NOFO AH-TP2-23-002.pdf

U.S. Department of Health and Human Services

Office of Population Affairs

Notice of Funding Opportunity: Teen Pregnancy Prevention Tier 2 Adolescent Sexual Health Innovation Hubs

Opportunity Number: AH-TP2-23-002

Application Due Date:

06/13/2023 at 6:00 PM Eastern

OVERVIEW

FEDERAL AGENCY NAME

The Office of the Assistant Secretary for Health, Office of Population Affairs

FUNDING OPPORTUNITY TITLE

Teen Pregnancy Prevention Tier 2 Adolescent Sexual Health Innovation Hubs

ACTION

Notice

ANNOUNCEMENT TYPE

Initial CA (Cooperative Agreement)

FUNDING OPPORTUNITY NUMBER

AH-TP2-23-002

ASSISTANCE LISTING NUMBER AND PROGRAM:

93.297 , Teen Pregnancy Prevention Program

DATES

Application Deadline: 06/13/2023 by 6:00 PM Eastern.

Technical Assistance Webinar: 04/24/2023 at 6:00 PM Eastern.

EXECUTIVE SUMMARY

The Office of Population Affairs announces the availability of funds for Fiscal Year (FY) 2023 under the authority of Division H, Title II of the Consolidated Appropriations Act, 2023 (Public Law No. 117-328).

This notice solicits applications for Teen Pregnancy Prevention (TPP) Program Tier 2 Adolescent Sexual Health Innovation Hubs (Hubs). The Office of Population Affairs (OPA) anticipates making $11,475,000 available each year for a period of performance of up to five years (five 12-month budget periods). The amount of funding an applicant may request ranges from $1,000,000 to $2,000,000 per year.

Hubs are expert intermediaries. They identify and support multiple cohorts of Innovation Development Teams (IDTs) to develop, refine, and test additional models and innovative strategies intended to reduce teen pregnancy, sexually transmitted infections (STIs), or associated risk factors, and promote positive youth development. Each Hub creates and maintains a pipeline (i.e., a defined, rigorous, and dynamic structure) that supports IDTs in advancing innovations through appropriate but progressive developmental phases marked by specific milestones and phase-specific supports. Hubs take the form of one of the following pipeline structures:

Incubator: Incubators support multiple cohorts of IDTs in discovery, exploring gaps and user needs, and building ideas through to prototype using participatory methods. By the end of their time with the Incubator, IDTs with promising prototypes should be prepared to transition to an Accelerator program. (Anticipated: 2-3 recipients)

Accelerator: Accelerators support multiple cohorts of IDTs with existing prototypes that demonstrate feasibility, appropriateness, and desirability, to rigorously test, refine, and prepare for future impact evaluation, dissemination, and/or the next stage appropriate to the specific innovation or innovative practice. External IDTs (i.e., IDTs that did not participate in OPA-funded Incubators) may also be selected by Accelerators.

(Anticipated: 2-3 recipients)

Hybrid: Hybrid projects support multiple cohorts of IDTs as a combined version of the Incubator and Accelerator models. Applicants who apply as Hybrids must make the case for why this model is likely to be more effective and efficient, but no less phased, dynamic, and equity-focused. (Anticipated: 1 recipient)

An organization may submit applications for multiple projects, but only one application will be funded for any organization.

The Office of the Assistant Secretary for Health (OASH) encourages all applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that their applications comply with all requirements and instructions.

Table of Contents

OVERVIEW

FEDERAL AGENCY NAME

FUNDING OPPORTUNITY TITLE

ACTION

ANNOUNCEMENT TYPE

FUNDING OPPORTUNITY NUMBER

ASSISTANCE LISTING NUMBER AND PROGRAM:

DATES

EXECUTIVE SUMMARY

A. Program Description

1. Background

2. Expectations for Funded Projects

3. Federal Agency Substantial Involvement

B. FEDERAL AWARD INFORMATION

1. Legal Authority

2. Award Information

3. Federal Agency Substantial Involvement

C. ELIGIBILITY INFORMATION

1. Eligible Applicants

2. Cost Sharing or Matching

3. Other - Application Responsiveness Criteria

4. Application Disqualification Criteria

D. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package

2. Content and Form of Application Submission

3. Application Content

4. Unique Entity Identifier and System for Award Management (SAM)

5. Submission Dates and Times

6. Intergovernmental Review

7. Funding Restrictions

8. Other Submission Requirements

E. APPLICATION REVIEW INFORMATION

1. Criteria

2. Review and Selection Process

3. Review of Risk Posed by Applicant

4. Final Award Decisions, Anticipated Announcement, and Federal Award Dates

F. FEDERAL AWARD ADMINISTRATION INFORMATION

1. Federal Award Notices

2. Administrative and National Policy Requirements

3. Program Specific Terms and Conditions

4. Closeout of Award

5. Lobbying Prohibitions

6. Non-Discrimination Requirements

7. Smoke- and Tobacco-free Workplace

8. Acknowledgement of Funding

9. HHS Rights to Materials and Data

10. Trafficking in Persons

11. Efficient Spending

12. Whistleblower Protection

13. Health Information Technology (IT) Interoperability

14. Prohibition on certain telecommunications and video surveillance services or equipment. 54

15. Human Subjects Protection

16. Research Integrity

17. Reporting

G. CONTACTS

1. Administrative and Budgetary Requirements

2. Program Requirements

3. Electronic Submission Requirements

H. OTHER INFORMATION

1. Awards under this Announcement

2. Application Elements

I. SUPPLEMENTARY MATERIALS

1. Acronyms

2. Considerations in Recipient Plans for Oversight of Federal Funds

3. Financial Assistance General Certifications and Representations

4. Hub-Appropriate Evaluation Activities

5. Figures

6. TPP Authorizing Language

7. Performance Measures

8. Templates

9. Resources

10. Glossary

11. References

A. Program Description The Office of Population Affairs announces the availability of funds for Fiscal Year (FY) 2023 under the authority of Division H, Title II of the Consolidated Appropriations Act, 2023 (Public Law No. 117-328).

OASH works to advance health equity, especially for those who have suffered historic disparities. In support of this vision, OPA promotes health across the reproductive lifespan through innovative, evidence-based sexual and reproductive health and family planning programs, services, strategic partnerships, evaluation, and research.

Our Teen Pregnancy Prevention (TPP) Program is a national, evidence-based program that funds diverse organizations working to reach adolescents to improve sexual and reproductive health outcomes and promote positive youth development. It strives to provide adolescents with “the support, confidence and resources to thrive, be healthy, and realize their full potential” (Ross et al., 2020). The TPP Program invests in the scaled implementation of effective programs (i.e., TPP Tier 1) and provides funding to develop, refine, and test additional models and innovative strategies to prevent unintended teen pregnancy, sexually transmitted infections (STIs), behavioral risk factors underlying teen pregnancy, or other associated risk factors (such as, but not limited to, initiation of sexual activity, frequency of sexual activity, number of sexual partners, contraceptive use, substance use, intimate partner violence), and promote positive youth development (i.e., TPP Tier 2).

Under TPP, innovation reflects a broad spectrum of new or adapted products, programming, strategies, approaches, interventions, policies, and practices. We further differentiate innovations by their pathway to future scaled delivery. Some eventually become evidence-based TPP approaches or programs, i.e., EBPs, which we describe in the TPP Tier 1 funding opportunity, are “those programs that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors.” Others are designed as innovative practices that youth-serving organizations (e.g., TPP Tier 1 recipients) may employ as part of their holistic approach to improve sexual and reproductive health outcomes, promote positive youth development, and advance health equity for adolescents, their family, and communities. These would not be considered EBPs according to the current Tier 1 definition.

Refer to Figure I (Section I.5) to see how TPP Tiers 1 and 2 projects feed into one another as part of a broader innovation-to-scale continuum.

https://www.grants.gov/web/grants/view-opportunity.html?oppId=342710

1. Background

Hubs are intermediaries. They are not themselves designing or testing innovations intended to promote positive youth development or reduce teen pregnancy, STIs, or associated risk factors.

Instead, Hubs identify and support multiple cohorts of Innovation Development Teams (IDTs) that generate and test their own unique innovations. A Hub may select an IDT that includes Hub staff, but this should be the exception rather than the norm. This NOFO aims to support an expansive and growing community of innovators, and not just one existing organization or network.

As intermediaries, Hubs oversee innovation pipelines and recruit IDTs to generate, test, and refine new or improved approaches that address gaps in the TPP evidence base (Figure I, Section I.5). As an integral part of the innovation-to-scale continuum, IDTs with promising innovations might later apply for rigorous impact evaluations (Tier 2 Rigorous Impact Evaluations) and eventually be scaled in communities across the country (Tier 1). Pipelines should be defined, rigorous, and dynamic structures that support IDTs in advancing innovations through appropriate but progressive developmental phases marked by specific milestones and phase-specific supports. Pipeline phases should be theory-driven and align with the specific hub type, as defined below: Incubator, Accelerator, or Hybrid (Figure II, Section I.5). We envision Hubs will play a critical role in enriching the broader TPP continuum (Section I.5) and advancing the missions of OASH and OPA. Refer to our logic model (Section I.5) for a complete overview of anticipated short and longer term outcomes.

This new cohort of Hubs should lead a dynamic, phased, and equity-focused design process with and for young people. What does that mean?

Dynamic. Each Hub should support multiple, staggered cohorts of IDTs. As a result, there should be opportunities for IDTs to move back and forth between hub types (i.e., Incubators and Accelerators) over the course of the period of performance depending on their needs, the promise of their innovations, and Hubs’ IDT selection process. For example, an IDT may complete its Incubator sprint with a promising prototype and could then be ready to participate in an Accelerator. Alternatively, an Accelerator's IDT with promising exploratory research but a prototype that does not resonate with its core audience may consider returning to the ideation and building phase with an Incubator without changing its focus area and, in the process, apply critical new knowledge from its first attempts in learning, or fails.

