FY15 Tier2Brevised.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 10, 2015

Rigorous Evaluation of New or Innovative Approaches to Prevent Teen

Pregnancy (Tier 2B)

Announcement Type: New

Announcement Number: AH-TP2-15-002

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

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

Announcement Type: New

Announcement Number: AH-TP2- 15-002

Catalog of Federal Domestic Assistance (CFDA) No. 93.297

Funding Opportunity Announcement And

Application Instructions

Application Due Date: April 10, 2015

Table of Contents

Executive Summary……………….……………..…………….……………………………….. 3 Purpose……………………………………………………………………………………………5 Background………………………………………………………………………………………7 Expectations of Grantees……………………………………………………………………….13 Proposed Intervention……………………………………………………………………13

Intervention Implementation and Work Plan ………………………………………… Collection and Use of Performance Measures…...………………………………………23 Evaluation Design Plan…………………………………………………...……………...25 Capacity and Experience of the Organization and its Partners…………………….…….29 Project Management and Partnerships……………………………………………… Cooperative Agreement Substantial Programmatic Involvement………………….……….33 Authority………………………………………………………………………………………...34 Award Information……………………………………………………………………………..34 Eligibility Information………………………………………………………………………….35 Application Responsiveness and Screening Criteria………….……………………………...36 Application Submission Information………………………………………………………….37

1. Information to Request Application Package…………………………………….37

2. Content and Form of Application Submission……………………………………38

a. Important Grants.gov Information………………………………………..41

b. Application Content………………………………………………………...43

i. Project Narrative…………………………………………………...43

1. Proposed Intervention…………………………...…………...43

2. Intervention Implementation and Work Plan………………...46

3. Collection and Use of Performance Measures..……………...49

4. Evaluation Design Plan

5. Capacity and Experience of the Organization and its

Partners………………...……….…………………………

6. Project Management and Partnerships………..……….……..63

ii. Budget Narrative……………………………………………………65

iii. Appendices…………………………………………………………..68

c. Submission Dates and Times………………………………………………69

d. Intergovernmental Review…………………………………………………69

e. Funding Restrictions………………………………………………………..69 Application Review Information………………………………………………………………71 Criteria…………………………………………………………………………………..71

Review and Selection Process………………………………………………………….78 Award Administration Information…………………………………………………………..81 Agency Contacts……………………………………………………………….………………..86 Appendices………………………………………………………………………………………87

Table of Contents

Executive Summary. 3 Purpose 5 Background 7 Expectations of Grantees 13

Proposed Intervention 13 Intervention Implementation and Work Plan 16 Collection and Use of Performance Measures 23 Evaluation Design Plan 25 Capacity and Experience of the Organization and its Partners 29 Project Management and Partnerships 30

Cooperative Agreement Substantial Programmatic Involvement 33 Authority 34 Award Information 34 Eligibility Information 35 Application Responsiveness and Screening Criteria 36 Application Submission Information 37

1. Information to Request Application Package 37

2. Content and Form of Application Submission 38

a. Important Grants.gov Information 41

b. Application Content 43

i. Project Narrative 43

1. Proposed Intervention 43

2. Intervention Implementation and Work Plan 46

3. Collection and Use of Performance Measures 49

4. Evaluation Design Plan 49

5. Capacity and Experience of the Organization and its

Partners 60

6. Project Management and Partnerships 63

ii. Budget Narrative 65

iii. Appendices 68

c. Submission Dates and Times 69

d. Intergovernmental Review 69

e. Funding Restrictions 69

Application Review Information 71 Criteria 71 Review and Selection Process 78

Award Administration Information 81 Agency Contacts 86 Appendices 87

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 Rigorous

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

ACTION: Notice

ANNOUNCEMENT TYPE: INITIALCOMPETITIVE COOPERATIVE AGREEMENT

FUNDING OPPORTUNITY NUMBER: TP2-AH-15-002

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 10, 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 Rigorous

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

ACTION: Notice

ANNOUNCEMENT TYPE: INITIALCOMPETITIVE COOPERATIVE AGREEMENT

FUNDING OPPORTUNITY NUMBER: TP2-AH-15-002

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 10, 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

Thursday, January 29th from 3:00-5:00 pm ET (start time of 2:00 pm CT, 1:00 pm MT, 12:00 pm

PT). Potential applicants should call 1-888-566-5780, passcode 3899321, and log-on to https://www.mymeetings.com/nc/join.php?i=PW1052995&p=3899321&t=c.

