oppCDC-RFA-DP18-1805-cfda93.427-cidCDC-RFA-DP18-1805-instructions.pdf

Centers for Disease Control

National Center for Chronic Disease Prevention and Health Promotion

Provision of Technical Assistance and Training Activities to Assure Comprehensive Cancer

Control Outcomes

CDC-RFA-DP18-1805

Application Due Date: 05/30/2018

Provision of Technical Assistance and Training Activities to Assure Comprehensive Cancer

Control Outcomes

CDC-RFA-DP18-1805

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. Application and Submission Information 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-DP18-1805. 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) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Provision of Technical Assistance and Training Activities to Assure Comprehensive Cancer Control Outcomes 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)).

New - Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP18-1805

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

93.427 F. Dates:

1. Due Date for Letter of Intent (LOI): 04/30/2018

2. Due Date for Applications: 05/30/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

4/16/2018 3:00 pm Eastern Standard Time. Call-in information:

Please access the call via Adobe Connects and the following:

https://ondieh.adobeconnect.com/infocall18_1805/ Dial in audio for the meeting is via Live Meeting at:

North America: 1-866-818-4509 / PPT CODE: 93611071#

G. Executive Summary:

1. Summary Paragraph:

The purpose of this Notice of Funding Opportunity (NOFO) is to fund up to two recipients with expertise, capacity and national reach in chronic disease prevention to provide technical assistance and training (TAT) to National Comprehensive Cancer Control Program (NCCCP) 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 https://ondieh.adobeconnect.com/infocall18_1805/ recipients and their coalitions.The aim is to build NCCCPs capacity to implement evidence-based and promising practices in primary prevention, cancer screening and diagnostic follow-up and cancer survivorship. Using TAT framework based on current research and evaluation findings, national organizations will implement core strategies: conducting a comprehensive needs assessment of NCCCP recipients capacity to implement evidence-based interventions;

identifying and implementing a process to build capacity among NCCCP recipients;

coordinating and collaborating among existing partnership networks to enhance TAT efforts;

developing, implementing and evaluating a TAT plan and evaluating TAT efforts.

Implementing the core strategies are necessary to attain the following outcomes: increase knowledge and capacity among NCCCP recipients to use evidence-based interventions or policy, system and environmental changes (PSE) planning models that contribute to improvements in cancer risk reducing behaviors; increased recommended cancer screenings;

enhanced cancer survivorship interventions; and that address cancer related disparities.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 2

d. Total Period of Performance Funding: $6,625,000

e. Average One Year Award Amount: $660,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 09/30/2018

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview Cancer is one of the leading causes of death and cancer survivors often face physical and psychosocial concerns. The National Comprehensive Cancer Control Program (NCCCP) aims to reduce the cancer burden through sustainable infrastructure. Funded programs convene coalitions to develop comprehensive cancer control (CCC) plans aligned with NCCCP priorities and based on cancer surveillance data. They collaborate with their coalitions to implement plans using environmental approaches, health system interventions, and community programs linked to clinical services to address the cancer continuum and advance health equity by reaching underserved populations.

Capacity-enhancing interventions can increase adoption and implementation of evidence-based practices (Leeman 2015). Multiple capacity-building frameworks exist to foster the translation of research into practice, such as the Interactive Systems Framework (Wandersman 2008). This framework conceptualizes the interaction between researchers who develop evidence-based practices, public health practitioners who deliver them and support systems that provide technical assistance and training (TAT) and disseminate tools for effective capacity building.

This Notice of Funding Opportunity (NOFO) supports TAT to NCCCP recipients and their coalitions to enhance organizational capacities, assure effective implementation of interventions and facilitate achievement of program outcomes that contribute to cancer risk, morbidity, and mortality reductions. TAT is defined as the planning, development, delivery, and evaluation of activities designed to achieve specific learning objectives, resolve problems, and foster the application of innovative approaches.

This NOFO supports a collaborative relationship between NCCCP recipients and the Comprehensive Cancer Control National Partnership (CCCNP) and the National Colorectal Cancer Roundtable (NCCRT). The CCCNP is a national network of leading cancer prevention and control organizations who provide technical assistance to CCC coalitions and coordinate national CCC efforts. They focus on HPV vaccination uptake, colorectal cancer screening, and survivorship tobacco cessation. The NCCRT is a national coalition of public, private and voluntary organizations and individuals dedicated to impacting morbidity and mortality from colorectal cancer through coordinated leadership, strategic planning and advocacy. This NOFO will not fund the CCCNP, but will leverage resources and subject matter expertise of current National Partners.