Another way Hubs are dynamic is in their deep connection and responsiveness to the greater adolescent health community. Hubs should establish partnerships and feedback loops with the field, which should include but not be limited to other OPA recipients – such as other Hubs, TPP Tier 1 implementation projects, and Title X Family Planning service sites - in order to ensure that the innovations explored best meet emergent needs.

Phased. Historically, TPP innovators have excelled in exploratory research, idea generation, prototyping, and early user testing. Greater investment in later stage innovation work (i.e., testing, refining, packaging, advancing and sustaining innovations, and preparing for impact https://opa.hhs.gov/grant-programs/teen-pregnancy-prevention-program-tpp/tpp-grantees/current-tpp-grantees https://opa.hhs.gov/grant-programs/title-x-service-grants/current-title-x-service-grantees evaluation) is necessary to enable more promising prototypes to move through to impact evaluation and/or eventual large-scale implementation. This is why we are funding a phased approach. We believe that by requiring Hubs to specialize as either Incubators or Accelerators, Hubs may better support IDTs in moving along the continuum and meeting important performance milestones and standards along the way. Therefore, we prefer Incubators and Accelerators operate as separate entities with stage-appropriate staffing expertise, timelines, innovation strategies, performance metrics, incentives, and capacity-building approaches.

Equity-Focused. Hubs should prioritize IDTs that are inclusive of individuals with lived experience and diverse backgrounds – especially young people. Teams should strive to generate innovations that enhance individual skills or competencies, or re-imagine systems, policies, and environments, to address health inequities. Hubs should ensure that innovations are age appropriate, medically accurate, culturally and linguistically appropriate, trauma-informed, and inclusive. IDTs should be well-situated to understand the complex root causes and structural inequities that contribute to health disparities (Section I.9). Design methods should be participatory, and power imbalances acknowledged and addressed.

Advancing health equity in TPP will require sustained, multipronged, multi-level interventions and strategies that are both innovative and evidence-based. By generating innovations and data to support new approaches for health promotion, Hubs will foster a broader, more inclusive evidence base for implementation recipients (Tier 1) to pull from (e.g., evidence-based approaches or EBPs) as well as more dynamic and equitable innovative practices, will strengthen partnerships and information sharing across grant programs, and may even advance a more expansive understanding of evidence standards (e.g., expand the evidence on interventions at various social ecological levels).

Hubs are experts in innovation science and process. They should not limit themselves and all their IDTs to only one priority area (e.g., justice-involved youth). However, their IDTs can and should individually specialize based on team member expertise and/or lived experience (e.g., one team might focus on exploring innovations for advancing foster youth health). The innovation process itself helps determine the appropriate direction of the resulting innovation(s). Hubs should therefore cultivate structures and supports that enable IDTs to develop, test, and package innovations at the appropriate social ecological levels (i.e., individual, interpersonal, system, environmental, policy) and for diverse users, as discovery warrants. Together, these features should help address significant gaps in the evidence base without limiting creativity, and promote a better understanding of the evidence necessary to assess ecologically-diverse innovations.

Hubs should take the form of one of the following pipeline structures:

Incubator: Supports multiple cohorts of IDTs in discovery, exploring gaps and user needs, and building ideas through to prototype using participatory methods. By the end of their time with the Incubator, IDTs with promising prototypes should be prepared to transition to an Accelerator program. (Anticipated: 2-3 awards)

Accelerator: Supports multiple cohorts of IDTs with existing prototypes that demonstrate feasibility, appropriateness, and desirability, to rigorously test, refine, and prepare for future impact evaluation, dissemination, and/or the next stage appropriate to the specific innovation or innovative practice. (Anticipated: 2-3 awards)

Hybrid: Will support multiple cohorts of IDTs as a joint version of the Incubator and Accelerator models. (Anticipated: 1 recipient)

An organization may submit applications for multiple projects, but only one application will be funded per organization.

a. Innovation Definition

Innovation refers to “the ability to generate and execute new ideas—incremental, evolutionary, or revolutionary—and it starts with creativity. Creativity is the ability to look past the obvious— to transcend traditional ways of seeing the world to create something new.” (IDEO, 2022) We uphold participatory co-design as an essential component of innovation.

For the TPP Program, innovation reflects a broad spectrum of new or adapted products, programming, strategies, approaches, interventions, policies, and practices that aim to prevent unintended teen pregnancy, prevent STIs among adolescents, and promote positive youth development. On the TPP Continuum (Section I.5), we further differentiate innovations by their pathway to future scaled delivery. Both types are equally valuable, and we intend to cultivate a diverse array of innovation projects.

1. Innovations Intended for the Evidence Base

Many innovators cultivate innovations with the goal of eventually conducting impact evaluations to demonstrate effectiveness in reducing unintended teen pregnancy, STIs, or associated risk factors. These innovations are positioned to eventually become EBPs, defined as “those programs that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors.” For more information about our approach to evidence-based programs, refer to: (1) TPP Tier 1 NOFO, (2) TPP Tier 2 Rigorous Impact Evaluation NOFO, and (3) the TPP Evidence Review website for current rigorous study quality standards.