EXECUTIVE SUMMARY: The HHS Office of Adolescent Health (OAH) announces the anticipated availability of funds for Fiscal Year (FY) 2015 cooperative agreement awards under the authority of Division H, Title II of the Consolidated Appropriations Act, 2014 (Public

Law No. 113-76), and the Continuing Resolution thus far for FY 2015 (Public Law No. 113-

164), for Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy

(Tier 2B). OAH intends to make available approximately $18 million for an estimated 30 awards.

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

Applicants may apply for more than one FOA. This FOA provides information for applying to Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier

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

The purpose of this FOA is to increase the number of evidence-based TPP interventions available by rigorously evaluating new or innovative approaches for preventing teen pregnancy and related high risk behaviors. OAH is especially interested in expanding the evidence base for

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

Thursday, January 29th from 3:00-5:00 pm ET (start time of 2:00 pm CT, 1:00pm MT, 12:00 pm

PT). Potential applicants should call 1-888-566-5780, passcode 3899321, and log-on to https://www.mymeetings .comlnc/join.php?i=PW1052995&p=3 899321 &t=c.

EXECUTIVE SUMMARY: The HHS Office of Adolescent Health (OAH) announces the anticipated availability of funds for Fiscal Year (FY) 2015 cooperative agreement awards under the authority of Division H, Title II of the Consolidated Appropriations Act, 2014 (Public

Law No. 113-76), and the Continuing Resolution thus far for FY 2015 (Public Law No. 113-

164), for Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy

(Tier 2B). OAH intends to make available approximately $18 million for an estimated 30 awards.

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

Applicants may apply for more than one FOA. This FOA provides information for applying to Rigorous Evaluation of New or Innovative Approaches to Prevent Teen Pregnancy (Tier

2B). Other 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)

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

The purpose of this FOA is to increase the number of evidence-based TPP interventions available by rigorously evaluating new or innovative approaches for preventing teen pregnancy and related high risk behaviors. OAH is especially interested in expanding the evidence base for https://www.mymeetings.com/nc/join.php?i=PW1052995&p=3899321&t=c the field of TPP by funding rigorous evaluations of innovative interventions designed to address gaps in the existing evidence, reduce disparities in teen pregnancy and associated sexual and reproductive health outcomes, and/or serve high-need populations. This includes, but is not limited to interventions designed for older adolescents (18-19), males, rural youth, and other youth populations at disproportionate risk of teen pregnancy (see data on pages 13-14). OAH is also interested in the use of non-traditional delivery methods (i.e., non-curriculum based approaches). The purpose of this FOA is not to enable and support early innovation that is not yet ready to be rigorously evaluated; that is the purpose of the Tier 2A FOA.

For the purposes of this FOA, OAH defines innovation broadly as new or promising approaches, strategies, interventions, or curricula, informed by scientific theory or empirical evidence that may lead to or have the potential to result in a substantial reduction in teen pregnancy rates, sexually transmitted infection (STIs) rates, and associated sexual risk behaviors.

A new intervention may either be a novel or recently developed intervention or an intervention that has been in use for some years but has never been rigorously evaluated.

OAH plans to fund projects that have the potential to yield high impact results, reduce public health burden and improve population health. OAH is looking for interventions that are not only effective, but efficient and sustainable. The applicant must be able to demonstrate that the proposed intervention is needed, likely to reduce rates of teen pregnancy and/or adolescent risk behaviors, relevant to the target population, and able to be rigorously evaluated. For this FOA, rigorous evaluation is defined as high quality randomized controlled trials (RCTs), quasi-experimental designs (QEDs), or Regression Discontinuity Designs (RDD) designed and implemented to meet the standards for a high or moderate rating on the HHS TPP Evidence

Review (see Appendix D or http://tppevidencereview.aspe.hhs.gov/ReviewProtocol.aspx.)

the field of TPP by funding rigorous evaluations of innovative interventions designed to address gaps in the existing evidence, reduce disparities in teen pregnancy and associated sexual and reproductive health outcomes, and/or serve high-need populations. This includes, but is not limited to interventions designed for older adolescents (18-19), males, rural youth, and other youth populations at disproportionate risk of teen pregnancy (see data on pages 13-14). OAH is also interested in the use of non-traditional delivery methods (i.e., non-curriculum based approaches). The purpose of this FOA is not to enable and support early innovation that is not yet ready to be rigorously evaluated; that is the purpose of the Tier 2A FOA.