This NOFO builds upon DP13-1315, National Support to Enhance Implementation of Comprehensive Cancer Control Activities, which funds organizations with demonstrated infrastructure, experience, and expertise to assure knowledge transfer of evidenced-based cancer prevention and control strategies. Successes under DP13-1315 include: collaborative NCCRT activities; the American Indian/Alaska Native Cancer Summit (2016); US Pacific Islands Jurisdiction Technical Assistance Workshop on HPV, Colorectal Cancer, and Survivorship (2017); CCCNP collaborative forums on HPV (2016) and colorectal cancer (2017) and development of an online resource, Cancer Control Technical Assistance Portal. Forums and workshops provided technical assistance for developing NCCCP priority-based action plans to implement evidence-based interventions. Although this NOFO continues to support national organizations who will use TAT to accelerate the spread and reach of evidence-based and promising practices, it uses a framework for TAT based on current research.

b. Statutory Authorities This program is authorized under 42 U.S.C. 241(a) and 42 U.S.C. 247b(k)(2).

c. Healthy People 2020 Healthy People 2020 Cancer-related Objectives Healthy People 2020 HPV vaccine-related Objectives https://www.healthypeople.gov/2020/topics-objectives/topic/cancer/objectives https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives

d. Other National Public Health Priorities and Strategies This NOFO supports the priorities of the NCCCP, which include primary prevention, early detection, survivorship, evaluation, reduction of disparities and systems, environmental change strategies.

The NCCCP priorities and this NOFO align with in the National Prevention Strategy (NPS), as well as The Guide to Community Preventive Services and The National Partnership for Action to End Health Disparities. This NOFO accelerates program implementation that aligns with strategies from these sources.

e. Relevant Work This NOFO builds on the program design and successes of DP13-1315, National Support to Enhance Implementation of Comprehensive Cancer Control Activities, which funds organizations with the demonstrated infrastructure, experience, and expertise to assure knowledge transfer of evidenced-based cancer prevention and control strategies through TAT. This effort also builds on and complements the TAT efforts of the Comprehensive Cancer Control National Partnership who assist Comprehensive Cancer Control (CCC) coalitions in developing and sustaining implementation of their plans.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Strategies and Activities Short-term Outcomes Intermediate Outcomes

Long-Term Outcomes

Conduct a needs assessment of current comprehensive cancer control programs

Identify a process to build program capacity in comprehensive cancer control programs

Technical Assistance and Training (TAT) Provider Change:

Improved TAT resource allocation

Reduced duplication of TAT efforts among different TAT providers

Improved quality and

Program Level Change

Promotion of CCC program successes

Improved abilities to leverage resources and garner support to sustain CCC activities

Sustained use of data and

Increase in health seeking and healthy lifestyle behaviors among general population (e.g., human papillomavirus

(HPV)

vaccination, Hepatitis B vaccination, improved https://www.cdc.gov/cancer/ncccp/about.htm https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html http://www.thecommunityguide.org/ http://www.minorityhealth.hhs.gov/npa http://www.minorityhealth.hhs.gov/npa https://www.cdc.gov/cancer/ncccp/partners.htm

Coordinate and collaborate with existing partnership networks to plan, implement, and evaluate technical assistance and training (TAT) activities

Develop and implement a TAT plan for

NCCCP

grantees and their coalitions that focuses on primary prevention, screening and survivorship

Conduct a quality improvement assessment TAT plan

Conduct a comprehensive evaluation accessibility of public education training, evaluation tools, and resources

TAT

Consumer/Program change

Increased capacity of

CCC

programs to foster relationships with key stakeholders to impact primary prevention, screening, and survivorship

Sustained efforts by

NCCCP

recipients and their coalitions to implement CCC plans and evidence-based interventions

Use of rigorous evaluation by

NCCCP

recipients and their coalitions evaluation to improve programs and to inform promising practices

Accelerated use of evidence-based and promising CCC practices

Policy Change

Increased adoption of policy, system and environmental change (PSE) planning models to efficiently implement PSE change strategies

Increased policies and systems that promote healthy lifestyle behaviors, high-quality cancer screening and lifestyle programs for survivors

Community Change

Increased environmental supports that physical activity, and improved diet).