2. Innovative Practices

Other innovators cultivate innovative practices or findings that youth-serving organizations (e.g., TPP Tier 1 recipients) may employ and scale as part of their holistic approach to improve sexual and reproductive health outcomes, promote positive youth development, and advance health equity for adolescents, their families, and communities.

These may not qualify as the project's EBP(s) under current Tier 1 NOFO standards, but could fit well under other project expectations (e.g., connect to network of adolescent-friendly supportive services, engage youth, ensure equitable environments).

Evidence standards evolve over time; therefore, so should definitions of innovation types and pathways. In 2022, the TPP Evidence Review (TPPER) announced a new protocol for https://www.grants.gov/web/grants/view-opportunity.html?oppId=342710 https://www.grants.gov/web/grants/view-opportunity.html?oppId=342732 https://www.grants.gov/web/grants/view-opportunity.html?oppId=342732 https://tppevidencereview.youth.gov/ https://tppevidencereview.youth.gov/pdfs/TPPER-Review-Protocol-Version-6.0.pdf identifying programs that impact teen pregnancy, STIs, and associated risk behaviors. The updated evidence review outlining qualifying programs shall likely launch in 2023. It is possible that future evidence standards may account more holistically for components of evidence-based programs, as well as programs overall. We will continue to work closely with innovators in developing the best framing, evaluation types, and pathways to scale for the unique innovation type. Finally, we expect our innovators will continue to shape and expand the field’s thinking on evidence and the future of evidence-based practice in TPP. Refer to the Glossary (Section I.9) for detailed definitions of other key innovation terms and the Innovation Resources Library (Section I.8).

b. Innovation Strategy

We live in an adaptive, dynamic, and fast-changing world. No challenge or opportunity is static.

No solution or evidence of positive impact offers a permanent fix. Needs change, as do our environment and the complex factors, including social determinants, which impact adolescent health. Consider the speed at which technology has evolved in the past twenty years, before or during the period when many older TPP Programs first emerged. Consider the fast-evolving federal and state policy landscape. Consider pharmaceutical and pharmaceutical policy change.

Finally, consider the detrimental community impact as well as the forced innovation resulting from the COVID-19 pandemic. Just as adolescents are adaptive, resilient, and creative, so too must we be if we want to meet the challenge before us and ensure adolescents can thrive. This is why TPP invests in innovation.

We innovate to identify and fill gaps in the evidence base that determines which programs and approaches Tier 1 recipients can implement to scale with hundreds of thousands of young people across the country. We revisit, adapt, and improve existing evidence-based programs through innovation and user-centered methods. We innovate to generate new evidence for what should qualify as TPP programming (e.g., expanding to more ecological levels beyond the individual), who can benefit from TPP programming (e.g., populations), and how we define and measure success. We also innovate to ensure that more and more health interventions are co-designed by the communities they serve (Blank, 2013). We all innovate.

Dedicated innovation funding, such as TPP Tier 2 funding, allows us to not just hope that innovation occurs, but to create the structures, supports, and culture that drive it forward with intentionality and speed. For example, without funding and appropriate metrics for early and middle stage innovation, many projects jump immediately to building a solution, without spending adequate time to make sure they thoroughly understand the problem itself. Further, without middle stage support, many innovators struggle to secure impact evaluation funding because they have not yet generated sufficient early evidence to demonstrate prototype desirability, feasibility, and viability.

Some underappreciated facilitators of successful innovation include strategy (Almquist et al., 2013), rigor, and discipline:

Innovative cultures are generally depicted as pretty fun. They’re characterized by a tolerance for failure and a willingness to experiment. They’re seen as being psychologically safe, highly collaborative, and nonhierarchical. Research suggests that these behaviors translate into better innovative performance. But despite the fact that innovative cultures are desirable, and that most leaders claim to understand what they entail, they are hard to create and sustain. That’s because the easy-to-like behaviors that get so much attention are only one side of the coin. They must be counterbalanced by some tougher and frankly less fun behaviors: an intolerance for incompetence, rigorous discipline, brutal candor, a high level of individual accountability, and strong leadership.

Unless the tensions created by this paradox are carefully managed, attempts to create an innovative culture will fail. (Pisano, 2020)

Given the role of intentionality and strategy in innovation, what is the best organizational structure for driving successful projects? There are no conclusive answers. We have explored different approaches. However, there is a significant body of research that suggests team cohorts, iterative processes, clear phases with decision points for determining whether an innovation should move to the next stage, intensive supports, networking, and stage-specific metrics and goals executed over short time periods – such as through Incubators and Accelerators – create the conditions for success. We have not outlined in detail a full literature survey here. Successful applicants will have instead demonstrated in their application their own knowledge, assessment, and application of such models. The basics, though, are that Incubators help teams explore and prototype, while Accelerators help those with existing prototypes conduct rigorous testing/evaluation, refinement, and packaging with the goal of preparing them for impact evaluation and/or scaling.

