oppCDC-RFA-DP18-1801-cfda93.981-cidCDC-RFA-DP18-1801-instructions.pdf

Centers for Disease Control

National Center for Chronic Disease Prevention and Health Promotion

Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools

CDC-RFA-DP18-1801

Application Due Date: 01/26/2018

Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools

CDC-RFA-DP18-1801

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Required Registrations E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-DP18-1801. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) B. Notice of Funding Opportunity (NOFO) Title:

Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP18-1801

E. Catalog of Federal Domestic Assistance (CFDA) Number:

93.981 F. Dates:

1. Due Date for Letter of Intent (LOI): 12/27/2017 Is a LOI: Recommended but not Required

2. Due Date for Applications: 01/26/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: 12/11/2017 An informational Conference Call will be held December 11, 2017, 3:00PM - 4:00PM Eastern Standard Time.

Conference Call Information Conference Call Number: 1-866-730-1290 Passcode: 42127644

G. Executive Summary:

1. Summary Paragraph:

The Centers for Disease Control and Prevention (CDC) announces the availability of Fiscal Year (FY) 2018 funds to implement CDC-RFA-DP18-1801, Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools. This Notice of Funding Opportunity (NOFO) is limited to state governments, specifically, State Education Agencies (SEAs). Approximately $7 million per https://www.grants.gov https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov year is available. The period of performance is 5 years with a 12-month budget period and an anticipated start date of June 30, 2018. The purpose of this project is to (1) Increase the number of students who consume nutritious food and beverages; (2) Increase the number of students who participate in daily physical education and physical activity; and (3) Increase the number of students who can effectively manage their chronic health conditions.

There are two priority areas SEAs can apply for:

Priority 1: Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Health Conditions in Schools

Priority 2: National Professional Development and Training to Improve Student Health

Priority 1 Strategies Approximately 19 SEAs will be funded to implement Priority 1 and will be responsible for implementing three strategies:

Strategy 1. Infrastructure Development Strategy 2. Professional Development and Training Strategy 3. Technical Assistance SEAs will be expected to implement these strategies using a comprehensive, statewide approach over the 5-year period of performance. While activities are expected to be implemented statewide, each SEA will select between 5 and 10 Local Education Agencies (LEAs) with which to prioritize their work. SEAs should work with the majority of schools within these LEAs at the elementary, middle, and high school levels.

Priority 2 Strategy One SEA will be funded to implement Priority 2 which focuses on building the capacity of Priority 1 SEAs. The recipient will plan, develop and deliver quality professional development and training to Priority 1 SEAs.

The Priority 2 SEA will be responsible for implementing one strategy:

Strategy 1: National Professional Development and Training Applicants seeking funding for Priority 2 must also apply for Priority 1 funding. Priority 2 applicants must compete and successfully be awarded Priority 1 funding in order to also be awarded Priority 2 funding.

a. Eligible Applicants: Limited

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 20 Priority 1: 19 awards Priority 2: 1 award

d. Total Period of Performance Funding: $35,000,000

e. Average One Year Award Amount: $350,000

Priority 1: $350,000 Priority 2: $450,000

f. Number of Years of Award: 5

g. Estimated Award Date: 05/30/2018

h. Cost Sharing and / or Matching Requirements: N Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text Executive Summary The Centers for Disease Control and Prevention (CDC) announces the availability of Fiscal Year (FY) 2018 funds to implement CDC-RFA-DP18-1801, Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools. This Notice of Funding Opportunity (NOFO) is limited to state governments, specifically, State Education Agencies (SEAs). Approximately $7 million per year is available. The period of performance is 5 years with a 12-month budget period and an anticipated start date of June 30, 2018. The purpose of this project is to (1) Increase the number of students who consume nutritious food and beverages; (2) Increase the number of students who participate in daily physical education and physical activity; and (3) Increase the number of students who can effectively manage their chronic health conditions.

There are two priority areas SEAs can apply for:

Priority 1: Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Health Conditions in Schools

Priority 2: National Professional Development and Training to Improve Student Health

Priority 1 Strategies Approximately 19 SEAs will be funded to implement Priority 1 and will be responsible for implementing three strategies:

Strategy 1. Infrastructure Development Strategy 2. Professional Development and Training Strategy 3. Technical Assistance SEAs will be expected to implement these strategies using a comprehensive, statewide approach over the 5-year period of performance. While activities are expected to be implemented statewide, each SEA will select between 5 and 10 Local Education Agencies (LEAs) with which to prioritize their work. SEAs should work with the majority of schools within these LEAs at the elementary, middle, and high school levels.

