HHS-2021-ACF-ACYF-AT-1922.pdf

Administration for Children and Families

Administration on Children, Youth and Families - Family and Youth Services Bureau

Tribal Personal Responsibility Education Program for Teen Pregnancy Prevention

HHS-2021-ACF-ACYF-AT-1922

Application Due Date: 07/26/2021

Tribal Personal Responsibility Education Program for Teen Pregnancy Prevention

HHS-2021-ACF-ACYF-AT-1922

TABLE OF CONTENTS

Overview Executive Summary

I. Program Description II. Federal Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Other

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

3. Unique Entity Identifier and System for Award Management

(SAM)

4. Submission Dates and Times

5. Intergovernmental Review

6. Funding Restrictions

7. Other Submission Requirements

V. Application Review Information

1. Criteria

2. Review and Selection Process

3. Anticipated Announcement and Federal Award Dates

VI. Federal Award Administration Information

1. Federal Award Notices

2. Administrative and National Policy Requirements

3. Reporting

VII. HHS Awarding Agency Contact(s) VIII. Other Information

Department of Health & Human Services Administration for Children and Families

Funding Opportunity Title: Tribal Personal Responsibility

Education Program for Teen Pregnancy Prevention

Announcement Type: Initial Funding Opportunity Number: HHS-2021-ACF-ACYF-AT-1922 Primary CFDA Number: 93.092 Due Date for Applications: 07/26/2021

Executive Summary

Notice:

Applicants are strongly encouraged to read the entire funding opportunity announcement (FOA) carefully and observe the application formatting requirements listed in Section IV.2. Content and Form of Application Submission.

For more information on applying for grants, please visit "How to Apply for a Grant" on the ACF Grants & Funding Page at https://www.acf.hhs.gov/grants/howto.

The Administration on Children, Youth and Families' (ACYF) Family and Youth Services Bureau (FYSB) announces the availability of funds to tribes and tribal organizations for development and implementation of the Tribal Personal Responsibility Education Program (Tribal PREP). The purpose of this program is to support projects that educate American Indian/Alaska Native (AI/AN) youth between the ages of 10 and 19, and pregnant and parenting youth under age 21, on both abstinence and contraception for the prevention of pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Funds will support the design, implementation, and sustainability of culturally and linguistically appropriate youth pregnancy prevention programs that replicate evidence-based effective programs, substantially incorporate elements of effective programs, or include promising practices within the AI/AN tribal communities. Projects are also required to incorporate at least three of the following six adulthood preparation subjects (APS):

1) healthy relationships, 2) adolescent development, 3) financial literacy, 4) parent-child communication, 5) educational and career success, and 6) healthy life skills. The 60-month project period will be divided into the following three phases: a planning period, full implementation period, and a final/close-out period. The Administration for Children and Families (ACF) will engage in a collaborative learning agenda that will provide support to Tribal PREP grantees engaged in local evaluations and support performance measure data collection efforts. In addition to collecting performance measures, Tribal PREP grantees must design and submit (during the planning period) a local evaluation of funded activities and must set aside a minimum of 15 and a maximum of 20 percent of their annual Tribal PREP budget to support their local evaluation.

http://www.acf.hhs.gov/grants/howto

I. Program Description

Statutory Authority PREP is authorized and funded by section 513 of the Social Security Act (42 U.S.C. 713), as amended by section 50503 of the Bipartisan Budget Act of 2018 (Public Law No. 115-123) extended by division CC, title III, section 302 of the Consolidated Appropriations Act, 2021 (Public Law No. 116-260).

Section 513(c)(2)(A) (42 U.S.C. 713(c)(2)(A)) specifically addresses the Tribal PREP, particularly the requirement for the Department of Health and Human Services (HHS) to consult with tribes and tribal organizations to review requirements for awarding the 5 percent set-aside for funding.

Description

BACKGROUND

PREP programs are designed to educate adolescents on both abstinence and contraception to prevent pregnancy and STIs, including HIV/AIDS. Preventing unintended pregnancy and STIs, including HIV/AIDS, is a U.S. public health priority, particularly among adolescents [1].

Projects must incorporate at least three of the following six APS: healthy relationships, adolescent development, financial literacy, parent-child communication, educational and career success, and healthy life skills.

PREP funding is directed toward the development of adolescent pregnancy prevention education programs that incorporate medically accurate approaches, while replicating evidence-based programs or elements of programs that have been demonstrated to change behavior.