There is more than one way to define an Incubator and an Accelerator, with significant variations in defined scope and purpose occurring across sectors (Lall, 2013). For purposes of this NOFO, the stated expectations in Section A.2 serve as a guide for recipients of awards.

c. Innovation in TPP

The TPP Program has funded a diversity of innovation projects over the past twelve years. We explored various approaches to both (1) generate new and innovative approaches, interventions, and programs to reduce teen pregnancy and improve adolescent sexual health, and (2) rigorously evaluate such programs. See TPP authority (Section I.6) and TPP grant history (Section I.9).

1. Development and Testing

Between 2015 and 2023, 15 TPP innovation intermediaries produced over 100 unique innovations. OPA-supported innovators have produced incremental or evolutionary innovations (IDEO) ranging from adaptations of existing TPP programs to entirely new interventions, systems reform, or technology in service of improving adolescent health.

Many of these showed early promise, but few successfully received next stage funding for impact evaluation. This means many innovations already exist that may benefit from more intensive testing and preparation for evaluation, dissemination, and scaling.

2. Impact Evaluation

We have also funded over 40 TPP impact evaluations to inform and expand the TPP evidence base. To date, the HHS Teen Pregnancy Prevention Evidence Review (TPPER) has identified 48 total TPP programs with evidence of effectiveness. The most recent cohort of completed TPP impact evaluations (2015-2020) expanded the diversity of evidence-based offerings. They produced new research on diverse types of innovative practices (e.g., using technology to deliver information, joint family programming) or specific populations and settings (e.g., LGBTQI+ students, rural areas). However, there continue to be significant gaps in the evidence base, which underscores the necessity of ongoing innovation along the TPP continuum (Section I.5).

All prior innovation grant cohorts are viewable on the OPA website.

2. Expectations for Funded Projects

Award recipients under this announcement should meet each of the following expectations in the execution of their funded project.

a. Attain planning period milestones

During the first 6-12 months of the award, we expect recipients to engage in an intensive planning period in collaboration with their Project Officer, OPA technical assistance (TA) liaisons, and each other. The duration of the planning period depends on each recipient’s demonstrated progress, but it should not exceed 12 months. The planning period is the time in which recipients check assumptions made in their application, refine their strategies and documents, and prepare for full launch of their Hub including welcoming their first IDT cohort.

We expect recipients to achieve the following planning period milestones:

Demonstrate organizational readiness to implement the project through staffing, training, and development of clear project management processes and protocols;

Convene with the Hub Community (e.g., participate in orientation) to share and workshop a Hub Community coordination structure, project-specific metrics, prototype measures of promise, deliverables, timelines, and optimal structures to facilitate dynamic movement between cohorts (e.g., collaborating on recruitment strategies to allow some Incubator IDTs to be selected for Accelerators, as appropriate, and vice versa);

Revise and obtain approval on the Innovation Strategy and its components;

Develop and obtain approval on its plans to assess IDT innovation capacity;

Create and test necessary project-specific measures, monitoring tools, and processes for monitoring and improving the project (including collection of OPA performance measures);

Finalize agreements with subject matter experts and other organizations external to the organization; and

Research and obtain, if needed, Institutional Review Board (IRB) approval(s) or a determination that project is exempt from IRB review.

https://tppevidencereview.youth.gov/FindAProgram.aspx https://opa.hhs.gov/TPPTier2BEvaluation https://opa.hhs.gov/TPPTier2BEvaluation https://opa.hhs.gov/grant-programs/funding/previous-funding-opportunities

Failure of a recipient to make satisfactory progress toward completion of planning period milestones within the 12-month planning period may impact continuation funding decisions.

b. Execute a clear vision to inspire health equity breakthroughs

We expect recipients to demonstrate a clear, enthusiastic, and compelling vision for why and how they will disrupt existing teen pregnancy prevention practice and generate innovation.

Recipients should aim to expand what is possible for improving sexual and reproductive health outcomes, promoting positive youth development, and advancing health equity for adolescents, their family, and communities. Recipients should use positive, empowering language and framing around adolescence and adolescent sexual health and well-being. Recipients see the power and possibility in this program’s dynamic, phased and equity-focused approach – and have a clear vision for how to put it into practice.

Hubs should identify and define their own core values that will enable them to foster innovation and advance meaningful breakthroughs in health equity. Values should clearly align with this NOFO's expectations and vision. Hubs should readily communicate these values and vision internally (to staff and IDTs) and externally. Hubs should create management and collaboration processes in alignment with these values. We expect Innovation Hubs to uphold psychological safety and creative risk taking, maintain team transparency and open communication, practice innovation discipline but provide grace and flexibility to people, and acknowledge and address inherent power dynamics within this funding structure. Hubs should value learning from failure, foster collaboration in place of competition across its teams and people, embrace positivity, create situations where stakeholders are treated as peer collaborators, identify opportunities to balance power and remove barriers that prevent equitable participation and instill empathetic user research and participatory co-design as core components of all innovation stages.

In support of this expectation, Hubs should develop and communicate a compelling values-centric Vision Statement. This could take the form of a typical Vision / Mission, North Star / Guiding Star, Outcomes / Impact, or similar structure. Under this vision, Hubs should define project success and establish a Logic Model, or similar graphic illustration, charting the relationship between the project’s resources, activities, and its intended outputs/outcomes in service of its vision.