For the purposes of this FOA, OAH defines innovation broadly as new or promising approaches, strategies, interventions, or curricula, informed by scientific theory or empirical evidence that may lead to or have the potential to result in a substantial reduction in teen pregnancy rates, sexually transmitted infection (STIs) rates, and associated sexual risk behaviors.

A new intervention may either be a novel or recently developed intervention or an intervention that has been in use for some years but has never been rigorously evaluated.

OAH plans to fund projects that have the potential to yield high impact results, reduce public health burden and improve population health. OAH is looking for interventions that are not only effective, but efficient and sustainable. The applicant must be able to demonstrate that the proposed intervention is needed, likely to reduce rates of teen pregnancy and/or adolescent risk behaviors, relevant to the target population, and able to be rigorously evaluated. For this FOA, rigorous evaluation is defined as high quality randomized controlled trials (RCTs), quasiexperimental designs (QEDs), or Regression Discontinuity Designs (RDD) designed and implemented to meet the standards for a high or moderate rating on the HHS TPP Evidence

Review (see Appendix D or http://tppevidencereview.aspe.hhs.gov/ReviewProtocol.aspx.)

http://tppevidencereview.aspe.hhs.gov/ReviewProtocol.aspx

I. FUNDING OPPORTUNITY DESCRIPTION:

PURPOSE

The purpose of this FOA is to increase the number of evidence-based TPP interventions available by rigorously evaluating new or innovative approaches for preventing teen pregnancy and related risk behaviors. The applicant must demonstrate that the proposed intervention is needed, likely to reduce rates of teen pregnancy and/or adolescent sexual risk behavior, relevant to the target population, and able to be rigorously evaluated. This is not a service delivery grant.

Service may be a byproduct of the funding, but is not the purpose for this FOA.

OAH is especially interested in expanding the evidence base for the field of TPP by funding rigorous evaluations of new or innovative interventions designed to address gaps in the existing evidence and reduce adolescent sexual and reproductive health disparities. This includes, but is not limited to interventions designed for older adolescents (18-19), males, rural youth, and other youth populations at disproportionate risk of teen pregnancy (see data on page 9). OAH is also interested in the use of non-traditional delivery methods (i.e., non-curriculum based approaches).

Overall, grantees will be expected to:

Engage the target population in the development or finalization of the intervention

Engage in a 6-12 month planning, piloting, and readiness period

Implement and rigorously evaluate the proposed intervention

Ensure that intervention materials are medically accurate, age appropriate, culturally and linguistically appropriate, and inclusive of Lesbian, Gay, Bisexual, Transgender, and

Questioning (LGBTQ) youth

Collect and use performance measure data to make continuous quality improvements

I. FUNDING OPPORTUNITY DESCRIPTION:

PURPOSE

The purpose of this FOA is to increase the number of evidence-based TPP interventions available by rigorously evaluating new or innovative approaches for preventing teen pregnancy and related risk behaviors. The applicant must demonstrate that the proposed intervention is needed, likely to reduce rates of teen pregnancy and/or adolescent sexual risk behavior, relevant to the target population, and able to be rigorously evaluated. This is not a service delivery grant.

Service may be a byproduct of the funding, but is not the purpose for this FOA.

OAH is especially interested in expanding the evidence base for the field of TPP by funding rigorous evaluations of new or innovative interventions designed to address gaps in the existing evidence and reduce adolescent sexual and reproductive health disparities. This includes, but is not limited to interventions designed for older adolescents (18-19), males, rural youth, and other youth populations at disproportionate risk of teen pregnancy (see data on page 9). OAH is also interested in the use of non-traditional delivery methods (i.e., non-curriculum based approaches).

