assessments and summary of CBO activities, drawing from some of the following data sources and activities:

o Document lessons learned related to CBOs’ activities, including recommendations and/or common challenges o Review the resources developed, incorporating input from key partners, including the following:

Practices in messaging to and communicating with racial and ethnic groups experiencing vaccination disparities that have been or are likely to be successful;

Practices in identifying and working with CBOs that have been or are likely to be successful; and

Learnings and insights from CBOs’ project implementation to inform CDC’s long-term strategy in addressing disparities in vaccination rates

- Respond to CDC’s ad-hoc requests for success stories and informal updates, which may require the recipient to informally track CBOs’ weekly progress

Part B: 1-2 recipient organizations implement additional cross-program activities, serving all recipients and CBOs involved in the program

Coordinate activities for CBOs and organizations participating in the broader program to share knowledge and expertise: Coordinate learning activities for all CDC-funded entities involved in the program

- Hire subject matter experts to provide as-needed technical assistance and learning opportunities to all CDC-funded entities involved in the program;

subject matter expertise may include racial and health equity, social determinants of health, immunization, and/or community engagement

- Manage and facilitate routine group and peer-to-peer learning opportunities across all CDC-funded entities involved in the program (e.g., expert webinars, recipient /CBO presentations, office hours)

- Maintain–and make available to all CDC-funded entities participating in the program–a master calendar with event information for all learning opportunities (e.g., webinars, presentations, office hours) led by CDC, recipients, CBOs, and other CDC-funded entities participating in the program

- Facilitate cross-program sharing of successes, challenges, and promising practices

- Facilitate support from the team providing Data- Informed Technical Assistance, where relevant

Manage materials created by CBOs and organizations participating in broader program: Work with recipient organizations to collate, adapt, assess and protocolize materials

- Conduct environmental scans across the program of recipient- and CBO-produced materials, as well as other community-based immunization outreach efforts and/or programs

- Collate and highlight promising materials among all CBOs, making them available for use by any recipient or CBO

- Establish a protocol for collecting communications materials, successful messaging strategies, and other materials or methods developed by CBOs, and share materials across with other CBOs, CDC, Data-Informed Technical Assistance, or Media Center, as appropriate

- Adapt materials and methods developed/used by some CBOs to create generalizable materials and methods that other entities can use within and/or outside of this program

- In collaboration with CDC, and as appropriate, develop, modify, and/or enhance resources, such as toolkits, checklists, and quick guides for community-level vaccination activities focused on awareness, access, and confidence o Please note that the CDC will not approve the materials developed, but may review and comment, or seek to ensure all appropriate disclaimers are used

- Develop and synthesize strategies and messaging for working with CBOs to understand vaccine needs, perceptions, and community-acceptable approaches for reducing racial and ethnic disparities in vaccination, including the following:

o Synthesizing practices, materials, and resources that have been or are likely to be successful across local entities’ efforts o Drawing on expertise, experience, and evidence base in racial and/or ethnic equity, health equity, and/or community-level interventions, identify, document, and share practices, materials, and resources

- Please note that under 45 CFR 75.322 materials managed by the recipient may be copyrighted by the recipient and licensed to the government. The CDC logo may not be used without a logo license.

Part C: CBOs implement influenza vaccination-related activities, as well COVID-19 vaccination-related activities, when appropriate Equip influential messengers by providing tailored, information, trainings, and materials designed to reach priority populations: Educate and empower “trusted voices” in the community to support vaccine education and delivery

- Develop and tailor education and outreach materials and/or leverage materials from the program and other recipients and CBOs involved in the program

- Support and leverage CDC’s seasonal influenza and COVID-19 materials and resources (as available) in outreach to relevant groups and communities to develop and implement community-based, culturally appropriate messages that focus on the following:

o Disease spread, symptoms, prevention, and treatment;

o Vaccine safety and efficacy;

o Vaccination purpose, need, and opportunities/locations;

o Similarities and differences between influenza and COVID-19 (https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm#anchor_1595599456);

and

- Identify and train trusted community-level spokespersons (e.g., faith leaders, teachers, community health workers, radio DJs, local shop owners, barbers) to communicate the burdens of influenza and COVID-19 and the importance of influenza and COVID-19 vaccination through local media outlets, social media, faith-based venues, community events, and other community-based, culturally appropriate venues

- Develop and implement social media strategies to mitigate and address influenza vaccine and COVID-19 vaccine misinformation and disinformation

- Support nonfunded local entities by sharing learnings and materials

Increase vaccination opportunities and enhance provider partnership:

Build partnerships between vaccination providers (e.g., pharmacies) and the community to increase the number, range, and diversity of opportunities for vaccination

- Connect vaccination providers with places of worship, community organizations, recreation programs, food banks/pantries, schools and colleges/universities, grocery stores, salons/barber shops/beauticians, major employers, and other key community institutions to set up temporary and/or mobile influenza and COVID-19 vaccination sites, especially in communities experiencing disparities

- Advocate for dialysis centers, prenatal care centers, well-baby care clinics, family planning clinics, dentists’ offices, nursing homes, COVID- 19 testing sites, and other specific provider sites or programs to deliver influenza vaccines where patients are already seeking care for themselves or their family members https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm#anchor_1595599456 https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm#anchor_1595599456

- Build partnerships with health care providers to increase provider understanding of the populations of interest and interventions to increase vaccination rates for these populations

- Work with vaccination service providers to expand the types of health professionals (e.g., community health workers, patient navigators, patient advocates) and administrative staff (e.g., front desk workers) engaged in promoting vaccination and increasing referrals of individuals to influenza and COVID-19 vaccination sites

- Organize events and mobile and/or temporary influenza vaccination sites for as long as the influenza vaccine is available, including during National Influenza Vaccination Week each year;

these activities may also be adapted for COVID- 19 vaccination, as appropriate

- Build partnerships with health care providers to increase provider understanding of the populations of interest and interventions to increase vaccination rates for these populations and facilitate an information exchange between partners

- Provide technology literacy trainings to support increased understanding of virtual technologies commonly employed to schedule vaccination appointments (e.g., how-to guides and events on using Zoom and other virtual meeting technologies)

- Provide technical assistance to support creative problem solving to mitigate issues created by lack of access to technology within priority populations related to vaccination appointment signups

- Provide training to support CBOs to advocate for more equitable vaccination implementation structures within their jurisdictions (i.e., holding spots for zip codes with large disparities, expanding phone signup opportunities vs solely online opportunities, expanding vaccination hours to accommodate diverse work and childcare schedules, etc.)

Establish partnerships with state and local health departments: Collaborate with state and local health departments

– and state immunization programs, as applicable – to build upon existing public health messages, information, and partnerships for focus areas C1 and C2 (listed above)

- Collaborate with state and local health departments – state immunization programs in particular – on mobile influenza and COVID-19 vaccination clinics, education campaigns, and other vaccination activities in communities experiencing disparities

- Where relevant, collaborate with trusted healthcare organizations, including community health centers and pharmacies, on mobile influenza and COVID-19 vaccination clinics, education campaigns, and other vaccination activities in communities experiencing disparities

1. Collaborations

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

This award builds on the work done through a supplement to CDC’s Racial and Ethnic Approaches to Community Health (REACH) program, and by its technical assistance provider – the Association of Immunization Managers (AIM). CDC funds REACH recipients to implement activities aiming to increase influenza (and COVID-19, when appropriate) vaccination coverage among racial and ethnic groups experiencing disparities. In addition to these REACH recipients, other CDC-funded entities participating in this program include minority-led national organizations and their local branches/chapters/affiliates, minority-led medical and professional associations, state and local health departments, and federally qualified health centers.

Any cross-program coordination and learning described in the activities of this NOFO includes all the CDC-funded entities listed above.

Recipients and CBOs will also benefit from technical assistance support resources, including learning opportunities, materials, collaboration opportunities with other organizations participating in the program, and Data-Informed Technical Assistance. Data-Informed Technical Assistance provides recipients and CBOs with data and data-use orientations, self-service data analysis, and office hours for data-related questions and needs that may help recipients and CBOs better focus their activities.

b. With organizations not funded by CDC:

Partnerships have been critical in the work in addressing health disparities and will continue to be so for this project. Without partnerships, the capacity to build trust and amplify messages in communities would be severely hampered. Recipients are required to build and/or continue strategic partnerships and collaborations with immunization stakeholders that have a role in achieving the NOFO outcomes and proposed activities.

2. Target Populations Recipient organizations should prioritize partnering with CBOs that serve any of the following populations currently experiencing disparities in the United States:

African American/Black American Indian/Alaska Native Asian American Hispanic/Latinx American Native Hawaiian/Other Pacific Islander

Recipient organizations are expected to provide, where available, data to show how they selected a target population and specific information on disparities experienced by their proposed population(s) in their applications, particularly for the CBOs they plan to partner with for part C activities.

