FY15 Tier1Arevised.pdf

U.S. Department of Health and Human Services Office of the Assistant Secretary for Health

Office of Adolescent Health

Funding Opportunity Announcement And

Application Instructions

Application Due Date: April 1, 2015

Capacity Building to Support Replication of Evidence-Based TPP

Programs (Tier 1A)

Announcement Type: New

Announcement Number: AH-TP1-15-001

Catalog of Federal Domestic Assistance (CFDA) No. 93.297

U.S. Department of Health and Human Services Office of the Assistant Secretary for Health

Office of Adolescent Health

Capacity Building to Support Replication of Evidence-Based TPP Programs (Tier 1A)

Announcement Type: New

Announcement Number: AH-TP1-15-001

Catalog of Federal Domestic Assistance (CFDA) No. 93.297

Funding Opportunity Announcement And

Application Instructions

Application Due Date: April 1, 2015

Table of Contents

Executive Summary……………….……………..…………….……………………………….. 3 Purpose……………………………………………………………………………………………5 Background………………………………………………………………………………………8 Expectations of Grantees………….……………………………………………………………15 Target Population and Need….…………………………………………………………..15 Plans for Selecting Organizations to Receive Community Based Assistance…………...17 Program Approach …………………………………………………………………… Performance Measures and Evaluation..……………………………………...………….26 Capacity and Experience of the Applicant Organization ………………………….…….29 Project Management……………………………………..…………………………… Cooperative Agreement Substantial Programmatic Involvement…………………………..31 Authority………………………………………………………………………………………...32 Award Information……………………………………………………………………………..32 Eligibility Information………………………………………………………………………….33 Application Screening Criteria………………………………………………………………...34 Application Submission Information………………………………………………………….36

1. Information to Request Application Package…………………………………….36

2. Content and Form of Application Submission……………………………………36

a. Important Grants.gov Information………………………………………..39

b. Application Content………………………………………………………...41

i. Project Narrative…………………………………………………...41

1. Target Population and Need...…………………...…………...42

2. Plans for Selecting Organizations to Receive Community

Based Assistance……………………………………………..44

3. Program Approach……………….…..….…………………...45

4. Performance Measures and Evaluation.....…………………...47

5. Capacity and Experience of the Applicant Organization…….48

6. Project Management…………………………..……………..52

ii. Budget Narrative……………………………………………………54

iii. Appendices…………………………………………………………..56

c. Submission Dates and Times………………………………………………58

d. Intergovernmental Review…………………………………………………58

e. Funding Restrictions………………………………………………………..58 Application Review Information………………………………………………………………61 Criteria…………………………………………………………………………………..61

Review and Selection Process………………………………………………………….65 Award Administration Information…………………………………………………………..67 Agency Contacts……………………………………………………………….………………..72 Appendices………………………………………………………………………………………74

Table of Contents

Executive Summary. 3 Purpose 5 Background 8 Expectations of Grantees 15

Target Population and Need 15 Plans for Selecting Organizations to Receive Community Based Assistance 17 Program Approach 19 Performance Measures and Evaluation 26 Capacity and Experience of the Applicant Organization 29 Project Management 31

Cooperative Agreement Substantial Programmatic Involvement 31 Authority 32 Award Information 32 Eligibility Information 33 Application Screening Criteria 34 Application Submission Information 36

1. Information to Request Application Package 36

2. Content and Form of Application Submission 36

a. Important Grants.gov Information 39

b. Application Content 41

i. Project Narrative 41

1. Target Population and Need 42

2. Plans for Selecting Organizations to Receive Community

Based Assistance 44

3. Program Approach 45

4. Performance Measures and Evaluation 47

5. Capacity and Experience of the Applicant Organization 48

6. Project Management 52

ii. Budget Narrative 54

iii. Appendices 56

c. Submission Dates and Times 58

d. Intergovernmental Review 58

e. Funding Restrictions 58

Application Review Information 61 Criteria 61 Review and Selection Process 65

Award Administration Information 67 Agency Contacts 72 Appendices 74

DEPARTMENT OF HEALTH AND HUMAN SERVICES

AGENCY: Office of the Secretary, Office of the Assistant Secretary for Health, Office of

Adolescent Health

FUNDING OPPORTUNITY TITLE: Announcement of Availability of Funds for Capacity

Building to Support Replication of Evidence-Based TPP Programs (Tier 1 A)

ACTION: Notice

ANNOUNCEMENT TYPE: INITIALCOMPETITIVE COOPERATIVE AGREEMENT

FUNDING OPPORTUNITY NUMBER: AH-TP1-15-001

CFDA NUMBER: 93.297

CFDA PROGRAM: Teenage Pregnancy Prevention Program

DATES: Non-binding letters of intent are due February 1, 2015

Applications are due April 1, 2015 by 5 p.m. ET. To receive consideration, applications must be received electronically via Grants.gov by the HHS Office of the Assistant Secretary for Health

(HHS/OASH), Office of Grants Management (OGM) no later than this due date. Applications which do not meet the specified deadlines will be returned to the applicant unread. All applicants must submit electronically via Grants.gov unless they obtain a written exemption from this requirement 2 business days in advance of the deadline by the Director, HHS/OASH Office of Grants Management. To obtain an exemption, applicants must request one via email from the