Current trend data reports that fewer teens are engaged in sexual activity. According to the 2019 nationwide Youth Risk Behavior Survey, 27.4 percent of high school students reported being sexually active [2]. In 2018, U.S. birth rates for persons aged 15–17 were 7.2 and for 18–19 years there were 32.3 births per 1,000 females, according to Centers for Disease Control and Prevention (CDC) data [3]. Over the past decade, there has been a 40 percent decline in the teen birth rate. [3]. Reasons for the recent declines are not totally clear; however, evidence suggests these declines are due to more teens abstaining from sexual activity and more teens who are sexually active using birth control [4]. Despite this significant decline in the rate of teen births for all groups, racial/ethnic, geographic, and socioeconomic disparities persist. In 2017, the birth rate for African American, Hispanic/Latino, and AI/AN youth was 27.5, 28.9, and 32.9 births per 1,000 women, respectively, and socioeconomically disadvantaged youth of any race or ethnicity experienced the highest rates of teen pregnancy and childbirth [5]. In 2018, birth rates among teens 15 to 19 years for non-Hispanic black teens was 26.3 and for Hispanic teens

26.7. These rates are almost two times the 12.1 rate for White teens [3].

Promoting Healthy Transitions to Adulthood Through Positive Youth Development FYSB is committed to promoting the behavioral health and social and emotional well-being of vulnerable young people through a strengths-based, positive youth development (PYD) approach. Historically, many programs concentrated on a specific problem behavior, like teen sexual activity, and involved narrowly focused interventions and educational activities for that issue. However, the increasing body of research on risk and protective factors highlights the important roles that multiple aspects of young people's attitudes, behaviors, relationships, and environments have in predicting problem behaviors like early sexual activity [6].

PYD is an intentional, pro-social approach that engages youth within its communities, schools, organizations, peer groups, and families in a manner that is productive and constructive. This approach recognizes, uses, and enhances youths' strengths. It also promotes positive outcomes for young people by providing multiple opportunities; fostering positive relationships; and furnishing the support needed to build their skills, sense of mastery, and leadership strengths.

The PYD approach promotes a number of beneficial outcomes for youth, including social skills, emotional competence, positive relationships with peers and adults, and civic and school engagement.

Typical elements of programs models with a PYD approach include on-going, structured activities that facilitate progressive skill-building, positive interactions between youth and peers as well as adults, and high-levels of youth participation and engagement. For more information on PYD, please see: https://www.acf.hhs.gov/fysb/positive-youth-development.

TRIBAL PREP PROGRAM OVERVIEW

Tribal PREP Goals and Objectives The goal of the Tribal PREP is to educate adolescents on both abstinence and contraception for the prevention of pregnancy and STIs, including HIV/AIDS. Programs must promote changes in behaviors associated with pregnancy or STIs through methods such as delaying sexual activity, increasing condom or contraceptive use, and reducing the number of partners.

The following overall objectives of Tribal PREP are to:

1. Design and implement programs to educate adolescents on both abstinence and contraception to prevent adolescent pregnancy and STIs, including HIV/AIDS;

2. Provide medically accurate, age-appropriate programming that is inclusive and culturally appropriate;

3. Use best practices to replicate evidence-based effective programs (using culturally and linguistically appropriate adaptations, as necessary), substantially incorporate elements of effective programs that are proven to change behaviors (to include delaying sexual activity or increasing condom and contraceptive use), or substantially incorporate elements or practices from promising practices that have demonstrated effectiveness within AI/AN tribal communities; and

4. Promote successful, healthy transitions to adulthood through the implementation of at least three APS.

Target Population

Tribal PREP efforts are dedicated to developing comprehensive, culturally appropriate interventions and services that rely on the best available research to inform and guide practice.

Research suggests that AI/AN populations continue to experience disproportionately higher rates of teen pregnancy compared to other racial and ethnic groups. According to the CDC, "substantial disparities persist in teen birth rates, and teen pregnancy and childbearing continue to carry significant social and economic costs. In 2017, American Indian/Alaska Native teen https://www.acf.hhs.gov/fysb/positive-youth-development birth rates remained more than two times higher than the white teen birth rate [7]."

Tribal PREP must serve AI/AN youth populations. For the purposes of this Funding Opportunity Announcement (FOA), youth are defined as those who are 10-19 years old (see 42 U.S.C. 713(e)(4)), except in the case of pregnant and parenting youth, which may include youth under 21 years old (42 U.S.C. 713(a)(1)(C)(III)).

Tribal PREP may serve AI/AN youth who have additional risk factors for teen pregnancy or otherwise have special circumstances, including youth in or aging out of foster care, homeless youth, youth with HIV/AIDS, pregnant youth who are under 21 years of age, or mothers who are under 21 years of age, and youth who are victims of human trafficking.

FYSB recognizes additional youth populations who are the most high-risk or vulnerable for pregnancies and STIs, including HIV/AIDS, or otherwise have special circumstances including culturally underrepresented youth populations such as Hispanic, African American, or Native American youth; systems-involved youth; rural youth; homeless youth; lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth; out-of-school youth; and fathers who are under 21 years of age. PREP projects must be welcoming and accessible to all youth with their voluntary participation.

FYSB also recognizes that the residential statuses of AI/AN families and communities are diverse. For example, more than twice as many AI/AN youth live in rural areas compared to other U.S. youth (42 percent of AI/AN youth compared to 15 percent of other U.S. youth).