Overall, grantees will be expected to:

• Engage the target population in the development or finalization of the intervention

• Engage in a 6-12 month planning, piloting, and readiness period

• Implement and rigorously evaluate the proposed intervention

• Ensure that intervention materials are medically accurate, age appropriate, culturally and linguistically appropriate, and inclusive of Lesbian, Gay, Bisexual, Transgender, and

Questioning (LGBTQ) youth

• Collect and use performance measure data to make continuous quality improvements

Document and package the intervention to be implementation ready and able to be replicated if found to be effective

Disseminate evaluation results and intervention information.

Interventions that are not acceptable for this FOA include (1) those already identified as an evidence-based TPP program by the HHS TPP Evidence Review, (2) significant adaptations of evidence-based TPP programs identified by the HHS TPP evidence review, or (3) programs currently undergoing a rigorous evaluation under the OPHS/OAH-TPP PREP Tier2-2010 FOA initially funded in FY 2010

(http://www.hhs.gov/ash/oah/news/assets/funding_announcment_research.pdf). (See a complete list in Appendix D).

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

Strategy

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

Successful Futures, Eliminate Health Disparities, and Accelerate the Process of Scientific

Discovery to Improve Health. 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, including, but not limited to, teen pregnancy and STIs

STIs. http://www.hhs.gov/strategic-plan/hhs-vision.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

• Document and package the intervention to be implementation ready and able to be replicated if found to be effective

• Disseminate evaluation results and intervention information.

Interventions that are not acceptable for this FOA include (1) those already identified as an evidence-based TPP program by the HHS TPP Evidence Review, (2) significant adaptations of evidence-based TPP programs identified by the HHS TPP evidence review, or (3) programs currently undergoing a rigorous evaluation under the OPHS/OAH-TPP PREP Tier2-2010 FOA initially funded in FY 2010

(http ://www.hhs gov/ash/oah/news/assets/funding announcment research.pdf). (See a complete list in Appendix D).

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

Strategy

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

Successful Futures, Eliminate Health Disparities, and Accelerate the Process of Scientific

Discovery to Improve Health. 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, including, but not limited to, teen pregnancy and STIs

STIs. http ://www.hhs .gov/strategic-plan/hhs-vision.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 http://www.hhs.gov/ash/oah/news/assets/funding_announcment_research.pdf http://www.hhs.gov/strategic-plan/hhs-vision.html http://www.healthypeople.gov/2020/default.aspx

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 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 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 anticipated availability of FY2015 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:

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 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 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 anticipated availability of FY20 15 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:

http://www.surgeongeneral.gov/initiatives/prevention/strategy/#The Goal http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/ http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/

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)

Status of Adolescent Sexual Risk Behaviors

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).

• 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)

Status of Adolescent Sexual Risk Behaviors

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).

• 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 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).

Gaps in the Current Evidence-Base for Teen Pregnancy Prevention

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, STIs, and/or behavioral risk factors underlying teen pregnancy. The HHS TPP evidence review, first conducted in 2009 and updated periodically, is led by the HHS Office of the Assistant Secretary for Planning and Evaluation

(ASPE). The most recent update was released in August 2014. There are currently 35 diverse evidence-based TPP program models identified by the HHS TPP Evidence Review.

In 2013, ASPE produced a working paper on the HHS TPP evidence review that notes the need for more research on TPP for specific populations at high risk for teen pregnancies or

STIs and identifies gaps in the existing evidence base (22). Grantees currently funded under

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).

Gaps in the Current Evidence-Base for Teen Pregnancy Prevention

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, STIs, and/or behavioral risk factors underlying teen pregnancy. The HHS TPP evidence review, first conducted in 2009 and updated periodically, is led by the HHS Office of the Assistant Secretary for Planning and Evaluation

(ASPE). The most recent update was released in August 2014. There are currently 35 diverse evidence-based TPP program models identified by the HHS TPP Evidence Review.

In 2013, ASPE produced a working paper on the HHS TPP evidence review that notes the need for more research on TPP for specific populations at high risk for teen pregnancies or

STIs and identifies gaps in the existing evidence base (22). Grantees currently funded under http://tppevidencereview.aspe.hhs.gov/EvidencePrograms.aspx http://tppevidencereview.aspe.hhs.gov/EvidencePrograms.aspx

OPHS/OAH-TPP PREP Tier 2-2010 FOA (http://www.hhs.gov/ash/oah/grants/grantee-map.html) are working to address some of the existing gaps; however there continue to be gaps in the evidence base. There are limited evidence-based TPP programs currently available for many populations at disproportionate risk for teen pregnancy, including:

Older teens – Few of the evidence-based TPP programs were designed and evaluated specifically for older teens (ages 18-19). Only one grantee funded under the

OPHS/OAH-TPP PREP Tier2-2010 FOA is developing and evaluating a program for older teens.