HHS/OASH Office of Grants Management, and provide details as to why they are technologically unable to submit electronically through Grants.gov portal. Requests should be submitted at least 4 business days prior to the application deadline to ensure the request can be

DEPARTMENT OF HEALTH AND HUMAN SERVICES

AGENCY: Office of the Secretary, Office of the Assistant Secretary for Health, Office of

Adolescent Health

FUNDING OPPORTUNITY TITLE: Announcement of Availability of Funds for Capacity

Building to Support Replication of Evidence-Based TPP Programs (Tier 1 A)

ACTION: Notice

ANNOUNCEMENT TYPE: INITIALCOMPETITIVE COOPERATIVE AGREEMENT

FUNDING OPPORTUNITY NUMBER: AH-TP1-15-001

CFDA NUMBER: 93.297

CFDA PROGRAM: Teenage Pregnancy Prevention Program

DATES: Non-binding letters of intent are due February 1, 2015

Applications are due April 1, 2015 by 5 p.m. ET. To receive consideration, applications must be received electronically via Grants.gov by the HHS Office of the Assistant Secretary for Health

(HHS/OASH), Office of Grants Management (0GM) no later than this due date. Applications which do not meet the specified deadlines will be returned to the applicant unread. All applicants must submit electronically via Grants.gov unless they obtain a written exemption from this requirement 2 business days in advance of the deadline by the Director, HHS/OASH Office of Grants Management. To obtain an exemption, applicants must request one via email from the

HHS/OASH Office of Grants Management, and provide details as to why they are technologically unable to submit electronically through Grants.gov portal. Requests should be submitted at least 4 business days prior to the application deadline to ensure the request can be considered prior to 2 business days in advance of the deadline. If requesting an exemption, include the following in the e-mail request: the HHS/OASH announcement number; the organization's DUNS number; the name, address and telephone number of the organization; the name and telephone number of the Authorizing Official; the Grants.gov Tracking Number

(GRANTXXXX) assigned to the submission; and a copy of the "Rejected with Errors" notification from Grants.gov. Send the request with supporting documentation to ogm.oash@hhs.gov. Note: failure to have an active System for Account Management (SAM) registration will not be grounds for receiving an exemption to the electronic submission requirement.

The HHS/OASH Office of Grants Management will only accept applications via alternate methods (hardcopy paper via US mail or other provider or PDF via email) from applicants obtaining prior written approval. The application must still be submitted by the deadline. Only applications submitted through the Grants.gov portal or alternate format

(hardcopy paper via US mail or other service or PDF via email) with an approved written exemption will be accepted. See the heading "APPLICATION and SUBMISSION

INFORMATION" for information on application submission mechanisms.

To ensure adequate time to successfully submit the application, HHS/OASH recommends that applicants register as early as possible in Grants.gov since the registration process can take up to one month. For information on registering for Grants.gov, refer to http://www.grants.gov or contact the Grants.gov Contact Center 24 hours a day, 7 days a week

(excluding Federal holidays) at 1-800-518-4726 or support@grants.gov.

Applicants are strongly encouraged to register multiple authorized organization representatives.

considered prior to 2 business days in advance of the deadline. If requesting an exemption, include the following in the e-mail request: the HHS/OASH announcement number; the organization’s DUNS number; the name, address and telephone number of the organization; the name and telephone number of the Authorizing Official; the Grants.gov Tracking Number

(GRANTXXXX) assigned to the submission; and a copy of the ‘Rejected with Errors’ notification from Grants.gov. Send the request with supporting documentation to ogm.oash@hhs.gov. Note: failure to have an active System for Account Management (SAM) registration will not be grounds for receiving an exemption to the electronic submission requirement.

The HHS/OASH Office of Grants Management will only accept applications via alternate methods (hardcopy paper via US mail or other provider or PDF via email) from applicants obtaining prior written approval. The application must still be submitted by the deadline. Only applications submitted through the Grants.gov portal or alternate format

(hardcopy paper via US mail or other service or PDF via email) with an approved written exemption will be accepted. See the heading “APPLICATION and SUBMISSION

INFORMATION” for information on application submission mechanisms.

To ensure adequate time to successfully submit the application, HHS/OASH recommends that applicants register as early as possible in Grants.gov since the registration process can take up to one month. For information on registering for Grants .gov, refer to http://www.grants.gov or contact the Grants.gov Contact Center 24 hours a day, 7 days a week

(excluding Federal holidays) at 1-800-518-4726 or support@grants.gov.

Applicants are strongly encouraged to register multiple authorized organization representatives.

mailto:ogm.oash@hhs.gov http://www.grants.gov/ mailto:support@grants.gov

Technical Assistance: A technical assistance webinar for potential applicants will be held on

Wednesday, January 21st from 2:30-4:30 pm ET (start time of 1:30 pm CT, 12:30 pm MT, 11:30 am PT). Potential applicants should call 1-888-566-5780, passcode 3899321, and log-on to https://www.mymeetings.com/nc/join.php?i=PW1052943&p=3899321&t=c.

EXECUTIVE SUMMARY: The HHS Office of Adolescent Health announces the availability of funds for Fiscal Year (FY) 2015 cooperative agreement awards authority of

Division H, Title II of the Consolidated Appropriations Act, 2014 (Public Law No. 113-76), and the Continuing Resolutions thus far for FY 2015 (Public Law No. 113-164) for Capacity

Building to Support Replication of Evidence-Based Teen Pregnancy Prevention (TPP)

Programs (Tier 1A). OAH intends to make available approximately $5 million for 5-8 competing cooperative agreements.