Additionally, only 22 percent of the AI/AN population reside on reservations according to the 2010 Census [8]. Tribal PREP may identify and provide services to the highest need geographic areas among AI/AN communities.

Tribal PREP Program Design

Under Tribal PREP, the following requirements must be addressed:

1. Substantial emphasis on both abstinence and contraception

2. Adulthood Preparation Subjects

3. Culturally and linguistically appropriate evidence-based, effective, or promising programs

4. Fidelity and adaptations

5. Medical accuracy and age-appropriateness

6. Trauma-informed approaches

Substantial emphasis on Abstinence and Contraception For the purposes of this FOA, Tribal PREP must include activities to educate AI/AN youth that place substantial emphasis on both abstinence and contraception for the prevention of pregnancy and STIs, including HIV/AIDS among AI/AN youth (see 42 U.S.C.

713(b)(2)(B)(iv)).

Adulthood Preparation Subjects (APS) Programs are required to include at least three of six APS be addressed in program implementation. These include the following:

1. Healthy relationships, such as including marriage and family interactions.

2. Adolescent development, such as the development of healthy attitudes and values about adolescent growth and development, body image, racial and ethnic diversity, and other related subjects.

3. Financial literacy

4. Parent-child communication

5. Educational and career success, such as developing skills for employment preparation, job seeking, independent living, financial self-sufficiency, and work-place productivity.

6. Healthy life skills, such as goal setting, decision making, negotiation, communication and interpersonal skills, and stress management.

Programs must be tailored and developed in appropriate ways to reflect the cultural, linguistic, and regional practices of the tribal communities and the target populations being served.

Programs must also assess the developmental needs of the target population(s) in order to inform the selection and incorporation of the adulthood preparation subjects. Additional guidance on APS is provided to state PREP grantees and may be useful to tribal PREP applicants.

For more information on implementing APS in PREP programs, please see the report on “Conceptual Models for Adulthood Preparation Subjects within the Personal Responsibility Education Program (PREP)” at https://www.acf.hhs.gov/sites/default/files/documents/opre /conceptual-models-adulthood-prep-feb-2021.pdf and the “Adulthood Preparation Subjects Resource Guide” at https://teenpregnancy.acf.hhs.gov/resources/adulthood-preparation-subjects -resource-guide-0-0.

Evidence-Based, Effective, or Promising Programs PREP projects are required to "replicate evidence-based effective programs or substantially incorporate elements of effective programs that have been proven on the basis of rigorous scientific research to change behavior, which means delaying sexual activity, increasing condom or contraceptive use for sexually active youth, or reducing pregnancy among youth" (see 42 U.S.C. 713(b)(2)(B)(i)).

Tribal PREP projects can also include promising practices within the AI/AN tribal communities, which includes substantially incorporating elements or practices from programs that have demonstrated effectiveness within AI/AN tribal communities.

HHS recognizes that to date there is little empirical research in AI/AN communities. To the extent possible, Tribal PREP should replicate evidence-based programs or substantially incorporate elements of effective programs that have been proven on the basis of rigorous scientific research to change behavior. Tribal PREP projects may include practices that AI/AN communities know to be effective for delaying sexual activity, increasing condom or contraceptive use for sexually active youth, or reducing pregnancy among youth.

Programs must demonstrate how their proposed programs meet the requirements to be evidence-based, incorporate elements of effective programs, or include promising practices by including the following:

1. References to a journal article or study where the program was shown to be effective (e.g., significant effects on outcomes of interests); or https://www.acf.hhs.gov/sites/default/files/documents/opre/conceptual-models-adulthood-prep-feb-2021.pdf https://www.acf.hhs.gov/sites/default/files/documents/opre/conceptual-models-adulthood-prep-feb-2021.pdf https://teenpregnancy.acf.hhs.gov/resources/adulthood-preparation-subjects-resource-guide-0 https://teenpregnancy.acf.hhs.gov/resources/adulthood-preparation-subjects-resource-guide-0

2. Data that demonstrate how the selected overall program systematically applies core curriculum components that have been found to be effective in delaying sexual activity, increasing condom or contraceptive use for sexually active youth, or reducing pregnancy among youth.

Programs must use culturally responsive interventions that incorporate the norms, beliefs, and values of the target population into programming. The proposed project should demonstrate cultural sensitivity and competence in providing social, linguistic, and culturally appropriate interventions with the target population.

Decades of social science research indicate that applied research is difficult. Identifying specific curricula that can be successfully, reliably, and broadly applied across many applications and among diverse audiences and locations is extremely challenging. However, social science and educational research is rich in identifying program elements that are key in attaining positive behavior change. Many of these elements have been identified in research summary documents such as the CDC Health Education Curriculum Analysis Tool: https://www.cdc.gov/healthyyou th/hecat/index.htm. This tool provides critical elements to success in implementing programs to positively change youth behavior. There may be other tools and resources available to assess curricula.