Priority 2 Strategy One SEA will be funded to implement Priority 2 which focuses on building the capacity of Priority 1 SEAs. The recipient will plan, develop and deliver quality professional development and training to Priority 1 SEAs.

The Priority 2 SEA will be responsible for implementing one strategy:

Strategy 1: National Professional Development and Training Applicants seeking funding for Priority 2 must also apply for Priority 1 funding. Priority 2 applicants must compete and successfully be awarded Priority 1 funding in order to also be awarded Priority 2 funding.

A. Funding Opportunity Description

1. Background

a. Overview Heart disease, cancer, and stroke are leading causes of death among adults in the U.S. These diseases are influenced, in part, by dietary and physical activity behaviors. Children and adolescents establish patterns of behavior and make lifestyle choices early in life that can affect their health throughout adulthood. Some children and adolescents have difficulty adopting behaviors that could decrease their risk of developing a chronic health condition in the future such as consuming healthy food and beverages and engaging in physical activity. Others may already struggle with a chronic health condition such as poor oral health, asthma, food allergies, seizure disorders, diabetes and other diseases, disabilities or conditions. Health promoting behaviors, effective chronic disease management, and positive health outcomes are influenced at the individual, peer, family, school, community, and societal levels. Social determinants such as poverty, race/ethnicity, and access to health care contribute to significant health disparities among youth. These health disparities are also related to inequities in education. Dropping out of school is associated with multiple social and health problems. Overall, individuals with less education are more likely to experience poor health compared with individuals with more education. Higher levels of education are associated with longer life expectancy and an increased understanding of basic health information and services. Adoption of policies, practices, and programs within school settings and during out-of-school time can play a critical role in improving health promoting and health protecting behaviors. Currently, about one in five school-aged children (ages 6–19) is obese. Most children and adolescents do not consume adequate amounts of fruits and vegetables and do not participate in at least 60 minutes of physical activity daily. Healthy eating and physical activity have been associated with increased life expectancy, increased quality of life, and reduced risk for many chronic diseases. In addition to improving health among children and adolescents, there is substantial evidence that healthy eating, physical activity, and effective management of chronic health conditions can help improve academic achievement. Research shows positive associations between school breakfast consumption and improved grade point average, academic grades, and standardized test scores. Furthermore, providing access to safe, free drinking water can help students maintain adequate hydration, which is associated with improved cognitive functioning. Multiple studies suggests that physical activity can have an impact on academic performance, including improved grades, school attendance, concentration and attention, and classroom behavior.

Studies have also shown that students who are able to manage their chronic health condition tend to have better academic performance, including reduced absenteeism, improved grades, and improved test scores. Schools have an opportunity to help prevent obesity, promote physical activity and healthy eating, and manage chronic health conditions through policies, practices, and programs. This NOFO supports evidence-based strategies and activities to reduce the risk of children and adolescents developing obesity, chronic disease in childhood and adulthood, and management of chronic health conditions prevalent in student populations.

There are two priority areas applicants can apply for under this NOFO:

Priority 1: Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Health Conditions in Schools

Priority 2: National Professional Development and Training to Improve Student Health and Academic Achievement

Priority 1 Strategies:

Priority 1 State Education Agencies (SEAs) will focus strategies and activities within the context of the Whole School, Whole Community, Whole Child, model (WSCC). The WSCC model, an expansion and update of the Coordinated School Health model, is a school-wide approach to support student health and learning through multiple strategies, such as policies, practices, and programs for health education, physical education, school health services, family and community involvement, social emotional climate, and the physical environment. Schools, health agencies, parents, and communities share a common goal of supporting the health and academic achievement of children and adolescents. Local Education Agencies (LEAs) and schools within the awarded SEAs will implement evidence-based school health policies, practices and programs that increase opportunities for healthy eating, physical activity and management of chronic health conditions during the school day as well as during out-of-school time.

Approximately 19 SEAs will be funded to implement Priority 1 and will be responsible for implementing three strategies:

Strategy 1. Infrastructure Development Strategy 2. Professional Development and Training Strategy 3. Technical Assistance SEAs will be expected to implement these strategies using a comprehensive, statewide approach over the 5-year period of performance. While activities are expected to be implemented statewide, each SEA will select between 5 and 10 LEAs with which to prioritize their work.

SEAs should work with the majority of schools within these LEAs at the elementary, middle, and high school levels.