Increased early detection of cancer.

Improved survivorship practices

Reduced cancer risk (e.g., tobacco, alcohol, exposure to ultraviolet (UV) rays).

Reduce cancer disparities

Decrease cancer morbidity and mortality reduce cancer risk

Increased supports that facilitate early detection of cancer and screening

Increased evidence based lifestyle and wellness survivorship programs

i. Purpose This NOFO will provide TAT to NCCCP recipients and their coalitions to build organizational capacity for implementing cancer-related policy, systems and environmental change (PSE) evidence-based interventions. PSE approaches consist of education about existing policies in local settings and informing stakeholders about evidence-based environmental and systems-level approaches that support health. Key activities are: needs assessments; program capacity-building;

collaborating with existing partners; implementing a TAT plan; and conducting evaluations.

ii. Outcomes Intermediate Outcomes Policy Change

Increased policies and systems that promote healthy lifestyle behaviors, high-quality cancer screening and lifestyle programs for survivors

Community Change

Increased evidence-based lifestyle and wellness survivorship programs

Long-Term Outcomes

Increase in health seeking and healthy lifestyle behaviors, for example, human papillomavirus (HPV) vaccination, Hepatitis B vaccination, improved physical activity, and improved diet

Increased early detection of cancer Improved survivorship practices

iii. Strategies and Activities Core Strategy 1: Conduct a Comprehensive Needs Assessment to determine current comprehensive cancer control programs' capacity to plan, adapt, and implement evidence-based interventions for cancer control; sustain multi-sector partnerships and coalitions;

collaborate with other chronic disease and risk factor prevention programs; strategically use cancer surveillance data; and conduct program monitoring and evaluation.

Using previous needs assessments (if available), identify current barriers to implementing the CCC priorities (i.e. primary prevention of cancer, screening and early detection of cancer, and improving quality of life of cancer survivors; along with the cross-cutting areas of addressing health equity; using policy, systems, and environmental change approaches; and conducting evaluation), document significant program successes, address emerging issues in cancer control, and include issues related to sustainability of evidence-based interventions and leveraging of internal and external resources among NCCCP recipients and comprehensive cancer control coalition partners.

In consultation with CDC, the CCC National Partners, and other CDC-funded cancer programs, identify potential topics for technical assistance and trainings. Recipients may use findings from recent evaluations to also identify TAT topics. In addition, this activity may examine gaps in evaluation findings to allow for a needs assessment that can focus on topic areas not previously covered and that need more information from CDC-funded cancer programs as to preferences around content and delivery.

Develop a brief needs assessment that yields results that can be used to refine technical assistance and training needs, identify programs that could serve as peer mentors, and determine preferred modes of receiving technical assistance and training on these topics.

The needs assessment needs to be updated every year to be consistent with changing NCCCP recipient needs over time.

Core Strategy 2: Identify a process to build program capacity in comprehensive cancer control programs that cultivate a set of mechanisms needed to successfully attain desired long term outcomes to include: reducing cancer risk, increasing and improving health seeking and healthy life style behaviors, promote early detection of cancer, and support survivors.

The selected recipients will identify a process or planning model to enhance program capacity in comprehensive cancer control programs, using an evidence-informed framework (e.g., Interactive Systems Framework (ISF); Evidence-Based System for Innovation Support (EBSIS); Getting To Outcomes for the provision of technical assistance and training (references: Leeman et al 2015; Chinman et al 2008). The framework chosen needs to aim to increase awareness, knowledge, skills, program performance, self-efficacy, and motivation for implementing or adapting evidence-based and promising practices to address CCC priorities and emerging areas in cancer prevention and control. CCC programs may also need support in building and maintaining cancer coalitions; collaborating with internal chronic disease (e.g. tobacco, diabetes, nutrition and physical activity) and other programmatic partners (e.g. immunization programs); using environmental approaches for sustainable cancer control; developing community-clinical linkages to aid patient support; supporting health systems changes;

and conducting evaluation to improve program performance and document outcomes.

The framework needs to address multiple strategies for enhancing capacity, such as training; tools; technical assistance; assessment and feedback; mentoring; and peer networking.