Fidelity and Adaptations Whether intervention designs replicate an entire evidence-based program or incorporate significant elements of evidence-based or effective programs, it is an established best practice to try to sustain fidelity to the original evidence-based or effective program model. When a full program model is being replicated with fidelity, adaptations to the program should generally be minimal. Any component that is added to an evidence-based program must be appropriately integrated into the evidence-based program model and should not alter the core components of the evidence-based program model. Frequently, developers that distribute evidence-based curricula will offer guidance on their core components and address how to ensure fidelity.

Programs must consult directly with curriculum developers to determine the core components of the program model they select for program implementation. Developers may offer checklists or other tools to assist with implementation.

If a tribe or tribal organization chooses to substantially incorporate elements of effective programs, they must ensure that the elements meet the PREP requirements. These added elements must improve the likelihood that interventions will fit the unique cultural needs of the AI/AN tribal population and have positive impacts on the targeted behaviors.

Medical Accuracy and Age Appropriateness Tribal PREP must provide “medically accurate and complete” information. For the purposes of this FOA, the term “medically accurate and complete” means verified or supported by the weight of research conducted in compliance with accepted scientific methods and the following:

1. Published in peer-reviewed journals, where applicable, or

2. Comprised of information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete (see 42 U.S.C. 713(e)(2)).

https://www.cdc.gov/healthyyouth/hecat/index.htm https://www.cdc.gov/healthyyouth/hecat/index.htm

Tribal PREP must provide medically accurate information, including up-to-date contraceptive information and age-appropriate information and activities. Topics, messages, and teaching methods must be suitable to specific age groups of youth based upon varying capacities of cognitive, emotional, and behavioral development.

Tribal programs must provide age-appropriate information and activities. The term “age-appropriate,” with respect to the information in pregnancy prevention, means topics, messages, and teaching methods suitable to particular ages or age groups of children and adolescents based on developing cognitive, emotional, and behavioral capacity typical for the age or age group.

Programs must verify that all final materials are age appropriate before the start of the implementation period.

Trauma Informed Approaches FYSB recognizes that AI/AN youth may have unique service needs related to the history of trauma in Indian Country. The Indian Country Childhood Trauma Center defines trauma within the AI/AN context as a "unique individual experience associated with a traumatic event or enduring conditions, which can involve an actual death or other loss, serious injury, or threat to a child's well-being, often related to the cultural trauma, historical trauma, and intergenerational trauma that has accumulated in AI/AN communities through centuries of exposure to racism, warfare, violence, and catastrophic disease [9]."

Several distinct forms of trauma have been identified in Indian Country, including cultural trauma, historical trauma, intergenerational trauma, and current trauma. Trauma experiences are significant and prevalent in the lives of AI/AN youth. For example, compared to their non- Indian peers, AI/AN children are 2.5 times more likely to experience trauma [10]. AI/AN children experience a rate of child abuse and neglect of 11.4 per 1,000 children, compared to the rate for all children of 9.1 per 1,000 [11]. Violence is more likely to be reported among AI/AN families, both as an element of abuse and/or neglect and in general. Repeated exposure to trauma results in the impaired ability to have positive relationships, communicate well, and demonstrate resiliency skills that have a direct connection to adolescent health behaviors and are emphasized within PREP projects.

Broadly speaking, trauma-informed approaches may recognize the high prevalence of trauma in the target populations that they are serving; assess for traumatic histories and symptoms;

recognize and reject practices that are re-traumatizing; place increased emphasis on the importance of culture; focus on collaboration with caregivers and support systems; address training needs of staff to improve knowledge and sensitivity; ensure that program staff understand the function of coping behaviors; and use objective, neutral language [9].

For example, effective programming that supports mental health, development of coping strategies, and increased protective factors in a youth's life can minimize a young person's risk of problematic behavior and increase his or her capacity to thrive. For more information on Trauma-Informed Care, please see the Promising Youth Programs Trauma-Informed brief: https ://www .acf.hhs.gov/opre/report/incorporating-trauma-informed-care-adolescent-pregnancy-preventionprograms.

In the context of Adolescent Pregnancy Prevention (APP) programs, trauma-informed care is an approach that recognizes trauma’s general impact on participating youth and helps guide programming, so it avoids re-traumatizing youth and facilitates youth engagement in the https://www.acf.hhs.gov/opre/report/incorporating-trauma-informed-care-adolescent-pregnancy-prevention-programs https://www.acf.hhs.gov/opre/report/incorporating-trauma-informed-care-adolescent-pregnancy-prevention-programs https://www.acf.hhs.gov/opre/report/incorporating-trauma-informed-care-adolescent-pregnancy-prevention-programs programming. A trauma-informed approach means that the project takes into account many areas of the program, which may include, but is not limited to, the staff’s approach to youth, the content of the intervention, the delivery or facilitation of the intervention, training for facilitators on how to identify signs of trauma, and the referral and follow-up process for youth who exhibit signs of trauma.

All programs should also create and maintain a “safe space” for youth; i.e., an environment that is welcoming to all youth, inclusive, and non-stigmatizing.