Priority 1 SEAs must submit Letters of Support (LOS) from each of the LEAs they plan to work with. LOS should describe how the LEA will help the SEA achieve the goals of the NOFO.

LOS will be a criterion used in evaluating the application.

Priority 1 SEAs are also required to also submit a Memorandum of Agreement (MOA) with the appropriate State Health Department with their application. Priority 1 SEAs are expected to direct part of their award to the State Health Department to support staff positions and activities associated with the NOFO. The MOA should clearly define the mutual goals, relationship, and responsibilities of the SEA and State Health Department. MOAs will be a criteria used in evaluating the application. Specific details of what should be included in the MOA can be found on page 14 of this NOFO.

Priority 2 Strategies One SEA will be funded to implement Priority 2 which focuses on building the capacity of Priority 1 SEAs. The recipient will plan, develop and deliver quality professional development and training to Priority 1 SEAs.

The Priority 2 SEA will be responsible for implementing one strategy:

Strategy 1: National Professional Development and Training Applicants seeking funding for Priority 2 must also apply for Priority 1 funding. Priority 2 applicants must compete and successfully be awarded Priority 1 funding in order to also be awarded Priority 2 funding.

b. Statutory Authorities Section 301(a) and 317(b)(k)(2) of the Public Health Service Act (PHS Act), 42 U.S.C.

247(b)(k)(2)

c. Healthy People 2020 This program addresses the “Healthy People 2020” topics and objectives related to:

Adolescent Health Access to Healthcare Educational and Community-Based Programs Environmental Health Nutrition and Weight Status Social Determinants of Health

d. Other National Public Health Priorities and Strategies National Prevention Strategy: https://www.surgeongeneral.gov/priorities/prevention/strategy /index.html

e. Relevant Work For almost 30 years the CDC has provided scientific leadership, technical expertise, and funding to state health and education agencies to assist with building capacity to develop, deliver, and implement chronic disease prevention and health promotion programs that have https://www.healthypeople.gov/2020/topics-objectives/topic/Adolescent-Health https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html measurable impact. This NOFO builds upon the successes of CDC-RFA-DP13-1305, State Public Health Actions to prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health as well as infrastructure and capacity developed through previous cooperative agreements with CDC over the past three decades. This NOFO is also related to CDC-RFA-DP16-1601, National Collaboration to Promote Health, Wellness, and Academic Success of School-Age Children which funds five national non-governmental organizations (NGOs). These CDC-funded NGOs provide training and technical assistance to current recipients funded under CDC-RFA-DP13-1305 and will continue to provide to future SEAs funded under CDC-RFA-DP18-1801. Training and technical assistance focuses on four school health priority areas: (1) Physical Education and Physical Activity; (2) School Nutrition Environment and Services; (3) Out of School Time Healthy Eating and Physical Activity; and

(4) School Health Services for Managing Chronic Health Conditions.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

i. Purpose The purpose of this project is to (1) Increase the number of students who consume nutritious food and beverages; (2) Increase the number of students who participate in daily physical education and physical activity; and (3) Increase the number of students who can effectively manage their chronic health conditions. Funding will support the implementation and evaluation of evidence-based strategies and activities to prevent obesity and reduce the risk of children and adolescents developing chronic disease in adulthood, and managing chronic health conditions prevalent in student populations including poor oral health, asthma, food allergies, seizure disorders, diabetes and other disease, disabilities or conditions.

ii. Outcomes As a result of the implementation of the strategies funded through this NOFO (i.e., infrastructure development, professional development and training, technical assistance), the following outcomes are expected to be achieved over the 5-year period of performance and are bolded in the logic model:

SHORT-TERM OUTCOMES (~ 1 to 3 years)

Priority 1: Increased skill among individuals trained to improve student health.

Priority 2: Increased percentage of individuals or teams whose skill in implementing school health policies and practices has increased.

INTERMEDIATE OUTCOMES (~ 3 to 5 years)

Priority 1: Increased percentage of schools that do not sell less healthy foods and beverages.*

Priority 1: Increased percentage of schools that have established, implemented and/or evaluated a Comprehensive School Physical Activity Program.*

Priority 1: Increased percentage of schools that provide case management for students with chronic health conditions.*

Priority 1: Increased percentage of schools that prohibit advertising of less healthy foods.*

Priority 2: Increased percentage of individuals or teams who have been able to transfer school health skills into practice.

LONG-TERM OUTCOMES (~ 5 or more years)

Priority 1: Increased percentage of students who ate vegetables 3 or more times per day.