Males - Currently, there are no evidence-based TPP programs designed specifically for males and only one grantee funded under the OPHS/OAH-TPP PREP Tier2-2010 FOA is developing and evaluating a program specifically for males.

LGBTQ youth – To date, there are no evidence-based TPP programs specifically tailored to the needs of LGBTQ youth and none under development under the

OPHS/OAH-TPP PREP Tier2-2010 FOA.

Rural youth – Relatively few of the evidence-based TPP programs were designed and evaluated specifically for use in rural areas and only one program is being developed and evaluated for rural youth under the OPHS/OAH-TPP PREP Tier2-2010 FOA.

Furthermore, some of the studies assessed by the HHS TPP evidence review suggest that youth residing in rural areas may respond differently to programs originally developed in urban settings (22).

Latino/Hispanic youth - Only two of the evidence-based TPP programs are designed specifically for Latino youth. Five additional evidence-based TPP programs were evaluated with predominately Latino research samples; however, the interventions are

OPHS/OAH-TPP PREP Tier 2-2010 FOA (http://www.hhs.gov/ash/oah/grants/granteemap.html

)are working to address some of the existing gaps; however there continue to be gaps in the evidence base. There are limited evidence-based TPP programs currently available for many populations at disproportionate risk for teen pregnancy, including:

• Older teens — Few of the evidence-based TPP programs were designed and evaluated specifically for older teens (ages 18-19). Only one grantee funded under the

OPHS/OAH-TPP PREP Tier2-2010 FOA is developing and evaluating a program for older teens.

• Males - Currently, there are no evidence-based TPP programs designed specifically for males and only one grantee funded under the OPHS/OAH-TPP PREP Tier2-2010 FOA is developing and evaluating a program specifically for males.

• LGBTQ youth — To date, there are no evidence-based TPP programs specifically tailored to the needs of LGBTQ youth and none under development under the

OPHS/OAH-TPP PREP Tier2-2010 FOA.

• Rural youth — Relatively few of the evidence-based TPP programs were designed and evaluated specifically for use in rural areas and only one program is being developed and evaluated for rural youth under the OPHS/OAH-TPP PREP Tier2-2010 FOA.

Furthermore, some of the studies assessed by the HHS TPP evidence review suggest that youth residing in rural areas may respond differently to programs originally developed in urban settings (22).

• Latino/Hispanic youth - Only two of the evidence-based TPP programs are designed specifically for Latino youth. Five additional evidence-based TPP programs were evaluated with predominately Latino research samples; however, the interventions are http://www.hhs.gov/ash/oah/grants/grantee-map.html http://www.hhs.gov/ash/oah/grants/grantee-map.html not culturally tailored for Latinos (22). Only one grantee funded under the OPHS/OAH-

TPP PREP Tier2-2010 FOA is developing and evaluating a program designed specifically for Latino youth.

Native American/American Indian youth – Currently, there are no evidence-based

TPP programs designed specifically for Native American or American Indian youth.

Three grantees funded under the OPHS/OAH-TPP PREP Tier2-2010 FOA are developing and evaluating programs specifically designed for Native American youth.

Expectant and parenting teens – Two of the evidence-based TPP programs are designed specifically for pregnant and parenting teens and another two are currently being tested under the OPHS/OAH-TPP PREP Tier2-2010 FOA.

Foster care youth - Currently, there are no evidence-based TPP programs designed specifically for youth in foster care. One grantee funded under the OPHS/OAH-TPP

PREP Tier2-2010 FOA is developing and evaluating a program specifically for foster care youth.