TRIBAL PREP PROJECT PHASES

FYSB recognizes the importance of engaging tribal communities in program planning and implementation that affects AI/AN youth. Therefore, Tribal PREP will have a project period of 5 years, which is divided into the following three phases:

Phase 1: Needs Assessment, Planning, and Capacity Building Phase 1 of the project will begin upon award of the grant and is expected to be completed no later than 9 months, which would be June 30, 2022. Phase 1 activities include the following: (1) assess the needs of the identified target community(ies) in the areas of adolescent pregnancy prevention and youth preparation for adulthood; (2) develop an evaluation and program implementation plan that includes the selection of a culturally appropriate teen pregnancy prevention program; and (3) begin building capacity to respond to identified needs.

The needs assessment must assess:

The quality and capacity of existing adolescent pregnancy prevention programs, if any;

and numbers and characteristics of youth and families who receive services or potentially may receive services;

The extent to which these program models are evidence-based and high-quality, and meet the needs of eligible families; and

The factors that may limit capacity in providing adolescent pregnancy prevention and APS material.

Planning and capacity-building activities during Phase 1 may include the following:

Identifying populations to be served on the basis of the needs assessment;

Building administrative and management capacity for the program (e.g., hiring key staff and locating space);

Strengthening relationships and developing formal agreements with partners and stakeholders;

Selecting evidence-based or effective adolescent pregnancy prevention programs for implementation;

Collaborating with the developers of the selected teen pregnancy prevention program(s) and the community to make culturally and linguistically appropriate adaptations to the programs, if needed;

Establishing formal agreements with developers;

Locating and securing partners (such as local evaluators) to plan for and participate in ongoing research and program evaluation activities.

Developing an implementation plan;

Developing an evaluation plan;

Obtaining Institutional Review Board (IRB) approval;

Completing and receiving approval of an evaluation design plan from FYSB; and Hiring and training staff.

Programs will transition from Phase 1 to Phase 2 upon submission and approval of their implementation and evaluation plan. Submission of the implementation plan to FYSB is subject to Office of Management and Budget (OMB) approval under the Paperwork Reduction Act (PRA). (For more information on implementation plans, see Section I. Program Description, Post Award Requirements, Implementation Plan.)

Phase 2: Implementation In Phase 2, June 30, 2022 through the end of the fourth year of the project period, Tribal PREP grantees will implement the various components of their approved Implementation Plans and work closely with FYSB to ensure high-quality services are implemented in their selected tribal communities.

Phase 2 activities include the following:

Building infrastructure to implement effective teen pregnancy prevention programs in the community;

Providing high-quality Tribal PREP projects to AI/AN youth in the community;

Measuring and reporting on progress in meeting benchmarks;

Participating in ongoing performance measurement data collection and program evaluation activities that will result in building the knowledge base around evidence-based teen pregnancy prevention programs for AI/AN populations;

Conducting fidelity monitoring and supervision activities;

Employing participant engagement and retention strategies to maximize attendance;

Conducting retention, tracking, and follow-up activities;

Collecting evaluation data;

Completing required OMB-approved evaluation templates to assist with keeping track of evaluation activities;

Developing and finalizing a sustainability plan;

Completing an implementation report; and Including control/comparison group participants (as applicable), for grantees that choose to conduct a rigorous evaluation study.

Phase 3: Final Year/Year 5 In Phase 3, Tribal PREP will continue implementation of the intervention.

Phase 3 activities include the following:

Provide programming to youth outside of the program evaluation study, if budget permits;

Develop and finalize an analysis plan that supports the analysis of primary and secondary evaluation questions;

Analyze outcome evaluation data Submit and finalize an evaluation report; and Conduct sustainability activities.

TRIBAL PREP EVALUATION

Performance Measurement Data and Evaluation Requirements ACF intends to engage in a collaborative learning agenda, to work with Tribal PREP programs to increase understanding of what works and why in Tribal PREP projects. Western teen pregnancy prevention programming remains a relatively new approach in many tribal settings, and may be challenging to adopt where more traditional, culturally based approaches tend to have more credibility. These challenges are further complicated by the lack of practices developed specifically for use with AI/AN populations that have been evaluated with impact designs.

Performance measurement data and evaluation of Tribal PREP projects will add to the evidence-base in the near-term. Additionally, a community-based research approach that involves community participation in the design, conduct, interpretation/analysis, and dissemination of research will be fundamental to the success of evaluation with AI/AN communities.

Activities include performance measure collection and submission and grantee-level evaluation called "local evaluation." Performance measurement is an ongoing data collection activity that examines program operations, progress, and accomplishments, and is often conducted through monitoring. Program evaluation measures and analyzes research questions that examine whether the program is achieving the outcomes it intends to achieve.