Priority 1: Increased percentage of students who ate fruit or drank 100% fruit juices two or more times per day. *

Priority 1: Increased percentage of students participating in 60 minutes of daily physical activity. *

* These outcomes will be collected using existing surveillance systems [i.e., School Health Profiles (Profiles), Youth Risk Behavior Survey (YRBS)] and reported by CDC.

iii. Strategies and Activities Priority 1: SEAs will be expected to implement the following strategies and activities using a comprehensive, statewide approach over the 5-year period of performance. While all strategies and activities are expected to be implemented statewide, each SEA will select between 5 and 10 LEAs with which to prioritize their work. SEAs should work with the majority of schools within these LEAs at the elementary, middle, and high school levels.

Strategy 1: Infrastructure Development SEAs will build infrastructure and capacity within LEAs and schools through implementation of the following activities:

Activity: Establish and coordinate a state-wide coalition with key school health stakeholders to facilitate collaboration and advance the program.

Lead and regularly facilitate a state-wide coalition to promote healthy schools through policy, practices and programs.

Through the coalition, increase awareness and promote the adoption of national standards and guidelines related to school-based health education, physical education/physical activity, healthy eating, and management of chronic health conditions.

Increase public and decision-maker awareness of the childhood obesity epidemic and other chronic health conditions and the evidence-based strategies and activities to address disease, disability and premature death.

Coordinate to address other school health priorities for the state.

Activity: Support the development of school health councils to advance health promoting strategies in schools by providing resources (e.g., funding, training, time, materials) and guidance to LEAs and schools on the following:

Identifying a school health coordinator who manages and coordinates health-related policies and practices, serves on the school health council and communicates the council’s decisions and actions to school-level health coordinators and teams, staff, students, and parents.

Developing and maintaining a school health council which serves as a planning, advisory, and decision-making group for school health policies and practices.

Identifying and including representatives from different segments of the school and community on the council including health and physical education teachers, nutrition service staff members, students, families, school administrators, school nurses and other health-care providers, social worker service professionals, religious and civic leaders and other members of the community.

Activity: Support use of the School Health Index for routine assessment to strengthen school health policies, practices, and programs.

Provide resources and guidance to priority LEAs and schools in promoting the School Health Index within elementary and secondary schools to (1) Identify strengths and weaknesses of health and safety policies, practices, and programs; (2) Develop an action plan for improving student health, which can be incorporated into the School Improvement Plan and can inform revisions to the local wellness policy; (3) Engage teachers, parents, students, and the community in promoting health-enhancing behaviors https://www.cdc.gov/healthyschools/shi/index.htm https://www.cdc.gov/healthyschools/shi/index.htm and better health.

Ensure trainers that conduct School Health Index trainings for schools follow the School

Health Index Training Manual and/or the eLearning module.

Monitor and document how school health councils use School Health Index results and other data to inform school boards and garner community support to improve health education, school nutrition, physical education and physical activity programs, and health services.

Activity: Use technology to increase the efficiency of communication, dissemination of information, and to support training, program implementation, and evaluation.

Develop a system to communicate with stakeholders and partners through email, listservs, social media and other methods of exchanging, promoting, and disseminating information

Use existing online resources for training such as CDC’s E-Learning Series: Training Tools for Healthy Schools.

Develop webinars and other online methods to provide professional development and training.

Strategy 2: Professional Development and Training Activity: Promote school health through professional development and training (e.g., Whole School, Whole Community, Whole Child approach, connections between health and academic achievement, and school health tools and resources).

Establish a cadre of trainers to provide professional development and training. Trainers should be familiar with CDC’s Professional Development and Training Tools, Profe ssional Development Practices and be comfortable with providing training in group settings and through one-on-one consultation.

Activity: Support LEAs and schools to improve, implement, and evaluate local wellness policies by providing professional development and training on:

The use of WellSat 2.0 or equivalent tool to assess local school wellness policies. * How data can be used to support changes in wellness policy and practices within schools, develop action plans, and track implementation.

*The WellSat 2.0 is the primary tool recommended by the USDA for wellness policy assessment. This free, relatively short (i.e., ~45 minutes) assessment tool aligns with USDA requirements and conveniently stores information that can easily be updated as needed.