Recipient organizations must also describe how they propose to solicit CBO applications, including outreach, application process, and selection criteria. Criteria can include CBO type, reach with various communities of focus, geographic focus, administrative capacity to manage the award and activities in part C, and public health need in the population or areas the CBO serves. At least one CBO must have a focus on rural communities as part of their work.

Where possible, applicants should include names of proposed CBOs they intend to partner with.

a. Health Disparities Data shows adult vaccination coverage remains low nationally and significant racial and ethnic disparities exist. The groups experiencing disparities are also disproportionately affected by COVID-19, at risk for serious illness from COVID-19, and/or at high risk for complications from influenza infections. Given the co-circulation of SARS-CoV-2 and influenza, it is critical to ensure equal uptake of the influenza and COVID-19 vaccines.

Achieving health equity requires valuing everyone equally with focused and ongoing efforts to address avoidable inequities, historical and contemporary injustices, and the elimination of health and healthcare disparities. The population health impact of COVID-19 has exposed long-standing inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19.

Persistent health disparities combined with historic housing patterns, work circumstances, and other factors have put members of some racial and ethnic minority populations at higher risk for COVID-19 infection, severe illness, and death. As we continue to learn more about the impact of COVID-19 on the health of different populations, immediate action is critical to reduce growing disparities in the impact of the COVID-19 pandemic among the populations known to be at disproportionate risk.

The goal of this NOFO is to support efforts to increase vaccination coverage for adults in racial and/or ethnic populations experiencing disparities in vaccination rates in the United States.

This project is in direct support of the CDC strategy to address disparities in influenza and COVID-19 vaccination on the basis of race and ethnicity. Work with these organizations will enable national organizations and CBOs to promote vaccination among racial and/or ethnic groups experiencing disparities.

iv. Funding Strategy This project will be supported with funding for response to the COVID-19 pandemic and may continue to be supported with funds intended to control the spread of COVID-19 or with other resources. The current year 1 funding of up to $40M in total will be allocated among the four sole-source national recipients based on capacity of the applicants and the strength of the applications received. In year 1, an estimated $34 million will go to recipients for Part A activities, of which 75 percent is required to be allocated to CBOs for Part C activities. The remaining $6 million is expected to be awarded to 1-2 of the national recipients who will also implement Part B community-wide support activities, including materials management and/or group and peer-to-peer learning. Recipients who apply for Part B activities, must provide an additional work plan and budget narrative specifically addressing Part B activities and anticipated expenses, separate from the required work plan and budget narrative for Part A activities. In the event that additional funding becomes available, CDC may also support other activities to promote vaccine confidence in racial and ethnic minority communities and populations through this notice of funding opportunity.

Specifically, the estimated average award in the first year for national recipients responsible for just Part A, and/or Part B activities is $10,000,000. However, actual awards will vary based on application and organizational capacity, in addition to whether a national recipient is selected to implement Part B activities in addition to receiving funds to implement Part A activities.

The average award amount is for one year, and the proposed budget should be for one year. All subsequent years will be awarded based on a non-competitive continuation application, successful progress, and the availability of funds.

The precise amount of funding will vary depending on the type of national recipient organization, how many CBOs they plan to partner with, and whether they are working on Part B activities in addition to the required activities in Part A. The maximum annual award for any national recipient organization implementing activities in Parts A and C only is estimated to be $10 million. The maximum annual award for any national recipient organization implementing activities in Parts A, B, and C is estimated to be $14 million.

At least 75% of funds allocated to recipients for Part A activities should be used to fund community-based organizations to implement Part C activities. The recipient organization may use up to 25% of their Part A funds for CBO application and contract management, technical assistance, evaluation, monitoring, and oversight activities for their CBO partnerships. The precise amount of funding will vary by national recipients’ and CBOs’ needs. Once a strategy is defined, national recipients are required to share a plan to fund their CBO network and seek CDC agreement. The awards to each CBO will be approximately $50,000-$100,000, with each national recipient awarding to approximately 50-100 CBOs. A national recipient may request to release awards larger than $100,000 on a case-by-case basis.

1-2 national recipients will also receive approximately $6 million in total to implement additional cross-program roles outlined in Part B.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation measures will be used to track implementation of recipient strategies and activities and determine progress on achieving the period of performance outcomes. CDC will use monitoring and evaluation data to determine lessons learned and make improvements to the program. Since this NOFO does not involve the generation or collection of public health data, a Data Management Plan is not required for this NOFO.