PREP Performance Measures All grantees and sub-recipient(s), including their implementation sites, will be required to collect and report information on program implementation and program outcomes through a common set of performance measures. This requirement applies to any community partners who agree to host a site or recruit program participants (e.g., school districts, non-profits). The purpose of the performance measures is to monitor and provide feedback about whether grantees are implementing PREP programs as intended and to demonstrate progress towards expected objectives. Performance measures can also create a foundation for program improvement efforts, prompted by federal, grantee, and program providers’ examination of the data. PREP performance measures provide information based upon the three categories of data collection listed below while rigorous evaluations assess program effectiveness and impact.

PREP performance measures will be distributed to grantees and funded recipients who will be required to collect and report on these measures approximately twice a year. ACF has defined measures at the grantee, provider, and program levels. For some performance measures, grantees provide data about activities they undertake directly at the grantee level. For other measures, data are based on information about each separate provider that serves youth directly (i.e., provider level) or each program model that a provider is implementing (i.e., program level). A program model is defined as the core curriculum plus other lessons or activities that may be integrated with the core curriculum to meet the PREP requirements. In addition, data are also collected from the youth themselves through participant entry and exit surveys. Ultimately, grantees are responsible for submitting performance measures from the grantee, provider, and program levels to ACF.

The following are the three categories of PREP performance measures for data collection and submission:

1. Structure, cost, and support for program implementation;

2. Attendance, reach, and dosage; and

3. Participants’ characteristics, behaviors, program experiences, and perceptions of effects

(through participant entry and exit surveys).

Applicants applying for funds must indicate their agreement to collect the PREP performance measures and submit the data to ACF. Grantees will be expected to check local and state laws, policies, and procedures to ensure that the collection of performance measures data is feasible and obtain any necessary permissions (e.g., formal agreements with partners, IRB approval, copies of school district approvals) to collect these data. Grantees are responsible for ensuring all sub-recipients and implementation sites collect and submit the PREP performance measures.

FYSB will provide training on how to conduct performance measures data collection and reporting. Grantees may develop additional indicators of program performance, as needed, including adding items to the entry or exit surveys. However, all FYSB OMB-approved items must be administered first, in the order presented in the approved survey, before any additional items are added. Any additional survey items should be added at the end of the OMB-approved survey and should not be submitted to ACF.

For more information about the PREP performance measures, including definitions, survey instruments, and data collection tools, please see https://www.prepeval.com/DataCollectionT oolsAndGuidance.html.

Grantees are expected to determine whether local IRB approvals are necessary. Grantees must determine which IRB has jurisdiction over a data collection effort for performance management purposes and whether the IRB requires the grantee to initiate an approval process. If IRB approval is necessary, grantees are expected to follow all IRB review requirements. All programs must ensure confidentiality and the security of the data collected. Failure to collect and report on the full set of OMB-approved performance measures at any time during the grant period may result in loss of continued funding. All programs must indicate their agreement to collect and report performance measures, once FYSB receives OMB approval, by signing the Tribal PREP Assurances Form in Appendix A.

NOTE: Consistent with the Paperwork Reduction Act (PRA) of 1995, (44 U.S.C.3501-3521), under this FOA, ACF will not conduct or sponsor, and a person is not required to respond to, a collection of information covered by such Act, unless it displays a currently valid OMB control number. ACF has obtained OMB approval (OMB Control Number 0970-0497; Expiration Date June 30, 2023) under PRA to request and collect performance measures.

Local Evaluation During Phase 1, programs must design and further develop their capacity to implement a plan for local evaluations to answer one or more grantee-specific evaluation question(s). The purpose of these evaluations is to learn from programs in order to inform and improve current and future programming. Local evaluations must be conducted by an independent evaluator, referred to as https://www.prepeval.com/DataCollectionToolsAndGuidance.html https://www.prepeval.com/DataCollectionToolsAndGuidance.html the "local evaluator." Local evaluations may not be conducted by persons directly involved in the administration of the program or project. Local evaluators may be universities, research organizations, evaluation consultants, or other institutions with experience in conducting rigorous evaluations. Local evaluators, while independent, must demonstrate past experience, and current capacity to work collaboratively and establish respectful relationships, with tribes, tribal organizations, and tribal communities.

Programs must set aside a minimum of 15 percent and a maximum of 20 percent of their annual PREP allocation for a local evaluation. Local evaluations should be descriptive local evaluations. Descriptive local evaluations are evaluations that do not have a control/comparison group.

Tribal PREP programs may only conduct one local evaluation. The evaluation question(s) must drive the local evaluation, including its design, methods, data, and analysis. The evaluation question(s) may focus on the entire Tribal PREP, the programming of one or more implementation sites, or a component(s) of the programming of the Tribal PREP or implementation site program. The evaluation question(s) must relate to the specific programming approach of the Tribal PREP or sub-recipient. Local evaluations must be designed to help inform current and future programming and expand the evidence base.

Although other topics are permissible, examples of evaluation topics include the following:

Populations, e.g., describing the populations reached and whether programming addresses the perceived needs of target populations, including especially tribal youth;

Adaptations, e.g., determining the differential outcomes of programming that adhere to standard curricula versus programming with significant adaptions, especially adaptations to address the needs of tribal youth;

APS, e.g., the impact of adding specific programming related to APS; and Overall program effectiveness.