This funding opportunity announcement (FOA) is one of a series of five (5) FOAs, each with a different focus, currently available from the OAH’s Teen Pregnancy Prevention (TPP)

Program. Applicants may apply for more than one FOA. This FOA provides information for applying to Capacity Building to Support Replication of Evidence-Based TPP Programs

(Tier 1A). Other available FOAs include:

Replicating Evidence-Based TPP Programs to Scale in Communities with the Greatest Need (Tier 1B) Supporting and Enabling Early Innovation to Advance Adolescent Health and Prevent Teen Pregnancy (Tier 2A) Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier 2B) Effectiveness of TPP Programs Designed Specifically for Young Males (Tier 2C).

The goal of this FOA is to fund intermediary organizations to provide capacity building assistance (CBA) to at least 3 youth-serving organizations to replicate evidence-based TPP

Technical Assistance: A technical assistance webinar for potential applicants will be held on

Wednesday, January 21st from 2:30-4:30 pm ET (start time of 1:30 pm CT, 12:30 pm MT, 11:30 am PT). Potential applicants should call 1-888-566-5780, passcode 3899321, and log-on to https ://www.mymeetings .comlnc/ioin.php?i=PW 1052943&p=3 899321&t=c.

EXECUTIVE SUMMARY: The HHS Office of Adolescent Health announces the availability of funds for Fiscal Year (FY) 2015 cooperative agreement awards authority of

Division H, Title II of the Consolidated Appropriations Act, 2014 (Public Law No. 113-76), and the Continuing Resolutions thus far for FY 2015 (Public Law No. 113-164) for Capacity

Building to Support Replication of Evidence-Based Teen Pregnancy Prevention (TPP)

Programs (Tier 1A). OAH intends to make available approximately $5 million for 5-8 competing cooperative agreements.

This funding opportunity announcement (FOA) is one of a series of five (5) FOAs, each with a different focus, currently available from the OAH’s Teen Pregnancy Prevention (TPP)

Program. Applicants may apply for more than one FOA. This FOA provides information for applying to Capacity Building to Support Replication of Evidence-Based TPP Programs

(Tier 1A). Other available FOAs include:

• Replicating Evidence-Based TPP Programs to Scale in Communities with the Greatest Need (Tier 1B)

• Supporting and Enabling Early Innovation to Advance Adolescent Health and Prevent Teen Pregnancy (Tier 2A)

• Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier 2B)

• Effectiveness of TPP Programs Designed Specifically for Young Males (Tier 2C).

The goal of this FOA is to fund intermediary organizations to provide capacity building assistance (CBA) to at least 3 youth-serving organizations to replicate evidence-based TPP https://www.mymeetings.com/nc/join.php?i=PW1052943&p=3899321&t=c programs in a defined service area with demonstrated need. CBA is the transmission of knowledge and building of skills to enhance the ability of organizations to implement, evaluate, and sustain evidence-based TPP programs. CBA can focus on building an organization’s capacity to develop and manage a TPP program (i.e., organizational CBA) as well as building an organization’s capacity to implement an evidence-based TPP program (i.e., programmatic CBA).

CBA can encompass diverse strategies and approaches, including but not limited to, training, technical assistance, coaching, mentoring, and peer-to-peer support. OAH anticipates that successful applicants will provide funding to organizations that receive CBA to support their efforts to replicate evidence-based TPP programs. Organizations in need of CBA are those that have experience working with youth, the ability to serve youth in areas of demonstrated need for

TPP, and support the replication of evidence-based TPP programs, but do not currently have the experience or capacity to implement evidence-based TPP programs to scale in their community.

The service area must be defined by clear geographic boundaries and may be county-level, city-level, state-level, or regional. The service area should not be narrowly focused at the neighborhood-level nor broadly focused at a national-level. Applicants will be funded to serve a single service area and must be able to demonstrate a teen birth rate for the defined service area that is at least above the current national average of 26.6 births for every 1,000 adolescent females ages 15-19, 2013 (1). OAH does not anticipate funding more than one applicant to serve the same service area. Furthermore, applicants are expected to be located in, or have a significant investment already in the service area, and be able to demonstrate how the CBA infrastructure developed under this grant will continue to serve the defined service area after the grant ends.

programs in a defined service area with demonstrated need. CBA is the transmission of knowledge and building of skills to enhance the ability of organizations to implement, evaluate, and sustain evidence-based TPP programs. CBA can focus on building an organization’s capacity to develop and manage a TPP program (i.e., organizational CBA) as well as building an organization’s capacity to implement an evidence-based TPP program (i.e., programmatic CBA).

CBA can encompass diverse strategies and approaches, including but not limited to, training, technical assistance, coaching, mentoring, and peer-to-peer support. OAH anticipates that successful applicants will provide funding to organizations that receive CBA to support their efforts to replicate evidence-based TPP programs. Organizations in need of CBA are those that have experience working with youth, the ability to serve youth in areas of demonstrated need for

TPP, and support the replication of evidence-based TPP programs, but do not currently have the experience or capacity to implement evidence-based TPP programs to scale in their community.