CDC seeks to gather monthly data on performance measures that can inform understanding of activity outputs and impacts. Potential measures include the following:

Equip Influential Messengers

Number and types of community-level spokespersons trained Number and types of audience-tested and culturally and linguistically appropriate communication products developed to promote influenza vaccinations (e.g., social media post, email, radio spot)

Number and types of audience-tested and culturally and linguistically appropriate communication products developed to promote COVID-19 vaccinations (e.g., social media post, email, radio spot)

Type(s) of communications vehicles or outlets used (e.g., social media platform, radio, television)

Number and types of events or campaigns held to promote influenza vaccination Number and types of events or campaigns held to promote COVID-19 vaccination Number of people who attended promotional events Identification of major successes for equipping influential messengers Identification of major challenges for equipping influential messengers

Increase Vaccination Opportunities and Enhance Provider Partnerships

List of partners and their notable contributions Number of temporary and/or mobile influenza vaccination sites established because of partnerships Number of temporary and/or mobile COVID-19 vaccination sites established because of partnerships Number of people vaccinated at mobile influenza vaccination sites in partnership with providers Number of people vaccinated at mobile COVID-19 vaccination sites in partnership with providers Location of temporary and/or mobile influenza vaccination sites (e.g., county, neighborhood, community) in partnership with providers Location of temporary and/or mobile COVID-19 vaccination sites (e.g., county, neighborhood, community) in partnership with providers

Number and types of educational campaigns conducted for providers or other healthcare professionals

Number and types of providers or other healthcare professionals reached through educational campaigns

Identification of major successes for provider partnerships Identification of major challenges for provider partnerships

Establish Partnerships with State and Local Health Department

List of partnerships and notable contributions Number of people vaccinated at mobile influenza vaccination sites in partnership with health departments Number of people vaccinated at mobile COVID-19 vaccination sites in partnership with health departments Location of temporary and/or mobile influenza vaccination sites (e.g., county, neighborhood, community) conducted in partnership with health departments Location of temporary and/or mobile COVID-19 vaccination sites (e.g., county, neighborhood, community) conducted in partnership with health departments

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/additionalrequirements/ar-25.html.

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

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

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 Part A and Part B Organizational Capacity Criteria:

All applicants should:

demonstrate relevant experience and capacity (management, administrative, and technical) to implement the activities and achieve the project outcomes, experience and capacity to implement the evaluation plan, and a staffing plan and project management structure sufficient to achieve the project outcomes and which clearly defines staff roles.

o This should include experience with existing partnerships and engagement of priority communities.

have project management skills critical to implementing this approach, including program planning, performance monitoring, financial reporting, budget management and administration, and personnel management.

describe in the narrative that they have a financial management system that will allow proper funds management and segregation of funds by program, and meet the requirements as stated in the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards: https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1302"45 CFR 75.302 The financial system should permit the preparation of reports required by general and program-specific terms and conditions;

and the tracing of funds to a level of expenditure adequate to establish that such funds have been used according to the federal statutes, regulations, and terms and conditions of the federal award.

demonstrate their ability to manage the required procurement efforts, including the ability to write and award contracts in accordance with applicable grants regulations.

describe intentions to collaborate with CDC in improving technical and program guidance and evaluation. Applicants should also describe capacity to participate in stakeholder meetings and other collaborative efforts with public health partners to provide expert consultation to CDC and CDC-funded programs (as requested).

Part B Specific Organizational Capacity Criteria:

Applicants interested in Part B funding to coordinate activities for CBOs and organizations participating in the broader program to share knowledge and expertise through group and peer-to-peer learning should demonstrate the following capacity:

previous relevant experience managing learning communities a deep understanding of the activities and needs of all partners participating within the broader program that will translate into content management and design improvements https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75%23se45.1.75_1302%2245%20CFR%2075.302 https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75%23se45.1.75_1302%2245%20CFR%2075.302 knowledge of public health and access to COVID-19 and public health subject matter experts that will enable them to quickly scale group and peer-to-peer learning opportunities, as well as demonstrate the internal and coordination capacity necessary to provide activities described in Part B at a scale and frequency that meets the needs of all partners participating in the broader program.

Applicants interested in Part B funding to manage materials created by CBOs and organizations participating in the broader program should demonstrate the following capacity:

have managed and facilitated the delivery of shared materials, through in-house capacity and/or partnerships, for organization cohorts are one of the recipient’s core competencies, including having examples of past successes and current experiences with this type of work.

a deep understanding of the activities and needs of all partners participating within the broader program.

have a background in health policy and a knowledge of public health, which creates access to COVID-19 and public health subject matter experts to…