For example, a program may adapt an evidence-based teen pregnancy prevention program for tribal youth. This program could identify whether participants increase knowledge of cultural understandings of teen pregnancy and whether participants indicate a change in their behaviors in order to prevent teen pregnancy; this would be a descriptive local evaluation. Local evaluations should be descriptive local evaluations. Tribal PREP projects must use their program logic models to identify evaluation questions. (For more information on logic models, see Appendix B.)

Programs and their local evaluators are required to collaborate with ACF to refine, improve, develop, or select assessments, pilot (if possible), and make necessary changes to the evaluation design/methods. ACF approval will be required prior to implementation of a proposed evaluation plan. ACF may review the evaluation funding for each of the evaluation activities and recommend an adjustment to the proposed level of funding. Where necessary, ACF may work with Tribal PREP to adjust the level of funding for evaluation activities based on the final, approved evaluation plan and may redirect funds reserved for local evaluation to programming.

In the event that a local evaluation is not approved, the budget and staff that would have supported the local evaluation will instead be directed toward other approved Tribal PREP activity.

After local evaluation research plans have been approved, Tribal PREP projects are expected to implement robust evaluations lasting throughout the grant period, instrument development (and possibly pre-testing the instruments), including data collection, data analysis, drafting of reports, and multiple dissemination efforts to inform many audiences. The final reported results must be clearly supported by analyses of data, and descriptions of the results must clearly communicate the implications of the study to others in the field. Tribal PREP projects may not undertake evaluative activities with PREP funds outside of what is expressly described in this FOA. ACF will provide technical assistance for all local evaluations, supporting Tribal PREP projects and their local evaluators during evaluation planning, evaluation implementation, analysis, and dissemination, in order to ensure maximum learning from these projects.

During the planning period or afterwards, Tribal PREP projects with a local evaluation will be required to obtain a federal-wide assurance (for more information, see http://www.hhs.gov/ohrp /assurances/assurances/filasurt.html). Afterwards, programs will need to secure tribal leadership approval of their evaluation plan and will need to submit their research projects to an IRB, which could be university-based, tribal-based, or Indian Health Service (IHS) based. Often Tribal PREP use the IRBs of their local evaluators, partner universities, or evaluation organizations to provide oversight. IRBs provide guidance regarding participant privacy and rights. For more information on IRBs and tribal evaluation, please see the Indian Health Service’s website at https://www.ihs.gov/dper/research/hsrp/instreviewboards/. General information about the HHS Protection of Human Subjects regulations can be obtained at https ://www.hhs.gov/ohrp/. States also may contact the Office for Human Research Protections by email at ohrp@hhs.gov, or by phone at (240) 453- 6900.

At the end of evaluations and upon approval by OMB of final report templates, Tribal PREP will be required to submit final reports; and according to data safety and monitoring standards that ACF will distribute, ACF may make aggregated data available to other Tribal PREP grantees and so that others may analyze and learn from the local evaluation data.

Federal Evaluation In addition to local evaluations, the federal government may sponsor federally led evaluations.

The federal evaluations will be conducted by independent contractors. As a condition of acceptance of an award under this FOA, all Tribal PREP that are asked, are required to participate fully in ACF-sponsored evaluations and adhere to all evaluation protocols established by ACF to be carried out by its designee contractors. In the event that a Tribal PREP is selected for a federally led evaluation, the federal government may incorporate the local evaluation into the federally led evaluation, or it may waive the local evaluation requirement. In all cases, Tribal PREP will still be required to collect performance measures.

Consistent with the PRA of 1995, (44 U.S.C. 3501-3521), under this FOA, FYSB will not conduct or sponsor, and a person is not required to respond to, a collection of information covered by such Act, unless it displays a currently valid OMB control number.

POST AWARD REQUIREMENTS

The acceptance of federal funds under this FOA will signify agreement by the grantee that it will comply with the following requirements:

Have Phase 1 project activities operating within at least 45 days and no more than 90-http://www.hhs.gov/ohrp/assurances/assurances/filasurt.html http://www.hhs.gov/ohrp/assurances/assurances/filasurt.html https://www.ihs.gov/dper/research/hsrp/instreviewboards/ https://www.hhs.gov/ohrp/ https://www.hhs.gov/ohrp/ days following the Notice of Award;

Formally train facilitators/educators in the selected evidence-based effective program model or elements of the effective program model by professionals who can provide follow-up technical assistance to facilitators;

Submit program and financial reports in the recommended format (to be provided) in a timely manner to the Federal Project Officer and Grants Management Specialist (as requested);

Budget the costs of sending at least two key staff persons to the 3-day Adolescent Pregnancy Prevention (APP) Program Annual Grantee Conference to be held tentatively in Atlanta, Georgia, or through a virtual platform in 2022, and locations to be determined for annual conferences.