Activity: Support LEAs and schools to improve the school nutrition environment by providing professional development and training on:

CDC’s Comprehensive Framework for Addressing the School Nutrition Environment and Services to schools, including out of school time staff, to help them assess and improve their nutrition environment (i.e. Smart Snacks in School, access to safe, https://www.cdc.gov/healthyschools/shi/training/index.htm https://www.cdc.gov/healthyschools/shi/training/index.htm https://www.cdc.gov/healthyschools/professional_development/e-learning/shi.html https://www.cdc.gov/healthyschools/tths/e-learning.htm https://www.cdc.gov/healthyschools/tths/e-learning.htm https://www.cdc.gov/healthyschools/trainingtools.htm https://www.cdc.gov/healthyschools/professional_development/documents/professional-development-practices-508.pdf https://www.cdc.gov/healthyschools/professional_development/documents/professional-development-practices-508.pdf http://www.wellsat.org/ https://www.cdc.gov/healthyschools/nutrition/pdf/school_nutrition_framework_508tagged.pdf https://www.cdc.gov/healthyschools/nutrition/pdf/school_nutrition_framework_508tagged.pdf free drinking water, Smarter Lunchrooms).

Activity: Support LEAs and schools to improve physical education and physical activity through Comprehensive School Physical Activity Programs by providing professional development and training on:

Assessing physical education curriculum through the Physical Education Curriculum Analysis Tool to ensure priority LEAs and schools have a quality physical education curriculum.

Comprehensive School Physical Activity Programs using the Comprehensive School Physical Activity Programs: A Guide for Schools, School Health Guidelines to Promote Healthy Eating and Physical Activity, Strategies for Recess in Schools, Recess Planning in Schools, Parents for Healthy Schools and other evidence-based resources to implement physical education and physical activity during the school day (e.g., recess and classroom physical activity), physical activity before and after school, school staff involvement and wellness, and parent/community engagement.

Activity: Support LEAs and schools in the development and maintenance of a system to manage chronic health conditions by providing professional development and training on:

Establishing systems for the management and support of students with chronic health conditions, and delivering disease specific education and awareness programs for students and school staff.

Coordinating health services with community health care providers to better manage emergency and routine needs of students identified with chronic health conditions. This includes coordinating communication about care plans to ensure continuation of care between school and out-of-school settings.

Activity: Support the role out-of-school time programs can play in supporting student health and academic achievement by providing professional development and training on:

The Healthy Eating and Physical Activity (HEPA) in Out-of- School Time Standards and/or other evidence-based guidelines for promoting healthy eating and physical activity in out-of-school settings for school administrators, out-of-school time administrators and frontline staff.

Policies and practices to address the needs of students with chronic health conditions during out-of-school time activities.

Activity: Promote the importance of quality health education curriculum and instruction by providing professional development and training on:

The Health Education Curriculum Analysis Tool, National Health Education Standards, Characteristics of an Effective Health Education Curriculum to help schools assess and select appropriate and effective health education curricula.

Strategy 3: Technical Assistance Activity: Provide technical assistance to support development and adoption of policies and https://www.cdc.gov/healthyschools/pecat/index.htm https://www.cdc.gov/healthyschools/pecat/index.htm https://www.cdc.gov/healthyschools/physicalactivity/pdf/13_242620-A_CSPAP_SchoolPhysActivityPrograms_Final_508_12192013.pdf https://www.cdc.gov/healthyschools/physicalactivity/pdf/13_242620-A_CSPAP_SchoolPhysActivityPrograms_Final_508_12192013.pdf https://www.cdc.gov/healthyschools/npao/pdf/mmwr-school-health-guidelines.pdf https://www.cdc.gov/healthyschools/npao/pdf/mmwr-school-health-guidelines.pdf https://www.cdc.gov/healthyschools/physicalactivity/pdf/2016_12_16_SchoolRecessStrategies_508.pdf https://www.cdc.gov/healthyschools/physicalactivity/pdf/2016_12_16_SchoolRecessStrategies_508.pdf https://www.cdc.gov/healthyschools/physicalactivity/pdf/2016_12_16_SchoolRecessStrategies_508.pdf https://www.cdc.gov/healthyschools/parentengagement/parentsforhealthyschools.htm https://www.cdc.gov/healthyschools/schoolhealthservices.htm https://www.cdc.gov/healthyschools/schoolhealthservices.htm https://naaweb.org/images/NAA_HEPA_Standards_new_look_2015.pdf https://www.cdc.gov/healthyyouth/hecat/index.htm https://www.cdc.gov/healthyschools/sher/standards/index.htm https://www.cdc.gov/healthyschools/sher/characteristics/index.htm practices that create supportive nutrition environments including:

Implementing federal nutrition standards for competitive foods consistent with Smart Snacks in School, ensuring foods and beverages sold or served offered outside of school meal programs are nutritious, and prohibiting the use of foods and beverages as rewards or punishment.