The service area must be defined by clear geographic boundaries and may be county-level, city-level, state-level, or regional. The service area should not be narrowly focused at the neighborhood-level nor broadly focused at a national-level. Applicants will be funded to serve a single service area and must be able to demonstrate a teen birth rate for the defined service area that is at least above the current national average of 26.6 births for every 1,000 adolescent females ages 15-19, 2013 (1). OAH does not anticipate funding more than one applicant to serve the same service area. Furthermore, applicants are expected to be located in, or have a significant investment already in the service area, and be able to demonstrate how the CBA infrastructure developed under this grant will continue to serve the defined service area after the grant ends.

I. FUNDING OPPORTUNITY DESCRIPTION:

PURPOSE

The goal of this FOA is to fund intermediary organizations that will provide CBA to at least 3 youth-serving organizations to replicate evidence-based TPP programs in a defined service area with demonstrated need. CBA is designed to enhance the ability of organizations to implement, evaluate, and sustain evidence-based TPP programs. CBA can focus on building an organization’s capacity to develop and manage a TPP program (i.e., organizational CBA) as well as building an organization’s capacity to implement an evidence-based TPP program (i.e., programmatic CBA). CBA can encompass diverse strategies and approaches, including but not limited to, training, technical assistance, coaching, mentoring, and peer-to-peer support.

Over the five-year project period, grantees are expected to (1) identify organizations in the defined service area in need of CBA (2) assess the CBA needs of each organization (3) provide

CBA on diverse topics and (4) use diverse approaches that are designed to best meet the needs of each organization. OAH anticipates that successful applicants will provide funding to organizations that receive CBA to support their efforts to replicate evidence-based TPP programs. The applicant must determine the length of time that each organization will be actively engaged in receiving CBA and the amount of funding each will receive. Applicants may elect to work with the same organizations over the course of the 5-year project period or may elect to work with organizations for a shorter period of time and initiate agreements with new organizations throughout the course of the project period.

Applicants may identify the organizations to receive CBA in the application and include a signed MOU clearly outlining the roles, responsibilities, and expectations for the applicant and

I. FUNDING OPPORTUNITY DESCRIPTION:

PURPOSE

The goal of this FOA is to fund intermediary organizations that will provide CBA to at least 3 youth-serving organizations to replicate evidence-based TPP programs in a defined service area with demonstrated need. CBA is designed to enhance the ability of organizations to implement, evaluate, and sustain evidence-based TPP programs. CBA can focus on building an organization’s capacity to develop and manage a TPP program (i.e., organizational CBA) as well as building an organization’s capacity to implement an evidence-based TPP program (i.e., programmatic CBA). CBA can encompass diverse strategies and approaches, including but not limited to, training, technical assistance, coaching, mentoring, and peer-to-peer support.

Over the five-year project period, grantees are expected to (1) identify organizations in the defined service area in need of CBA (2) assess the CBA needs of each organization (3) provide

CBA on diverse topics and (4) use diverse approaches that are designed to best meet the needs of each organization. OAH anticipates that successful applicants will provide funding to organizations that receive CBA to support their efforts to replicate evidence-based TPP programs. The applicant must determine the length of time that each organization will be actively engaged in receiving CBA and the amount of funding each will receive. Applicants may elect to work with the same organizations over the course of the 5-year project period or may elect to work with organizations for a shorter period of time and initiate agreements with new organizations throughout the course of the project period.

Applicants may identify the organizations to receive CBA in the application and include a signed MOU clearly outlining the roles, responsibilities, and expectations for the applicant and the CBA partner or applicants may describe the process they will use to identify organizations to receive CBA once the grant is awarded. If an applicant anticipates providing CBA to different organizations over the course of the five-year grant period, it must describe how and when new organizations will be selected to receive CBA and whether those organizations that had previously received CBA will continue to receive CBA.

It is expected that the priorities, content, and approach for CBA may differ across organizations. For each organization that will receive CBA, the grantee will be expected to submit a detailed CBA plan to OAH outlining the topics, format, and target audience for CBA;

how CBA will be provided; the length of time CBA will be provided for; the expected outcomes of the CBA; the amount of funding provided to the organization to support its efforts to replicate evidence-based TPP programs; and how the CBA plan aligns with the needs of the organization.

Focus areas for CBA can include:

Organizational CBA: Building an organization’s capacity to develop and manage a TPP program by providing CBA in the following areas (but not limited to) -- program staffing, identifying and collaborating with community stakeholders, developing a community needs assessment, financial and budget planning for managing a TPP Program, planning for sustainability, etc.

Programmatic CBA: Building an organization’s capacity to implement an evidence-based

TPP program by providing CBA in the following areas (but not limited to) -- selecting the appropriate evidence-based TPP program for implementation; implementing evidence-based

TPP programs with fidelity and quality; selecting strategies for recruiting, retaining, and engaging youth; collecting and using performance measure data for continuous quality improvement; etc.

the CBA partner or applicants may describe the process they will use to identify organizations to receive CBA once the grant is awarded. If an applicant anticipates providing CBA to different organizations over the course of the five-year grant period, it must describe how and when new organizations will be selected to receive CBA and whether those organizations that had previously received CBA will continue to receive CBA.

It is expected that the priorities, content, and approach for CBA may differ across organizations. For each organization that will receive CBA, the grantee will be expected to submit a detailed CBA plan to OAH outlining the topics, format, and target audience for CBA;

how CBA will be provided; the length of time CBA will be provided for; the expected outcomes of the CBA; the amount of funding provided to the organization to support its efforts to replicate evidence-based TPP programs; and how the CBA plan aligns with the needs of the organization.