Budget the costs of sending a minimum of two staff persons to attend at least one of two topical training sessions offered each year of the project in areas such as Washington, DC, and other regions of the country, or through a virtual platform, annually.

Collect and report on all of the federal PREP Performance Measures (grantee and partners and sub-recipients). PREP Performance Measures are currently approved under OMB # is 0970-0497, expiration date June 30, 2023;

Participate in evaluation activities, to include ACF contracted technical assistance for local evaluations that relate to this FOA;

Participate in a grantee orientation webinar to be held shortly after the official award date;

Submit all program and training materials to FYSB for medical accuracy review and complete recommended revisions; and

Other requirements as noted in this FOA or the award terms and conditions.

Partnerships During Phase 1 of the project, Tribal PREP must build and sustain meaningful partnerships with agencies or organizations at the tribal, state, or local level that address the various and complex needs of AI/AN youth. Efforts may include partnerships with organizations that have experience in providing AI/AN youth with effective teen pregnancy prevention educational services, and plans to mitigate risk factors that lead to teen pregnancy and challenges to transition to adulthood among AI/AN youth. One opportunity may be developing relationships with state agencies receiving PREP funding. States that accept funding are required to develop state plans that addressed how they will target AI/AN youth in their identified service areas.

Tribal PREP are encouraged to identify the agency within their state that is receiving state PREP funding in order to further develop or build a partnership. A list of agencies that accepted 2020 state PREP funding is available on the FYSB website at https://www.acf.hhs.gov /fysb /grant-funding/fy2020-state-personal-responsibility-education-program-awards. Tribal PREP are encouraged to build partnerships with organizations that use a trauma-informed approach in services for AI/AN youth.

Subawards

Recipients under this grant program may opt to transfer a portion of substantive programmatic work to other organizations through subaward(s). The prime recipient must maintain a substantive role in the project. ACF defines a substantive role as conducting activities and/or https://www.acf.hhs.gov/fysb/grant-funding/fy2020-state-personal-responsibility-education-program-awards https://www.acf.hhs.gov/fysb/grant-funding/fy2020-state-personal-responsibility-education-program-awards providing services funded under the award that are necessary and integral to the completion of the project.

Subrecipient monitoring activities alone as specified in 45 CFR § 75.352 do not constitute a substantive role. Furthermore, ACF does not fund awards where the role of the applicant is primarily to serve as a conduit for passing funds to other organizations unless that arrangement is authorized by statute. Subrecipient(s) must meet the eligibility requirements identified in the FOA, Section III.1. Eligible Applicants. Additionally, all subrecipient(s) must obtain a Data Universal Numbering System (DUNS) number, or after government-wide implementation, a Unique Entity Identifier assigned by the System for Award Management (SAM), if they do not already have one. Prime recipients are required to check the SAM to verify that the subrecipient(s) is/are not debarred, suspended, or ineligible.

Please reference the Award Term and Condition on Subawards on the ACF Administrative and National Policy Requirements website for further requirements involving subawards.

Implementation Plan Tribal PREP grantees will use the information gathered during Phase 1 to complete an OMB-approved implementation plan that is reasonable and responds to the needs identified among the target population(s). Once FYSB has received OMB approval, FYSB will develop the template for the implementation plan and share it with grantees in the Orientation Webinar, which will be held shortly after the official award date.

The Implementation Plan will include specific information on how grantees will meet all Tribal PREP Project Requirements, as outlined in Section I. Program Description, Tribal PREP Program Overview, Tribal PREP Program Design, in the implementation of their proposed programs.

As a component of the implementation plan to be submitted no later than June 30, 2022, ACF will require that a final evaluation design and budget be drafted and submitted (some programs may be excused from this requirement). The final evaluation design and budget must demonstrate how the program will use evaluation findings to improve programming for tribal youth.

Once FYSB receives OMB approval, grantees will submit their implementation plan to FYSB for review and feedback no later than June 30, 2022. Grantees will receive feedback on their proposed implementation plan from FYSB within 30 days of submission. Grantees may be asked to make revisions to their plans and may receive technical assistance to incorporate the recommendations of FYSB. Grantees whose initial implementation plans are not approved will be required to submit a revised plan incorporating FYSB's recommendations in order to proceed with program implementation.

Pending final approval of their implementation plan and a non-competing continuation application required of all discretionary grantees, funds will be provided for Year 2 of the Tribal

PREP.

COVID-19 Response If, during the project period, FYSB and/or grantees are required to adjust program and/or grant requirements due to COVID-19 or other emergency, FYSB will exercise maximum flexibilities, as needed. Requirements may be conducted virtually or timelines may be modified, in https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements consultation with FYSB.

DEFINITIONS AND EXPLANATIONS OF TERMS

For purposes of this FOA, the following definitions are applicable:

Activities - All the actions needed to prepare for and carry out the project that is proposed. This includes program and financial management, intervention activities, partnership activities, hiring and training, evaluation, and…