Restricting marketing of foods and beverages that do not meet the Smart Snacks in School standards, and promoting foods and beverages that support healthy diets (e.g., fruits and vegetables, safe, free drinking water) including placing nutritious items where they are easy for students to access.

Using verbal prompts, parental outreach, and point-of-purchase promotions; supporting access to safe, free drinking water; and using pricing strategies to encourage students to buy healthy items.

Activity: Support LEAs and schools to create supportive environments for physical education and physical activity through a Comprehensive School Physical Activity Program (CSPAP) by providing technical assistance on:

The components (e.g., physical education, physical activity during recess, classroom and before/after school; staff involvement; family and community) and process of developing and implementing a CSPAP.

Implementation of the Physical Education Curriculum Analysis Tool and other evidence-based resources for physical education and physical activity.

Activity: Foster a systematic approach to address the management of chronic health conditions among students, including disease specific education, managing emergency needs, and care coordination by providing technical assistance on:

Establishing a system for the management and support of students with chronic health conditions in schools.

Selecting and providing disease specific education and awareness programs for students and school staff.

Coordinating school, family, and community efforts to better manage emergency and routine care needs of students identified with chronic health conditions.

Activity: Assist LEAs and schools in the integration of health promoting activities in out-of-school time, such as increasing access to healthy foods and beverages, physical activity and care coordination for students with chronic health conditions by providing technical assistance on:

Implementation of evidence-based policies and practices (e.g., HEPA standards).

Assessment of current activities and development and implementation of an action plan that reflects local assets, constraints, context, and readiness.

Priority 2: National Professional Development and Training to Improve Student Health and Academic Achievement.

The recipient will plan, develop and deliver quality professional development and training to

Priority 1 SEAs.

Strategy 1: National Professional Development and Training The selected applicant will collaborate with the CDC-funded NGOs to coordinate and provide professional development and training events to Priority 1 SEAs by:

Activity: Coordinating and providing professional development and training to funded SEAs by:

Convening a consortium of national and state stakeholders for the purpose of planning and coordinating school health professional development and training.

Assessing and identifying key professional development and training needs of Priority 1 SEAs.

Developing professional development and trainings that support school health priorities using CDC’s professional development practices.

Delivering up to two, in person, professional development and training events annually that bring together state teams.

Offering other professional development opportunities such as webinars, blogs, newsletters, and Communities of Practice.

1. Collaborations

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

Priority 1 Applicants: Applicants are expected to collaborate with relevant CDC-funded programs and organizations such as State Health Departments (e.g., chronic disease/health promotion, school health, surveillance and epidemiology programs) and NGOs. Priority 1 SEAs are expected to direct part of their award to the State Health Department to support staff positions and activities associated with the NOFO. Priority 1 applicants are required to submit a MOA with their State Health Department outlining collaborative activities and data sharing expectations. The MOA must be detailed, specific, binding, and outline who, what, where and when. The MOA should include:

Names of agencies entering the agreement.

An effective date range that spans the length of the proposed project.

Commitment of the State Health Department to work with the SEA and other collaborative partners to address program requirements and implement project activities, delineating specific roles in achieving the goals of the NOFO.

Commitment to work collaboratively to: (1) Assess the needs and existing capacity to achieve goals; (2) Select and implement activities described in the NOFO; (3) Share relevant surveillance data and other risk factor data; (4) Monitor implementation progress; (5) Participate in meetings and conference calls with SEA and CDC as appropriate.

Commitment of the SEA to work with the State Health Department to address project requirements, including the designation of point(s) of contact.

While this is not a contract, the budget and justification should be outlined along with deliverables/services to be provided.

Counter-signatures for both parties by authorized representatives.

Applicants are also expected to work closely with CDC’s Division of Adolescent and School Health (DASH) to support data collection via the YRBS and Profiles. Funding is available for the administration of the YRBS and Profiles through DASH. All states are encouraged to apply for this funding.

Priority 2 Applicants: Applicants will collaborate with CDC-funded NGOs to coordinate and provide professional development and training to Priority 1 SEAs.

b. With organizations not funded by CDC:

Priority 1 Applicants: Applicants are encouraged to collaborate as appropriate on federal initiatives that support healthier schools such as the United States Department of Agriculture’s child nutrition programs and Team Nutrition initiative; United States Department of Education’s initiatives; Substance Abuse and Mental Health Services Administration’s Safe Schools, Healthy Students; Environmental Protection Agency’s, Healthy Schools, Healthy Kids and non-CDC funded NGOs.