In building program capacity, it is important to consider dosage, and to deliver technical assistance and training that is engaging and requires active participation. The chosen framework may need to consider that programs are at different stages of readiness for implementing evidence-based and promising practices, and programs may have different levels of organizational capacity (i.e. within the health department or coalition) to implement effective practices to address the burden of cancer in their jurisdictions.

Programs may have different levels of resources (time, staff, financial, etc.), and they may have underserved populations that will require interventions to be adapted to fit their local context. Technical assistance and training providers may need to consider that some CCC programs may need support in building their capacity to identify evidence-based and promising practices found in multiple sources (e.g. The Community Guide, Research Tested Intervention Programs (RTIPs), Best Practices for Tobacco Control Programs, MAPPS, and others) that best fit their population, resources, and are most likely to achieve intended outcomes.

The selected recipient will consult with CDC about emerging training needs, and will build and foster respectful relationships with CCC programs so that programs have a high level of satisfaction in the information presented, and can provide constructive feedback to the selected recipient. Some CCC programs have extensive practice-based experience conducting successful interventions, and may serve as resources to the selected recipient for training, provision of technical assistance, and peer mentoring.

The recipient will also work with CDC to assess current capacity building efforts and build on those activities to minimize duplication. All materials and resources developed by the recipient need to be accessible to CCC programs and their stakeholders. The recipient will work with CDC to ensure that materials are archived in a space accessible to programs even after funding for this initiative ends.

Core Strategy 3: Coordinate and collaborate with existing partnership networks: award recipients need to develop a process to 1) identify and sustain appropriate engagement strategies (i.e., progression from networking, to coordination, collaboration, and cooperation); 2) communicate and update partners on technical assistance and training strategies; 3) secure commitment to provide technical assistance and training; and 4) share resources and information.

Conduct a partnership gap analysis to determine the viability of relationships essential to the provision of technical assistance and training. Foster relationships with established partnership networks and forge strategic alliances with organizations who have a stake in facilitating NCCCP recipient achievement of cancer prevention and control goals. Networks and organizations such as the Comprehensive Cancer Control National Partnership (CCCNP) member organizations, chronic disease partner networks, the Cancer Prevention and Control Research Network (CPCRN), the National Colorectal Cancer Roundtable, and organizations that represent disparate populations at high risk for cancer should be engaged. These relationships should be sought out to identify opportunities to streamline technical assistance and training efforts. Establish and facilitate formal agreements for partner organizations to exchange information and share resources among the partnership network. Consult partnership to identify [or refine from initial assessment] topics for technical assistance and training.

Enhance -- but do not duplicate -- existing TAT resources and websites (e.g. Cancer Control PLANET, The Community Guide, etc.).

Employ CCCNP member organization resources such as the National Colorectal Cancer Roundtable, National Cancer Institute's Research to Reality's online forums and communities of practice, and the Cancer Control Technical Assistance Portal (TAP).

Establish and assist in the implementation of a communication protocol between NCCCP recipients and their coalition leadership for the purpose of increasing knowledge transfer.

Core Strategy 4: Develop a technical assistance and training plan that uses either standard, evidence-based, or promising practices for technical assistance and training.

Identify promising practices from CCCP recipients or by reviewing meeting or conference materials.

Review the results of the needs and resource assessment to identify which knowledge and performance gaps can be addressed through technical assistance and training.

The technical assistance and training plan needs to include:

o A year one action plan, a matrix that identifies the SMART objectives, supporting activities, individuals responsible, deliverables and timeframe.

o An overall training curriculum and guide for technical assistance and training to include critical topics and preferred learning formats (i.e. webinars, face-to-face training sessions, web-based tools, in-person trainings at conferences, phone support, online forums, peer-to-peer mentoring and other job aids).

Support translation of new evidence-based or promising practices by offering technical assistance and training on other emerging topics in cancer control, in consultation with CDC and the CCC National Partners.

Develop a coordination and collaboration plan to demonstrate how funded recipients will coordinate to ensure maximizing and leveraging of each others' resources, and minimizing duplication of activities and efforts.

https://www.cccnationalpartners.org/ https://www.cccnationalpartners.org/ http://smhs.gwu.edu/cancercontroltap/

Core Strategy 5a: Implement the technical assistance and training plan by disseminating and conducting training resources and opportunities such as webinars, down-loadable web-based materials, job aids, and face-to-face training opportunities (i.e. workshops, conferences) to cover specific topic- and skill-related needs.