Focus areas for CBA can include:

• Organizational CBA: Building an organization’s capacity to develop and manage a TPP program by providing CBA in the following areas (but not limited to) -- program staffing, identifying and collaborating with community stakeholders, developing a community needs assessment, financial and budget planning for managing a TPP Program, planning for sustainability, etc.

• Programmatic CBA: Building an organization’s capacity to implement an evidence-based

TPP program by providing CBA in the following areas (but not limited to) -- selecting the appropriate evidence-based TPP program for implementation; implementing evidence-based

TPP programs with fidelity and quality; selecting strategies for recruiting, retaining, and engaging youth; collecting and using performance measure data for continuous quality improvement; etc.

Supporting HHS Strategic Goals, Healthy People 2020, and the National Prevention

Strategy

This FOA supports the HHS Strategic Goal to “Put Children and Youth on the Path for

Successful Futures.” Under this goal, HHS is committed to supporting both evidence-based programs and innovative approaches for children and youth in order to positively impact a range of important social and health outcomes such as child maltreatment, school readiness, teen pregnancy, youth violence, sexually transmitted infections (STIs), mental illness, substance abuse, and delinquency. HHS is investing in strategies that give children and youth a positive start in life and help ensure their future health and development. http://www.hhs.gov/strategic-plan/youth_futures.html

This FOA addresses the Healthy People 2020

(http://www.healthypeople.gov/2020/default.aspx) overarching goals to (1) achieve health equity, eliminate disparities, and improve the health of all groups and (2) promote quality of life, healthy development, and healthy behaviors across all life stages. The FOA addresses several

Healthy People 2020 goals and objectives, including Family Planning Objectives 7 through 13;

STD Objectives 1 and 6; HIV Objective 2; Adolescent Health Objectives 3 and 5; and the

Lesbian, Gay, Bisexual, and Transgender (LGBT) Topic Area Goal.

This FOA also supports the National Prevention Strategy’s

(http://www.surgeongeneral.gov/initiatives/prevention/strategy/#The Goal) overarching strategic direction to help people make healthy choices and eliminate health disparities. This FOA supports the recommendations in the reproductive and sexual health priority area to (1) provide

Supporting HHS Strategic Goals, Healthy People 2020, and the National Prevention

Strategy

This FOA supports the HHS Strategic Goal to “Put Children and Youth on the Path for

Successful Futures.” Under this goal, HHS is committed to supporting both evidence-based programs and innovative approaches for children and youth in order to positively impact a range of important social and health outcomes such as child maltreatment, school readiness, teen pregnancy, youth violence, sexually transmitted infections (STIs), mental illness, substance abuse, and delinquency. HHS is investing in strategies that give children and youth a positive start in life and help ensure their future health and development. http://www.hhs.gov/strategicplan/youth futures.html

This FOA addresses the Healthy People 2020

(http://www.healthypeople.gov/2020/default.aspx) overarching goals to (1) achieve health equity, eliminate disparities, and improve the health of all groups and (2) promote quality of life, healthy development, and healthy behaviors across all life stages. The FOA addresses several

Healthy People 2020 goals and objectives, including Family Planning Objectives 7 through 13;

STD Objectives 1 and 6; HIV Objective 2; Adolescent Health Objectives 3 and 5; and the

Lesbian, Gay, Bisexual, and Transgender (LGBT) Topic Area Goal.

This FOA also supports the National Prevention Strategy’s

(http ://www. surgeongeneral.gov/initiatives/prevention/strategy/#The Goal) overarching strategic direction to help people make healthy choices and eliminate health disparities. This FOA supports the recommendations in the reproductive and sexual health priority area to (1) provide http://www.hhs.gov/strategic-plan/youth_futures.html http://www.hhs.gov/strategic-plan/youth_futures.html http://www.healthypeople.gov/2020/default.aspx http://www.surgeongeneral.gov/initiatives/prevention/strategy/#The Goal effective sexual health education, especially for adolescents, and (2) enhance early detection of

HIV, viral hepatitis, and other STIs and improve linkages to care.

BACKGROUND

OAH’s Teen Pregnancy Prevention Program

OAH announces the availability of FY 2015 funding to support the TPP Program, which was initiated in FY 2010 as one of six major evidence-based policy initiatives across the Federal government. OAH supports two types of grants through the TPP program: (1) projects that replicate evidence-based TPP program models that have been shown to be effective through rigorous evaluation, referred to as “Tier 1” and (2) research and demonstration projects in order to develop and test additional models and innovative strategies to prevent teen pregnancy, referred to as “Tier 2.” Additional information about OAH and specifically about the TPP

Program can be found on the OAH website ( http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/).

Within this framework, OAH is announcing five separate FOAs, each with a different focus.

Available FOAs include:

Capacity Building to Support Replication of Evidence-Based TPP Programs (Tier 1A) Replicating Evidence-Based TPP Programs to Scale in Communities with the Greatest Need (Tier 1B) Supporting and Enabling Early Innovation to Advance Adolescent Health and Prevent Teen Pregnancy (Tier 2A) Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier 2B) Effectiveness of TPP Programs Designed Specifically for Young Males (Tier 2C) effective sexual health education, especially for adolescents, and (2) enhance early detection of

HIV, viral hepatitis, and other STIs and improve linkages to care.