As part of its overarching approach, Hubs should operationalize a connective role in the dynamic TPP continuum. Hubs should tap into a deep familiarity, connection, and responsiveness to past and present OPA-funded adolescent and sexual health projects (TPP Tier 1, TPP Tier 2, Title X Family Planning, TPP and Title X evaluation demonstration projects), the TPP Evidence Review (TPPER), and the broader adolescent health and sexual health fields. Hubs should demonstrate their environmental understanding with a living Stakeholder Map. Hubs should establish partnerships and feedback loops with the field – including other OPA-funded recipients - to ensure that innovations align with existing or emergent needs. Under at least two of the expectations in its work plan, the Hub should incorporate strategies that intentionally involve TPP Tier 1 implementation and/or Title X Family Planning projects in mutually beneficial ways.

For example, Hubs might partner with TPP or Title X projects to: identify new IDT members, host ideation or concept sessions, test prototypes, solicit input, and/or disseminate findings.

Additionally, Hubs should be in regular communication and coordination with each other to advance their vision and a collective impact on the field.

c. Implement theory-driven incubator and/or accelerator structure to facilitate team-based innovations

Each hub should document its specific approach in an overarching Innovation Strategy document. This strategy should incorporate all necessary elements specific to the Incubator/Accelerator/Hybrid model. The Innovation Strategy should cover: theoretical grounding and methods, cohort timelines, process visual, definition of success, overview of IDT approach, and IDT recruitment processes. To ensure diverse participation, the strategy should include IDT selection criteria, recruitment and selection procedures, initial definition proposed for promising innovation(s), IDT capacity-building and evaluation support activities, and IDT awarding and agreement procedures. Hubs should weave equity principles throughout all phases and strategies.

1. Teams

Hubs should have a defined team recuitment approach but be flexible throughout the period of performance based on monitoring and improvement findings. Similarly-sized innovators often have success with annual cohorts of multiple teams (between 5-10 IDTs) within each cohort.

Teams foster creativity, learning, and growth. Such teams work best when small, or about 3-5 persons per IDT. Hubs may when necessary provide reasonable incentives for IDT member participation in their pipeline, or to recruit and engage users for an IDT.

Hubs may have a competitive IDT recruitment strategy that employs diverse and equity-focused dissemination and promotion methods. Hubs should conduct recruiting to promote diversity of thought, innovation experience, and personal experience within and across teams. Hubs should consider recruitment of individuals representing historically underserved populations and individuals with relevant lived experience, including young people, to work on challenges or explore ideas relevant to their communities. We expect Hubs to recruit nationally, and not limit themselves by geographic location. Hubs will foster opportunities for IDTs to move back and forth between Hub types over the course of the performance period depending on IDT needs, the promise of their innovations/prototypes, and Hubs’ IDT selection criteria. Hubs should not pre-select IDTs prior to award and their planning period.

Hubs should employ creative methods to foster a more accessible, dynamic, and equitable selection process. For example, Hubs may facilitate more diverse IDT participation by: providing TA during the selection process, allowing video submissions or interviews instead of written submission, allowing for interviews, and conducting live feedback sessions to support all candidates regardless of whether they are successful. Hubs should capture enough information through the selection and on-boarding process to know if IDT members and/or their prototypes were previously involved with any OPA innovation funding (e.g., TPP20 Innovation Networks, TPP15 2A, another Hub). Hubs should take steps to ensure that selectees do not enter with preconceived ideas or solutions they are not willing to let go regardless of user research and formative findings. Hubs should recruit and support IDTs that aim to address gaps in the relevant evidence. We expect Hubs to be open to new IDTs as well as IDTs applying from other Hubs or past OPA innovation grants (e.g., Innovation Networks, 2A Innovation Accelerators, even TPP Tier 1 projects). We do not require Accelerators accept IDTs emerging from Incubator sprints into their Accelerator cohort, or vice versa.

2. Intermediary Type

As intermediaries, Hubs should align with one of the following structure types:

Incubator

Incubators should support multiple cohorts of IDTs in discovery, exploring gaps and user needs, and building ideas through to prototype using participatory co-design methods. By the end of their time with the Incubator, IDTs with promising prototypes should be prepared (not necessarily selected) to transition to an Accelerator program. It is also possible some prototypes may show poor fit or feasibility, and not be prepared. Both experiences offer valuable insights for innovation capacity building and learning. While Incubators should define their own phases based on research and organizational practice, they should allow their IDTs to start with exploration of a question or challenge, and not immediately work on solution-finding. For example, Incubator phases may consist of some combination or variation on the following activities: needs assessments, question framing, preliminary ethnographic research (e.g., observation), synthesis, concept generation, prototyping, and early feasibility testing. Incubators should not conduct outcome or impact evaluations. See Section I.4 for appropriate evaluation approaches for Hub types.