Trainings need to be delivered according to methods preferred by CCC programs. They should be interactive, engaging participants to ask questions and share experiences.

Multiple methods need to be used to reinforce technical assistance and training objectives, which could include a mix of multiple modalities such as one-on-one consultations, group training, peer-networking, mentoring, etc.

Trainings need to improve organizational capacity among NCCCP recipients and result in the transfer of knowledge among NCCCP recipients to their internal (health department) and external (cancer coalition) cancer control partners.

Trainings should be responsive to changing needs within the program. They need to be coordinated with trainings conducted by CDC and its partners to avoid conflicting schedules. Resources should be allocated to reduce duplication of effort if more than one recipient is awarded in this NOFO.

Core Strategy 5b: Conduct performance monitoring and continuous quality improvement activities to assess participant satisfaction with various aspects of the TAT, including content, speakers, and technological delivery. Assess participants' perceptions on the usefulness and applicability of the TAT and how it relates to the programs' intentions to implement interventions.

Each TAT activity needs to include a brief evaluation activity to ensure it met expectations of NCCCP recipients and to improve future sessions. Other TAT aspects to evaluate include dose response and tailoring of technical assistance to local context.

Changes in knowledge, awareness, and intentions following TAT sessions need also to be assessed to determine the effectiveness of the technical assistance and training in meeting short term outcomes.

Knowledge transfer from NCCCP recipients to their internal and external cancer control partners need to be measured to assess if NCCCP recipients can confidently disseminate effective cancer control practices, or if they have concrete plans to train cancer control partners in concepts presented during trainings.

Other outcomes that may be considered are changes in self-efficacy for using evidence-based interventions or PSE approaches, motivation for adopting sustainable practices, and readiness for using more effective approaches in cancer prevention and control.

To align with continuous quality improvement approaches, topics that do not display changes in short term outcomes such as knowledge, awareness, and intentions may need further refinement to improve uptake.

Strategy 6: Conduct a comprehensive evaluation to assess how the applicant's TAT is contributing to progress being made by comprehensive cancer control programs to achieve their overall cancer plan goals and objectives.

Provide a draft evaluation plan and performance measurement strategy that focuses on core activities implemented in the first year of the program. The plan should demonstrate how the selected recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement section of this NOFO.

The evaluation plan should be updated annually, building off of results from the previous year's evaluation findings and by year 5, include plans to evaluate the contribution of the TAT to attainment of CCC program goals and objectives.

Focus areas guiding this evaluation should include evaluating practices known to improve program performance (quality improvement activities, developing sustainable partnerships, evaluating the effectiveness of partner organization contributions and their impact on CCC-related outcomes; sustainable interventions).

Recipients will be responsible for developing and implementing a comprehensive written evaluation plan that defines both process and outcomes measures that will be evaluated.

The evaluation plan should consider components identified in the CCC Program Evaluation Toolkit. Distal outcome measures should include assessment of recipient program activities' contribution to CCC programs making incremental progress toward their cancer plan goals and objectives.

The comprehensive evaluation plan needs to:

1. Identify key evaluation stakeholders and describe the stakeholder engagement strategy.

2. Describe evaluation stakeholder's potential role in evaluation planning and implementation.

3. Describe how evaluation stakeholders will utilize evaluation findings.

4. Include a logic model to illustrate program design.

5. Describe specific, measurable, and realistic short-term (one-year), intermediate, and long-term program objectives consistent with the purpose of this NOFO.

6. Address how the applicant intends to assess the extent to which recipient activities are implemented appropriately and the extent to which these activities yield the intended outcomes.

7. Describe indicators for process and outcome measures, address data collection sources and methods.

8. Describe how findings will be disseminated from this program to CDC, CCC recipients and key stakeholders in order to support the use of evidence- based and practice based strategies/interventions.