Priority 2 Applicants: Applicants are encouraged to collaborate with other partners deemed necessary to carry out the activities outlined in the NOFO.

2. Target Populations Priority 1 Applicants: Applicants should ensure that data, including burden data, are used to select LEAs and schools located in areas disproportionately affected by chronic diseases and the risk factors that cause them. Emphasis should be placed on child and adolescent populations that have a high prevalence of overweight or obesity, have limited access to healthy foods and beverages, do not obtain adequate physical activity, who lack access to care for consistent and appropriate management of chronic health conditions, and who lack access to quality, healthy out-of-school time programs.

Priority 2 Applicants: Applicants will address target populations and health disparities through professional development and training. This will be based on assessments to determine professional development and training needs of Priority 1 SEAs.

a. Health Disparities Applicants will address health disparities by working with LEAs and schools located in areas disproportionately impacted by chronic disease and the risk factors that cause them. Emphasis should be placed on areas with high rates of poverty, racial/ethnic minorities, and populations living in rural/urban areas.

iv. Funding Strategy (for multi-component NOFOs only)

NA

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Priority 1 Applicants: Evaluation and performance measurement help demonstrate achievement of project outcomes, build a stronger evidence base for specific interventions;

clarify applicability of the evidence base to different populations, settings, and contexts; and drive continuous improvement. Evaluation and performance measurement can also determine if strategies and activities are scalable and effective at reaching target populations. Priority 1 SEAs are required to allocate at least 10% of their award to support evaluation activities (i.e., including surveillance and data collection), and are encouraged to work with professional evaluators to help ensure that a comprehensive evaluation is used and public health objectives are met.

Throughout the 5-year period of performance, CDC will work individually and collectively with each funded Priority 1 SEA to answer the following evaluation questions based on the program logic model, strategies, and activities:

1. To what extent have Priority 1 SEAs provided quality professional development, training and technical assistance to LEAs and schools?

2. To what extent have Priority 1 SEAs developed a strong school health infrastructure throughout the state and among LEAs and schools?

3. To what extent have Priority 1 SEAs supported the development and implementation of school health policies and practices, including during out-of-school time?

4. To what extent have Priority 1 SEAs increased healthful behaviors and improved the management of chronic health conditions among students?

CDC will use an evaluation approach that consists of ongoing monitoring and evaluation.

Priority 1 SEAs will (1) Develop an evaluation and performance measurement plan that addresses the evaluation questions being asked; (2) Report on evaluation results and performance measures annually; and (3) Report on successes and challenges. This evaluation approach will provide information on the progress made toward activities that promote health and support and reinforce healthful behaviors among students. CDC will use evaluation results from reports and the 5-year period of performance to assess the progress of Priority 1 SEAs and to establish key recommendations on program impact, sustainability, and continued program improvement that can be shared with decision makers and other stakeholders.

While Priority 1 SEAs are expected to use a state-wide, comprehensive approach, they will also be expected to select between a minimum of 5 LEAs, and a maximum of 10 LEAs, within which to prioritize and monitor the NOFO strategies and activities for the duration of the 5-year period of performance. Priority 1 SEAs should work with the majority of schools within these LEAs at the elementary, middle, and high school level; however, monitoring via CDC surveillance systems (i.e., YRBS and Profiles) will only occur among middle and high schools.

For this reason, Priority 1 applicants should ensure that among LEAs, a significant portion of the schools they have chosen to work with are at the middle and high school level to monitor progress.

Priority 1 SEAs will to work with CDC project officers and CDC evaluators on ways to collect information to help them monitor progress, communicate results, and identify technical assistance needs. All performance measure data captured by CDC surveillance systems among LEAs and schools will be reported by CDC on behalf of states. School-level performance measures will be measured through Profiles items in even-numbered years and student-level performance measures will be measured through YRBS items in odd-numbered years.

Surveillance data collected by CDC through sampling of LEAs and schools will be limited to the LEAs identified by Priority 1 SEAs at the beginning of the NOFO and cannot be modified throughout the 5-year period of performance.