Accelerator

Accelerators should support multiple cohorts of IDTs with existing prototypes that demonstrate some promise as they rigorously evaluate, refine, and prepare innovations for future evaluation, dissemination, and/or the next stage as appropriate. What is “promising” should be determined by the Accelerator with our input but should align with theory and accepted scientific discovery processes. Accelerators should communicate to IDT applicants with existing innovation prototypes that they should anticipate ongoing user feedback and should therefore be open to refinement, iteration, and even failing. All IDTs should employ participatory co-design methods. Accelerators define their own phases and specific activities, but evaluation related activities should be summative oriented. See Section I.4 for appropriate evaluation approaches for Hub types.

Hybrid

Hybrid models should support multiple cohorts of IDTs as a combined version of the Incubator and Accelerator models and phases. This option leaves open the possibility of having and testing a one-stop-shop model for advancing IDT innovation development and testing. The Hybrid should still be open to accepting new IDTs to join at the Accelerator phases.

Regardless of Hub type, we expect all recipients to create and maintain a process-oriented visual that documents each IDT's journey through the pipeline. This visual should distinguish clear phases of the early innovation process, including what recipients call these phases, their time-frame, and end product(s) or milestone(s). As part of the approach, we expect Hubs to cultivate processes, culture, environments, and prototypes that are age appropriate, medically accurate, culturally and linguistically appropriate, trauma-informed, and inclusive. Accelerators should institute procedures for ensuring that later-stage innovations are age appropriate, medically accurate, culturally and linguistically appropriate, trauma-informed, and inclusive prior to packaging.

3. IDT Evaluation Support

We expect Hubs to guide and assist IDTs with learning and conducting appropriate evaluation activities related to their individual innovations. All IDTs should establish and refine logic models and/or theories of change to guide and assess their prototypes. As part of the pipeline process and supports, Hubs should work with IDTs to develop definitions of success and measures that align with their approach(es), intervention type/modality, social ecological level, and other unique considerations. Hubs’ IDT evaluation support will differ depending on whether the entity is an Incubator, Accelerator, or Hybrid, and should be innovation stage appropriate.

Regardless, Hub Innovation Strategies should clearly identify evaluation activities and technical assistance (TA) supports as part of their pipeline. The Hub should collect and report on its IDTs measures and findings to OPA as part of regular reporting (Section F.17). We will not fund impact evaluations (e.g., randomized controlled trials) under this initiative. See Section I.4 for appropriate evaluation approaches for Hub types.

4. Focus

Hubs should not focus innovation development on one priority area, unlike in previous Innovation NOFOs from OPA. Instead, Hubs should be open to diverse IDTs that advance the goals of this NOFO around promoting health equity and expanding the evidence base. IDTs can and should specialize according to team member expertise and/or lived experience. Because the innovation process itself helps determine the appropriate direction of the resulting innovation(s), Innovation Hubs should cultivate structures and supports that enable IDTs to develop, test, and package innovations at appropriate social ecological levels (i.e., individual, interpersonal, system, environmental, policy) and for diverse end-users (e.g., youth, caregivers, youth-serving professionals, youth-serving systems).

d. Advance multiple team cohorts through the Hub using intensive innovation capacity-building process(es)

We expect Hubs to identify and provide appropriate supports for IDTs at each stage of the innovation journey through intensive capacity and skill-building. Hubs should identify anticipated supports as well as have a clear process for assessing and filling gaps in supports.

They should be flexible and tailored to IDT needs. Hubs can use a variety of capacity-building approaches including: mentors, coaches, stage-specific method toolkits, assessments, templates, peer or cohort-based learnings, trainings, and others. Hubs may also incorporate subject matter experts (SME) throughout the course of the project to meet evolving IDT needs. Hubs with external SMEs or trainers should establish appropriate agreements delineating concrete tasks and expectations consistent with the values and equity considerations expected of IDTs and Hub staff.

We expect Hub’s IDT capacity-building to address diverse topics that best meet the needs of each team and cohort. For example, Incubators may decide to build IDT capacity around creative confidence, question framing, logic models, pitching ideas, facilitating youth focus groups and soliciting youth input, and early testing methods. Accelerators may decide to build IDT capacity around later stage testing methods (e.g., piloting, preliminary effectiveness), branding and packaging, dissemination, and implementing sustainability efforts to maintain and advance their innovations.

To measure progress in cultivating innovation capacity and inform course corrections, Hubs should adopt, adapt, or create their own Innovation Capacity Assessment Tool for IDTs as part of their cohort on-boarding and off-boarding. Based on their pre- and post-findings, Hubs should make necessary changes to their IDT supports or internal processes to ensure they stay on track for cultivating IDTs skilled in innovation methods and confident in innovation mindsets.

Each Hub will also have access to two training and technical assistance liaisons from OPA. One liaison focuses on evaluation and another on programmatic improvement. Hubs are encouraged to engage the OPA TA liaisons as needed to develop their broader capacity building activities.

OPA TA liaisons will provide overarching support for the Hub itself (e.g., input on the Dissemination Strategy). However, the Innovation Hub is responsible for building IDT capacity and supporting IDT movement through its own Incubator and/or Accelerator pipeline. This is not the responsibility of the two OPA TA liaisons.

e. Learn, curate, and propagate findings

Hubs should commit to intentional learning and dissemination in pursuit of their broader vision.