BACKGROUND

OAH’s Teen Pregnancy Prevention Program

OAH announces the availability of FY 2015 funding to support the TPP Program, which was initiated in FY 2010 as one of six major evidence-based policy initiatives across the Federal government. OAH supports two types of grants through the TPP program: (1) projects that replicate evidence-based TPP program models that have been shown to be effective through rigorous evaluation, referred to as “Tier 1” and (2) research and demonstration projects in order to develop and test additional models and innovative strategies to prevent teen pregnancy, referred to as “Tier 2.” Additional information about OAH and specifically about the TPP

Program can be found on the OAH website (http://www.hhs.gov/ash/oah/oahinitiative s/teen pregnancy!).

Within this framework, OAH is announcing five separate FOAs, each with a different focus.

Available FOAs include:

• Capacity Building to Support Replication of Evidence-Based TPP Programs (Tier 1A)

• Replicating Evidence-Based TPP Programs to Scale in Communities with the Greatest Need

(Tier 1B)

• Supporting and Enabling Early Innovation to Advance Adolescent Health and Prevent Teen

Pregnancy (Tier 2A)

• Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier 2B)

• Effectiveness of TPP Programs Designed Specifically for Young Males (Tier 2C) http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/ http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/

Status of Adolescent Sexual Risk Behaviors

Teen Pregnancy and Existing Disparities

Teen pregnancy and birth rates in the United States dropped to a record low since their peak in the early 1990’s. The teen birth rate declined ten percent in 2013 alone and declined 38 percent since 2007 (1). There have also been improvements in teens’ sexual behavior and use of contraceptives. In 2013, about half (47%) of all high school students reported having ever had sex. In that same year among high school students who were sexually active, 86% reported using some method of contraception the last time they had sex (2).

Despite the progress that has been made to reduce teen pregnancy and sexual risk taking, there were still approximately 614,000 pregnancies to women younger than age 20 in 2010 (3) and 25% of teens in the U.S. will become pregnant at least once by the age of 20 (4).

Furthermore, young people age 15 to 24 account for nearly one-half of all new cases of STDs although they only comprise one quarter of the sexually active population in the U.S. (5).

In addition, great disparities continue to exist – by age, race and ethnicity, geography, urbanicity, and among especially vulnerable populations.

Age - Birth rates are much higher among older teens (47.3 per 1,000) than younger teens

(12.3 per 1,000), with 2/3 of teen births to girls ages 18 to 19 and 1/3 to girls ages 17 and younger (6,7).

Race and Ethnicity - In 2010, the teen pregnancy rate among non-Hispanic Black and

Hispanic teen girls age 15-19 was more than twice as high as the teen pregnancy rate among non-Hispanic White teen girls age 15-19 (8). In 2012, the teen birth rate was 46

Status of Adolescent Sexual Risk Behaviors

Teen Pregnancy and Existing Disparities

Teen pregnancy and birth rates in the United States dropped to a record low since their peak in the early 1990’s. The teen birth rate declined ten percent in 2013 alone and declined 38 percent since 2007 (1). There have also been improvements in teens’ sexual behavior and use of contraceptives. In 2013, about half (47%) of all high school students reported having ever had sex. In that same year among high school students who were sexually active, 86% reported using some method of contraception the last time they had sex (2).

Despite the progress that has been made to reduce teen pregnancy and sexual risk taking, there were still approximately 614,000 pregnancies to women younger than age 20 in 2010 (3) and 25% of teens in the U.S. will become pregnant at least once by the age of 20 (4).

Furthermore, young people age 15 to 24 account for nearly one-half of all new cases of STDs although they only comprise one quarter of the sexually active population in the U.S. (5).

In addition, great disparities continue to exist — by age, race and ethnicity, geography, urbanicity, and among especially vulnerable populations.

• Age - Birth rates are much higher among older teens (47.3 per 1,000) than younger teens

(12.3 per 1,000), with 2/3 of teen births to girls ages 18 to 19 and 1/3 to girls ages 17 and younger (6,7).

• Race and Ethnicity - In 2010, the teen pregnancy rate among non-Hispanic Black and

Hispanic teen girls age 15-19 was more than twice as high as the teen pregnancy rate among non-Hispanic White teen girls age 15-19 (8). In 2012, the teen birth rate was 46 per 1,000 for Hispanic teens; 44 per 1,000 for Black, non-Hispanic teens; 35 per 1,000 for American Indian teens; 21 per 1,000 for White, non-Hispanic teens; and 10 per 1,000 for Asian/Pacific Islander teens (9).

Geography - Substantial geographic variation exists in adolescent childbearing across the United States with the lowest teen birth rates reported in the Northeast, and the highest rates reported across the southern part of the country (10).

Urbanicity - Teen birth rates are much higher in rural areas (43 per 1,000) compared to small-medium metro areas (36 per 1,000) and large urban cities (24 per 1,000) (11).

Vulnerable Populations – Rates of teen pregnancy and teen births have been found to be higher among especially vulnerable youth, including youth in foster care, parenting teens, and LGBTQ youth. Teen girls who are in foster care are 2.5 times more likely than their counterparts who are not in foster care to get pregnant by age 19 (12). Teens who are already parents are also at increased risk of becoming pregnant again. Overall, 17% of all teen births are repeat teen births (13). Lesbian, Gay, Bisexual, and Transgender

(LGBT) youth are 2-3 times more likely to be involved in a pregnancy compared to non-

LGBT youth. Lesbian, Gay, and Bisexual (LGB) youth are more likely to initiate sex at a very young age, have multiple partners, use alcohol and other substances before engaging in sexual intercourse; and are less likely to use contraception compared to non-LGB youth (14).