Priority 1 SEAs will report annually on progress and activity information not captured by CDC surveillance systems. CDC will help Priority 1 SEAs develop specific activity and progress reporting processes and templates. CDC will manage and analyze activity and progress information in order to target areas for quality improvement and technical assistance needs. As resources permit, CDC may also identify and conduct additional evaluation projects (analytic studies, case studies, etc.) to evaluate program activities and outcomes. CDC will lead the design, data collection, analysis, and reporting for these studies in collaboration with Priority 1 SEAs. All information will be collected via a secure system to be developed.

Specific short-term, intermediate, and long-term performance measures for Priority 1 are listed in the table below. Priority 1 SEAs are expected to report on all (i.e., Tier 1) performance measures.

Short-term Performance Measures

Intermediate Performance Measures

Long-term Performance Measures

Priority 1 - Improving Student Health and Academic Achievement through Nutrition, Physical Activity and the Management of Chronic Health Conditions in Schools

(Tier 1) Percentage of individuals whose skill in improving school health has increased as a result of receiving professional development and training.

schools that do not sell less healthy foods and beverages (soda pop or fruit drinks, sport drinks, baked goods, salty snacks, candy). (Reported by CDC)

(Tier 1) Percentage of schools that have established, implemented and/or evaluated Comprehensive School Physical Activity Programs. (Reported by

CDC)

(Tier 1) Percentage of students who ate vegetables 3 or more times per day.

(Reported by

CDC)

(Tier 1) Percentage of students who ate fruit or drank 100% fruit juices two or more times per day.

(Reported by schools that provide case management for students with chronic health conditions. (Reported by

CDC)

(Tier 1) Percentage of schools that prohibit advertising of less healthy foods. (Reported by

CDC).

(Tier 1) Percentage of students participating in 60 minutes of daily physical activity.

(Reported by

Priority 2 Applicants: Evaluation and performance measurement help demonstrate achievement of project outcomes, build a stronger evidence base for specific interventions;

clarify applicability of the evidence base to different populations, settings, and contexts; and drive continuous improvement. Evaluation and performance measurement can also determine if strategies and activities are scalable and effective at reaching target populations. Priority 2 SEAs are required to allocate at least 10% of their award to support evaluation activities (i.e., including surveillance and data collection), and are encouraged to work with professional evaluators to help ensure that a comprehensive evaluation is used and public health objectives are met.

Throughout the 5-year period of performance, CDC will work individually and collectively with the funded Priority 2 SEA to answer the following evaluation questions based on the program logic model, strategies, and activities:

1. To what extent has providing national professional development and training increased the capacity of Priority 1 SEAs to deliver effective professional development and training?

2. To what extent has providing national professional development and training supported the development and implementation of school health policy, practices and programs?

To answer these questions, CDC will use an evaluation approach that consists of routine monitoring and evaluation. The Priority 2 SEA will be required to (1) Report on CDC developed performance measures as specified in the performance measure table below; (2) Develop an evaluation and performance measurement plan, and (3) report evaluation results. This evaluation approach will provide data on the progress made with professional development and training activities to improve student health and academic achievement.

The Priority 2 SEAs will work with CDC project officers and CDC evaluators on ways to collect information to help them monitor progress, communicate results, and identify technical assistance needs. The Priority 2 SEAs will report annually on progress and activity information not captured by CDC surveillance systems. CDC will help the Priority 2 SEA develop specific activity and progress reporting processes and templates. CDC will manage and analyze activity and progress information in order to target areas for quality improvement and technical assistance needs. As resources permit, CDC may also identify and conduct additional evaluation projects (analytic studies, case studies, etc.) to evaluate program activities and outcomes. CDC will lead the design, data collection, analysis, and reporting for these studies in collaboration with the Priority 2 SEA. All information will be collected via a secure system to be developed.

Specific short-term and intermediate performance measures for Priority 2 are listed in the table below. The Priority 2 SEA is expected to report on all (i.e., Tier 1) performance measures.

Short-term Performance Measures

Intermediate Performance Measures

Priority 2 - National Professional Development and Training to Improve Student Health and Academic Achievement

(Tier 1) Percentage of individuals or teams whose skill in implementing school health policies and practices has increased.

(Tier 1) Increased percentage of individuals or teams who have been able to transfer school health skills into practice.

Priority 1 and 2 Applicants: All performance measure data will be collected via a secure data system that will be developed. Priority 1 and 2 SEAs will report their performance measures data annually via the data system and will only have access to their data. Over the 5-year performance period, data will be secured with limited access to authorized CDC program and evaluation staff.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and

Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans.

For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

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

Describe the type of evaluations (i.e., process,…