In addition, many of the evidence-based TPP programs identified by the HHS TPP evidence review were created more than a decade ago (23), and as a result, many do not address the role of technology or use technology for program delivery. According to the Pew Research Center’s

Internet Project, in 2012, 95% of all teens (ages 12-17) in the US used the internet, and three-fourths of teens accessed the internet via mobile devices such as cellular telephones or tablets

(24). The use of internet, texting, and mobile devices was relatively consistent across teens of various socioeconomic and racial groups (25). Interventions which incorporate technologies, such as internet and social media, have strong potential to reach teens of diverse racial, ethnic and socio-economic backgrounds. Further, these interventions have the potential to reach not culturally tailored for Latinos (22). Only one grantee funded under the OPHS/OAHTPP

PREP Tier2-2010 FOA is developing and evaluating a program designed specifically for Latino youth.

• Native American/American Indian youth — Currently, there are no evidence-based

TPP programs designed specifically for Native American or American Indian youth.

Three grantees funded under the OPHS/OAH-TPP PREP Tier2-2010 FOA are developing and evaluating programs specifically designed for Native American youth.

• Expectant and parenting teens — Two of the evidence-based TPP programs are designed specifically for pregnant and parenting teens and another two are currently being tested under the OPHS/OAH-TPP PREP Tier2-2010 FOA.

• Foster care youth - Currently, there are no evidence-based TPP programs designed specifically for youth in foster care. One grantee funded under the OPHS/OAH-TPP

PREP Tier2-2010 FOA is developing and evaluating a program specifically for foster care youth.

In addition, many of the evidence-based TPP programs identified by the HHS TPP evidence review were created more than a decade ago (23), and as a result, many do not address the role of technology or use technology for program delivery. According to the Pew Research Center’s

Internet Project, in 2012, 95% of all teens (ages 12-17) in the US used the internet, and threefourths of teens accessed the internet via mobile devices such as cellular telephones or tablets

(24). The use of internet, texting, and mobile devices was relatively consistent across teens of various socioeconomic and racial groups (25). Interventions which incorporate technologies, such as internet and social media, have strong potential to reach teens of diverse racial, ethnic and socio-economic backgrounds. Further, these interventions have the potential to reach adolescents in communities with limited school-based TPP programming, as well as youth who have transient living arrangements, such as youth in foster care (26).

Gaps also exist in the current evidence-base related to the program’s focus. Most of the current evidence-based TPP programs are designed to be delivered directly to youth. Few evidence-based TPP programs are available where the focus is on families, schools, neighborhoods, environments, addressing norms, etc. Only one evidence-based TPP program is designed for working with parents and one other evidence-based TPP program is designed as a systems-level approach for working with an entire school. Furthermore, many of the current evidence-based TPP programs do not address topics important to preventing teen pregnancy, such as cultural norms, gender equity, economic and educational opportunities, and healthy relationships.

EXPECTATIONS OF GRANTEES

Included below are OAH’s expectations of grantees throughout the five-year project period.

Failure of a grantee to meet major milestones as required/defined by OAH may result in the discontinuation of grant funding at any time during the project period.

PROPOSED INTERVENTION

The applicant should include a clear and thorough description of the proposed intervention that demonstrates why the intervention is promising, innovative, feasible, and likely to have a significant impact on reducing teen pregnancy and existing disparities. The applicant should describe the:

adolescents in communities with limited school-based TPP programming, as well as youth who have transient living arrangements, such as youth in foster care (26).

Gaps also exist in the current evidence-base related to the program’s focus. Most of the current evidence-based TPP programs are designed to be delivered directly to youth. Few evidence-based TPP programs are available where the focus is on families, schools, neighborhoods, environments, addressing norms, etc. Only one evidence-based TPP program is designed for working with parents and one other evidence-based TPP program is designed as a systems-level approach for working with an entire school. Furthermore, many of the current evidence-based TPP programs do not address topics important to preventing teen pregnancy, such as cultural norms, gender equity, economic and educational opportunities, and healthy relationships.

EXPECTATIONS OF GRANTEES

Included below are OAH’s expectations of grantees throughout the five-year project period.

Failure of a grantee to meet major milestones as required/defined by OAH may result in the discontinuation of grant funding at any time during the project period.

PROPOSED INTERVENTION

The applicant should include a clear and thorough description of the proposed intervention that demonstrates why the intervention is promising, innovative, feasible, and likely to have a significant impact on reducing teen pregnancy and existing disparities. The applicant should describe the:

Intervention Content and Implementation – The applicant…