Risky behaviors are often co-occurring. Teens who drink or use drugs are at increased risk of (1) being sexually active, (2) not using contraception when they have sex, (3) having sex at an earlier age, and (4) having multiple partners (15). Teen pregnancy is also linked with various per 1,000 for Hispanic teens; 44 per 1,000 for Black, non-Hispanic teens; 35 per 1,000 for American Indian teens; 21 per 1,000 for White, non-Hispanic teens; and 10 per 1,000 for Asian/Pacific Islander teens (9).

• Geography - Substantial geographic variation exists in adolescent childbearing across the United States with the lowest teen birth rates reported in the Northeast, and the highest rates reported across the southern part of the country (10).

• Urbanicity - Teen birth rates are much higher in rural areas (43 per 1,000) compared to small-medium metro areas (36 per 1,000) and large urban cities (24 per 1,000) (11).

• Vulnerable Populations — Rates of teen pregnancy and teen births have been found to be higher among especially vulnerable youth, including youth in foster care, parenting teens, and LGBTQ youth. Teen girls who are in foster care are 2.5 times more likely than their counterparts who are not in foster care to get pregnant by age 19 (12). Teens who are already parents are also at increased risk of becoming pregnant again. Overall, 17% of all teen births are repeat teen births (13). Lesbian, Gay, Bisexual, and Transgender

(LGBT) youth are 2-3 times more likely to be involved in a pregnancy compared to nonLGBT youth. Lesbian, Gay, and Bisexual (LGB) youth are more likely to initiate sex at a very young age, have multiple partners, use alcohol and other substances before engaging in sexual intercourse; and are less likely to use contraception compared to non-LGB youth (14).

Risky behaviors are often co-occurring. Teens who drink or use drugs are at increased risk of (1) being sexually active, (2) not using contraception when they have sex, (3) having sex at an earlier age, and (4) having multiple partners (15). Teen pregnancy is also linked with various types of violence including dating violence, intimate partner violence, domestic violence and sexual abuse. Girls in high school who reported experiencing dating violence were four to six times more likely to have ever been pregnant than peers who had not experienced dating violence. Adverse childhood experiences such as physical abuse, verbal abuse, and witnessing intimate partner violence are also linked with having sex at an early age. Approximately 50 to 60 percent of adolescents who become pregnant have a history of childhood sexual or physical abuse (16).

In addition to understanding sexual risk behaviors, it is important to understand the interrelated roles of protective factors, positive youth development, and trauma informed approaches when implementing programs to prevent teen pregnancy.

Sexual Risk and Protective Factors

There are several risk and protective factors that influence a teen’s decision to engage in sexual behavior. The majority of risk and protective factors fall into one of four categories: (1) biological factors such as age, physical maturity, and sex; (2) disadvantage, disorganization, and dysfunction in the lives of teens and their families, peers, and communities; (3) sexual values and norms expressed or modeled by teens themselves or by their families, romantic partners, peers, faith communities, schools, and communities; and (4) teens’ connection to groups or institutions that discourage risky sexual behavior, encourage responsible behavior, or both (17). It is important for organizations to understand the factors that influence teens’ sexual behavior to have the greatest impact on reducing sexual risk taking.

types of violence including dating violence, intimate partner violence, domestic violence and sexual abuse. Girls in high school who reported experiencing dating violence were four to six times more likely to have ever been pregnant than peers who had not experienced dating violence. Adverse childhood experiences such as physical abuse, verbal abuse, and witnessing intimate partner violence are also linked with having sex at an early age. Approximately 50 to 60 percent of adolescents who become pregnant have a history of childhood sexual or physical abuse (16).

In addition to understanding sexual risk behaviors, it is important to understand the interrelated roles of protective factors, positive youth development, and trauma informed approaches when implementing programs to prevent teen pregnancy.

Sexual Risk and Protective Factors

There are several risk and protective factors that influence a teen’s decision to engage in sexual behavior. The majority of risk and protective factors fall into one of four categories: (1) biological factors such as age, physical maturity, and sex; (2) disadvantage, disorganization, and dysfunction in the lives of teens and their families, peers, and communities; (3) sexual values and norms expressed or modeled by teens themselves or by their families, romantic partners, peers, faith communities, schools, and communities; and (4) teens’ connection to groups or institutions that discourage risky sexual behavior, encourage responsible behavior, or both (17). It is important for organizations to understand the factors that influence teens’ sexual behavior to have the greatest impact on reducing sexual risk taking.

Trauma Informed Care

Organizations should be aware that the youth they will be working with may have experienced some form of trauma. Youth can be exposed directly or indirectly to trauma through child abuse, neglect, domestic violence and other forms of violence. Exposure to traumatic events can have social, behavioral and emotional impacts on youth and lead to poor outcomes in youth. Youth who have been exposed to violence are more likely to become teen parents, with those who have experienced physical and sexual abuse more likely to experience a repeat pregnancy (18).