9. Describe how evaluation findings will be used to enhance program implementation activities.

1. Collaborations

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

To ensure optimal use of limited resources, minimize duplication and provide quality technical assistance, this NOFO requires recipients to collaborate extensively with CDC programs, and CDC funded organizations. Recipients should strive to use advanced partnership strategies. These include coordinating, cooperating, and collaborating, where each strategy evolves from or builds upon another, as a continuum. (Himmelman 2001, Himmelman 2002). Collaboration involves https://www.cdc.gov/cancer/ncccp/prog_eval_toolkit.htm https://www.cdc.gov/cancer/ncccp/prog_eval_toolkit.htm exchanging information, aligning activities, and sharing resources to enhance each one's capacity to work towards a common purpose. The award recipients are required to collaborate with CDC to improve technical assistance and training implementation and evaluation, to participate in stakeholder meetings and on request to provide expert consultation to CDC and CDC-funded programs and networks. These include other CDC-funded chronic disease and risk-factor related programs, and the Cancer Prevention and Control Research Network. Such collaborations will support the achievement of NOFO outcomes by eliminating duplication of technical assistance and training efforts.

b. With organizations not funded by CDC:

The award recipients are also expected to work with non-CDC funded networks and organizations to leverage subject matter expertise and other resources related to the desired outcomes, strategies and activities of this NOFO. This may include, but is not limited to networks and organizations such as the the Comprehensive Cancer Control National Partnership (CCCNP) ;member organizations, National Colorectal Cancer Roundtable, chronic disease partner networks, organizations that represent disparate populations at high risk for cancer, professional associations, and academic institutions.

Applicants are requested to provide letters of support, or Memoranda of Understanding/Agreement (MOU/MOA) to verify evidence of collaboration with both CDC- and non-CDC-funded organizations. Letters of support should describe the organization's commitment to assisting in TAT efforts which could include but are not limited to planning support, provision of resources (e.g., subject matter experts, facilities, funding) promotion of TAT efforts and implementation of TAT activities. Applicants must file the letter or support, MOU or MOA, as appropriate, name the file "MOUs/MOAs", and upload it as a PDF file at www.grants.gov.

2. Target Populations While NCCCP recipients strive to improve the health status of their entire population, they seek to advance health equity by targeting interventions towards specific populations disproportionately affected by cancer. As such, TAT outcomes are expected to specifically benefit individuals who live within jurisdictions of NCCCP recipients and their coalitions, with particular focus on populations disproportionately affected by cancer. NCCCP recipients review surveillance data to identify cancer disparities by race, ethnicity, gender identity, sexual orientation, geography, socioeconomic status, disability status, primary language, and health literacy.

a. Health Disparities While all segments of society are affected by cancer, there are certain populations that are disproportionately burdened by the increased risk of cancer or by the lack of adequate health care options for prevention and/or treatment. Recipients should seek to achieve health equity by targeting efforts on populations disproportionately affected by cancer, and training NCCCP recipients on how to use data to identify these populations and to select culturally appropriate interventions for implementation. Disproportionately burdened populations may be defined by sex, race, ethnicity, disability, sexual orientation, gender identity, geographic location (particularly rural and frontier areas), low health literacy, uninsured, or socioeconomic status.

http://cpcrn.org/ http://cccnationalpartners.org/ http://cccnationalpartners.org/ http://nccrt.org/ https://foa.grantsolutions.gov/www.grants.gov

Applicants should also target efforts towards reaching English speakers of other languages (ESOL) and tribal populations.

iv. Funding Strategy N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy CDC will conduct a formal evaluation with recipients to determine if the NOFO strategies and activities have been implemented as expected and if the intended period of performance outcomes have been achieved. CDC will follow the CDC framework for program evaluation to design a comprehensive evaluation to include process measures for the strategies and activities in the logic model and outcome measures for the period of performance in the logic model (see proposed outcome measures below).

CDC will use information collected through programmatic reviews ( e.g. program plans, evaluation plans and reports, action plans), key informant interviews, focus groups of program implementers and key stakeholders, electronic surveys, and surveillance data, including national and state-based surveys such as BRFSS.

Performance measures and evaluation findings will inform NOFO impacts at both technical assistance and training provider and recipient levels. For example, at the provider level, findings will inform aspects such as: improved use of resources for TAT, coordination and collaboration with networks for program capacity building; improved quality, and accessibility of public education TAT tools and resource. At the recipient level, evaluation findings will inform on CCC programs' sustained efforts to implement cancer plans; adoption and increase in implementation of evidence-based interventions;

increased ability and commitment to evaluate “promising practices”; increased capacity of CCC programs to foster relationships with stakeholders, leverage resources and effect changes across the cancer continuum.