Dissemination is an ongoing, strategic, and adaptive activity, not an end of project activity.

1. Learning Agenda

The Hub should maintain and continually execute a Hub-level Learning Agenda designed to ask and answer thoughtful questions about the Hub’s unique approach to fostering TPP innovation (e.g., process oriented). The Learning Agenda should include specific: learning questions, learning activities, and anticipated learning products. Learning products might include: media, infographics, videos, webinars, podcasts, learning collaboratives, articles, demo days, etc. geared toward sharing learnings. The Learning Agenda represents both a concrete product and a process/implementation evaluation process, enabling the Hub to continually learn and improve in intentional ways.

2. Dissemination Strategy

Hubs should prioritize disseminating IDT innovations and innovative practices, but should also share emerging stories about the Hub's overall innovation process, formative findings, and failures, as all have potential to advance the field. The dissemination strategy should identify diverse audiences including: potential sustainability or transition partners, other OPA recipients, the public health innovation and social innovation field, the adolescent health field, the reproductive and sexual health field, relevant focus area specific audiences and more. The Dissemination Strategy should use diverse approaches such as: national conferences, peer-reviewed articles, policy memos, one-pagers, infographics, interactive media, and more. In addition, the strategy should outline goals, activities, timelines, and project-specific measures of dissemination success. Hubs should frequently promote innovations showing early promise and not wait until they undergo impact evaluation. Hubs should also have a dynamic virtual presence including on online platforms most relevant to its key stakeholders. Hubs should incorporate and uplift IDTs, community members, and young people as powerful messengers of shared stories.

We will partner with the Hubs on shared dissemination efforts that align with the project, such as submission of content for an innovation showcase, participation with OPA on group presentations, or innovation compilation resources, as appropriate. Hubs should also engage in regular conversation with each other. To improve communication, the recipient should develop a clear, appealing, and values-based branding for the project overall. This identity should enable the Hub to connect with its core users and other stakeholders on a compelling, emotional level.

Your brand should communicate who you are, what you do, what you stand for and why. It should identify core visual and textual expectations.

Finally, we expect Accelerators to host “demo days”, or something similar, at the end of cohort to which they invite external entities or partners to learn more about the concluding IDTs and their projects. Demo days may be done in concert with other Hubs.

By the end of the project, as part of the final report, the recipient should complete a final Innovation Hub Package that documents the overall Hub approach as well as the overall project learnings. We will share detailed guidance in the final year of the project.

f. Monitor and improve

The Hub should conduct rigorous program monitoring using data to understand whether its project is meeting its benchmarks and make ongoing improvements based on findings.

Monitoring should include collecting, analyzing, addressing, and reporting on performance measures. The Hub should collect shared OPA performance measures (pending OMB approval).

Previous OMB-approved performance measures are found in Section I.7. We will share with recipients the final, OMB-approved measures within the first six months of their project. Hubs should also develop their own definition of success for the project and measures that align with its unique approach. Hubs should align measures related to the outputs/outcomes in the Logic Model(s) and the Learning Agenda. We will review and provide feedback on any project specific measures by the end of the Planning Period or during the project, as necessary. Hubs should report on these project-specific measures as part of their regular reporting each reporting period (Section F.17).

g. Manage complex and adaptive innovation project

Project success hinges on the capacity, expertise, culture, and experience of the Hub and its core staff with managing a complex innovation project of this size. Therefore, while Hubs may recruit

IDTs with little to no experience in innovation or diverse teams with no prior experience working together, the Hub itself should demonstrate significant innovation experience. Such experience should include the ongoing capacity, relationships, processes, commitment, and expertise with respect to managing innovation projects in any related field, although public health and sexual health innovation fields are particularly relevant. Recipients should ensure that the project aligns with the primary applicant’s organizational mission and experience.

We expect an experienced team to manage the overall project, with core staff roles and responsibilities clearly defined. Project staff can consist of staff or core partners from more than one organization. The project team should uphold the same vision and values expected of the project overall. Expectations for project staff and IDTs should be clear. The project should have sufficient staff to carry out all objectives thoroughly and expertly. As new needs emerge, we expect the recipient to deliberately identify, recruit, and onboard new staff and/or partners. To support coordination across all project deliverables and activities, the recipient should maintain an annual work plan with clear goals, SMARTIE objectives, and timelines (Section D.3.c.1 and Section I.8).

3. Federal Agency Substantial Involvement

Recipients will receive funding under a cooperative agreement. A cooperative agreement is a form of assistance that allows for substantial involvement by federal agency. Additional details of the substantial involvement for awards made under this NOFO are described in Section B.3.

B. FEDERAL AWARD INFORMATION

1. Legal Authority

Division H, Title II of the Consolidated Appropriations Act, 2023 (Public Law No. 117-328)

2. Award Information

We intend to make funds available for competing CA (Cooperative Agreement) awards.

We will fund awards in annual increments and generally for a period of performance up to 5 year(s), although we may approve shorter periods of performance.