Adverse childhood experiences (ACEs) including abuse, neglect, violence, and other stressors can have a lifelong impact on one’s health. As the number of ACEs increase, the risk for health problems (e.g., heart disease, depression, smoking, intimate partner violence, risky sexual behavior, and alcohol or drug abuse) increases. Trauma-informed care is an approach that is welcoming and appropriate for trauma survivors (e.g., those with ACEs), including avoiding re-traumatization. A trauma-informed approach is one in which all parties involved recognize and respond to the impact of ACE, trauma, and toxic stress on children, caregivers, and service providers. Organizations should prepare to incorporate a trauma informed approach when providing sexual health education to youth, which includes taking into consideration ACEs and the influence that they have on sexual health and decision making (19, 20).

Positive Youth Development

Positive youth development is an intentional, pro-social approach that engages youth within their communities, schools, organizations, peer groups, and families in a manner that is productive and constructive; recognizes, uses, and enhances youths' strengths; and promotes

Trauma Informed Care

Organizations should be aware that the youth they will be working with may have experienced some form of trauma. Youth can be exposed directly or indirectly to trauma through child abuse, neglect, domestic violence and other forms of violence. Exposure to traumatic events can have social, behavioral and emotional impacts on youth and lead to poor outcomes in youth. Youth who have been exposed to violence are more likely to become teen parents, with those who have experienced physical and sexual abuse more likely to experience a repeat pregnancy (18).

Adverse childhood experiences (ACEs) including abuse, neglect, violence, and other stressors can have a lifelong impact on one’s health. As the number of ACEs increase, the risk for health problems (e.g., heart disease, depression, smoking, intimate partner violence, risky sexual behavior, and alcohol or drug abuse) increases. Trauma-informed care is an approach that is welcoming and appropriate for trauma survivors (e.g., those with ACEs), including avoiding re-traumatization. A trauma-informed approach is one in which all parties involved recognize and respond to the impact of ACE, trauma, and toxic stress on children, caregivers, and service providers. Organizations should prepare to incorporate a trauma informed approach when providing sexual health education to youth, which includes taking into consideration ACEs and the influence that they have on sexual health and decision making (19, 20).

Positive Youth Development

Positive youth development is an intentional, pro-social approach that engages youth within their communities, schools, organizations, peer groups, and families in a manner that is productive and constructive; recognizes, uses, and enhances youths’ strengths; and promotes positive outcomes for young people by providing opportunities, fostering positive relationships, and furnishing the support needed to build on their leadership strengths (21). According to research on positive youth development, youth may have fewer behavioral problems and may be better prepared for a successful transition to adulthood if they have a variety of opportunities to learn and participate at home, at school, in community-based programs and in their neighborhoods. Organizations should work to incorporate key positive youth development practices into all interactions with and programs for youth (22).

Evidence-Based Teen Pregnancy Prevention Programs Eligible for Replication

The Department of Health and Human Services (HHS) conducts the HHS TPP Evidence

Review (http://tppevidencereview.aspe.hhs.gov/EvidencePrograms.aspx) which uses a systematic process for reviewing evaluation studies against a rigorous standard in order to identify programs shown effective at preventing teen pregnancies, sexually transmitted infections, and/or sexual risk behaviors. The evidence review, first conducted in 2009 and updated periodically, is led by the HHS Office of the Assistant Secretary for Planning and

Evaluation. The most recent update was released in August 2014. There are currently 37 evidence-based TPP program models identified by the HHS TPP Evidence Review. The 37 programs are diverse on a number of variables, including program approach, target population, implementation setting, length of program, program outcomes, duration of program outcomes, and study design quality rating.

Evidence-based TPP programs eligible for replication by the applicant’s CBA partners under this FOA are those that meet the following criteria prior to the end of the planning and readiness period:

positive outcomes for young people by providing opportunities, fostering positive relationships, and furnishing the support needed to build on their leadership strengths (21). According to research on positive youth development, youth may have fewer behavioral problems and may be better prepared for a successful transition to adulthood if they have a variety of opportunities to learn and participate at home, at school, in community-based programs and in their neighborhoods. Organizations should work to incorporate key positive youth development practices into all interactions with and programs for youth (22).

Evidence-Based Teen Pregnancy Prevention Programs Eligible for Replication

The Department of Health and Human Services (HHS) conducts the HHS TPP Evidence

Review (http ://tppevidencereview .aspe.hhs .gov/EvidencePrograms .aspx) which uses a systematic process for reviewing evaluation studies against a rigorous standard in order to identify programs shown effective at preventing teen pregnancies, sexually transmitted infections, and/or sexual risk behaviors. The evidence review, first conducted in 2009 and updated periodically, is led by the HHS Office of the Assistant Secretary for Planning and

Evaluation. The most recent update was released in August 2014. There are currently 37 evidence-based TPP program models identified by the HHS TPP Evidence Review. The 37 programs are diverse on a number of variables, including program approach, target population, implementation setting, length of program, program outcomes, duration of program outcomes, and study design quality rating.

Evidence-based TPP programs eligible for replication by the applicant’s CBA partners under this FOA are those that meet the following criteria prior to the end of the planning and readiness period:

file:///C:/Users/Amy.Bianchi/Documents/OAH/Supplemental%20Proposals/Planning%20for%202014%20TPP%20FOA/HHS%20TPP http://tppevidencereview.aspe.hhs.gov/EvidencePrograms.aspx

1. Have been identified as having evidence of effectiveness by the HHS TPP Evidence

Review…