Performance measures and evaluation findings will identify whether the provision of technical assistance and training contributed to the promotion and expansion of implementation of evidence-based interventions addressing primary prevention, screening, survivorship, and disparities which in turn can lead to reductions in cancer risk, morbidity and mortality.

CDC will disseminate findings from the evaluation through dissemination products that articulate evaluation findings and recommendations through products such as manuscripts, program publications, and presentations.

Performance measures and evaluation findings will be used to assess recipient compliance with requirements of this NOFO, making budgetary decisions, and informing guidance and technical assistance.

CDC will only collect data that is consistent with key evaluation questions and the identified process and outcome performance measures to ensure that data collection is limited only to data that will be analyzed and used for program improvement, monitoring and documented outcomes.

Performance Measures(PM) Intermediate Outcome Increased policies and systems that promote healthy lifestyle behaviors, high-quality cancer screening and lifestyle programs for survivors.

Tier 1 PM Recipients are expected to implement both of the following:

• Number of state, tribal, and/or territorial cancer control programs with demonstrable increased capacity to implement evidence based policy, system and environmental change interventions to address healthy lifestyles (e.g., tobacco use prevention; obesity; alcohol consumption) as a result of technical assistance from the awardees as demonstrated by the increase in the number of programs demonstrating that evidence.

• Number of state, tribal, and/or territorial cancer programs with increased capacity to implement health systems change interventions to increase breast, cervical, colorectal, and lung cancer screening rates, as demonstrated by the increased number of health systems change interventions initiated in programs.

Intermediate Outcome Increase evidence based lifestyle and wellness survivorship programs Tier 1 PM Recipients are expected to implement the following:

• Number of state, tribal, and/or territorial cancer programs with increased capacity to implement community clinical linkage interventions to improve the quality of life and healthy lifestyle behaviors of cancer survivors.

Tier 2 Performance Measures: Recipients are expected to select three of the following measures from # 1-6 (below). All tier two measures can be tracked through CDC surveillance (US Cancer Statistics and Behavioral Risk Factor Surveillance System) and/or tracking measures may be obtained through measures tracked by cancer prevention and control programs. Targets for each performance measure will be set by recipient after awards are made.

Long Term Outcomes Increase in health seeking and healthy lifestyle behaviors among general population (e.g., elimination of tobacco use, human papillomavirus (HPV) vaccination, Hepatitis B vaccination, improved physical activity, and improved diet).

Tier 2 PM Recipients are expected to implement the following:

1) Percent decrease in the prevalence of adults aged 18 years and older who are current smokers in identified priority populations (to be determined by the recipient based on cancer burden data).

Consideration should be given to underserved or underrepresented populations, or cancer survivors.

2) Percent increase in the prevalence of adults meeting 150 minutes of physical activity/week in identified priority populations (to be determined by the recipient based on cancer burden data).

Consideration should be given to underserved or underrepresented populations, or cancer survivors.

Long Term Outcomes Increased early detection of cancer Tier 2 PM Recipients are expected to implement the following:

3) Breast cancer screening: % increase of women aged 50-74 years in priority population who have had a mammogram in the past 2 years.

4) Cervical cancer screening: % increase of women aged 21-65 years in the priority population who have been screened for cervical cancer within the past 3 years;

5) Colorectal cancer screening: % increase of adults aged 50-75 years in the priority population who have been screened for colorectal cancer.

Long Term Outcomes Improved survivorship practices Tier 2 PM Recipients are expected to implement the following:

6) Percent increase in cancer survivors indicating that their overall health was excellent, very good, or good after receiving a survivorship care plan or participating in a lifestyle program.

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, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

https://www.cdc.gov/grants/additionalrequirements/ar-25.html

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, within the first 6 months of award, as described in the Reporting Section of this NOFO.

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.

Plans for disseminating evaluation findings, including development of white papers.

The evaluation and performance measurement plan should align with expectations set forth in Section iii. Strategies and Activities of this NOFO. Detailed expectations for the evaluation plan are described under Strategy 6.

Recipients will be required to submit a more detailed Evaluation Plan within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must meet the following criteria to fully demonstrate capacity to carry out the strategies outlined in the NOFO:

Background

A national presence, perspective and organizational focus dedicated to advancing the NCCCP, specifically an existence of local affiliates or chapters with demonstrated success or experience supporting cancer control activities to ensure national reach/impact.

A minimum 5-year history working with CCC programs and their coalitions; experience includes establishing appropriate relationships, collaborating to develop and implement public health program activities, and evaluating related to outcomes.

Demonstrate prior experience and success in providing technical assistance for 1) developing jurisdictional cancer plans and 2) strengthening cancer coalitions.

Capacity to engage or convene diverse, multi-sector public health partners or organizations to impact cancer control.

Content-specific Capacity

Subject matter expertise and experience in areas such as policy, systems, and environmental change for cancer control.

Experience and demonstrated success utilizing adult learning strategies to provide technical assistance and training opportunities to public health programs and their partners.

Capacity to communicate to a variety of audiences including, but not limited to, public health practitioners, decision-makers, scientists and physicians, and other CDC funding recipients.

Ability to facilitate a seamless interface between the provision of TAT provided by CDC (via program consultants) and the TAT provided by CCC national partners.

Program management

Demonstrate organizational structure and staffing with sufficient knowledge, skills and abilities to ensure program success. Applicants must name these files "CVs/Resumes" and "Organizational Charts" and upload it at www.grants.gov.

Ability to conduct ongoing performance management, performance monitoring and evaluation.

Fiscal management, monitoring and reporting, including development and implementation of a resource allocation plan.

Technological tools or resources to execute proposed strategies (i.e. methods of communicating with CCC program managers and coalition leaders via, at minimum, a website and email distribution list).

Administrative management of the required procurement efforts including the ability to write and award contracts.

d. Work Plan Applicants must submit a work plan that aligns with the strategies outlined in this NOFO. The following project period outcomes of this NOFO are listed below and should appear in the work plan as project period objectives associated with the strategy of implementing the training plan:

(1). increased knowledge and capacity among trainees to use interventions to improve healthy lifestyle behaviors and health seeking to reduce cancer risk (2). increased knowledge and capacity among trainees to use interventions to increase recommended cancer screenings (3). Increased knowledge and capacity among trainees to use cancer survivorship interventions (4). Increased use of PSE change planning models among trainees.

(5). Increased knowledge and capacity to address cancer-related health disparities.

Applicants may develop their own project period objectives to support other strategies (conducting the needs assessment, collaborating with partners) listed in the NOFO.

Each project period objective should be linked to a related program strategy and one or more annual objectives that support how the project period objective will be achieved after completion of the five-year funding period. Annual objectives can be process measures such as the following:

• Number and type of technical assistance products developed by the recipients for use by cancer programs and coalitions

• Number and type of trainings developed by the recipients and made available to cancer programs and coalitions.

• Number of cancer programs and coalitions that have received technical assistance and training from the recipient http://www.grants.gov/

• Number and type of methods/channels used by the recipient to disseminate TAT efforts to cancer programs, coalitions and partners.

Key activities to support each annual objective should be listed, along with lead personnel, key partners/contractors, and start/finish dates.

Project period and annual objectives should be in SMART (specific, measurable, achievable, relevant, and time-phased) format. This includes identifying what will be measured, the direction of change expected, the unit of measurement, the baseline and target values, the proposed data source for the measurement, and the timeframe the objective covers.

Applicants are encouraged to use the sample work plan template at DP18-1805 Program Information.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

In the cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant management. To assist recipients in achieving the purpose of this award, CDC will conduct the following activities:

Collaborate with recipients in work plan development, evaluation, performance measurement, program planning and capacity building https://www.cdc.gov/chronicdisease/about/foa/cancer-control/index.htm

Collaborate with recipients in the development of technical assistance efforts.

Collaborate with recipients in the development of publications, manuals, modules, etc.

that relate to the purpose of this NOFO, pending CDC approval.

Facilitate the exchange of information and coordination and collaboration between recipients funded under this announcement.

Provide recipients periodic updates regarding comprehensive cancer control, including information on best practices related to NCCCP priorities of emphasis of primary prevention activities, coordination of secondary prevention activities; activities that address cancer survivor needs, elimination of health disparities, use of policy systems and environmental approaches, and evaluation for outcome measurement.

Participate in conference calls; review, edit and approve summaries and reports.

Attend and participate in any in-person meetings, conference calls, etc.

Provide technical assistance in the areas of…