PKG00258252-instructions.pdf

DEPARTMENT OF

HEALTH AND HUMAN SERVICES

OFFICE OF THE

ASSISTANT SECRETARY FOR HEALTH

Office of Population Affairs

Funding Opportunity: Optimally Changing the Map for Teen Pregnancy

Prevention (Tier 1)

Opportunity Number: PA-TP1-20-001

Application Due Date:

Monday, April 13, 2020 6:00 PM Eastern

OVERVIEW

FEDERAL AGENCY NAME

Office of the Assistant Secretary for Health / Office of Population Affairs

FUNDING OPPORTUNITY TITLE

Optimally Change the Map of Teen Pregnancy through Replication of Programs Proven

Effective (Optimally Changing the Map for Teen Pregnancy Prevention – Tier 1)

ACTION

Notice

ANNOUNCEMENT TYPE

Competitive Cooperative Agreement

FUNDING OPPORTUNITY NUMBER

PA-TP1-20-001

CFDA NUMBER AND PROGRAM:

93.297 Teen Pregnancy Prevention

DATES

Application Deadline: Monday, April 13, 2020 by 6:00 PM Eastern.

Technical Assistance: Monday, February 24, 2020 at 2:30 pm Eastern Time

EXECUTIVE SUMMARY

The Office of Population Affairs announces the availability of funds for Fiscal Year (FY)

2020 cooperative agreement awards under the authority of Division A, Title II of the Further

Consolidated Appropriations Act, 2020 (Public Law No. 116-94).

This notice solicits applications for projects to serve communities and/or populations with the greatest need to Optimally Change the Map of Teen Pregnancy through Replication of

Programs Proven Effective (Optimally Changing the Map for Teen Pregnancy Prevention –

Tier 1).

The goal of this Funding Opportunity Announcement (FOA) is to have a significant impact on improving the optimal health of adolescents and reducing teen pregnancy and sexually transmitted infections (STIs) through saturation of communities with the greatest needs and disparities using a systems thinking approach to replicate effective programs with fidelity. The

Office of Population Affairs (OPA) intends to make available approximately $54 million for an estimated 65 awards. The amount of funding an applicant may request ranges from $500,000 to

$1.5 million per year for a period of 3 years (three 12-month budget periods).

The goal of this FOA will be realized through:

• Ensuring areas of greatest need are targeted in an effort to promote equity in reaching optimal health and preventing teen pregnancy and STIs

• Utilizing a systems thinking approach to identify multiple leverage points to maximize impact on promoting optimal health and preventing teen pregnancy and STIs

• Replicating with fidelity effective programs and supportive services that are culturally appropriate, age appropriate, medically accurate, and trauma-informed.

• Applying the power of youth and community voice to ensure the project is of the highest quality and best fit for the community(ies) and population(s) to be served.

• Monitoring, evaluating, and improving the project; and using key performance measures to document the project.

• Communicating and disseminating information, successes, lessons learned, and knowledge.

For the purposes of this FOA, “project” refers to all activities described in the application and funded by the award (e.g., staffing, partnerships, supportive services, professional development, evaluation, dissemination, etc.) whereas “effective program(s)” refers to programs proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors and eligible for replication (e.g., curriculum, interventions, etc.).

HHS/OASH encourages applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that its application complies with all requirements and instructions.

FUNDING OPPORTUNITY DETAILS

A. DATES

1. Application Deadline

Your application is due Monday, April 13, 2020 by 6 p.m. Eastern Time. To receive consideration, you must submit your application electronically via Grants.gov no later than this due date and time. If you do not submit your application by the specified deadline, we will return it to you unread. You must submit electronically via Grants.gov unless you obtain a written exemption from this requirement 2 business days in advance of the deadline from the Director, HHS/Office of the Assistant Secretary for Health (OASH) Office of Grants Management (OGM).

To obtain an exemption, you must request one via email from the HHS/OASH OGM, and provide details as to why you are technologically unable to submit electronically through Grants.gov. Your request should be submitted at least 4 business days prior to the application deadline to ensure your request can be considered prior to 2 business days in advance of the deadline. If you request an exemption, include the following in your e-mail request: the HHS/OASH announcement number;

your organization's DUNS number; your organization’s name, address and telephone number; the name and telephone number of your Authorizing Official; the Grants.gov Tracking Number (for example, GRANT####) assigned to your submission; and a copy of the "Rejected with Errors" notification from Grants.gov. Send the request with supporting documentation to ogm.oash@hhs.gov. Note: failure to have an active System for Account Management (SAM) registration prior to the application due date will not be grounds for receiving an exemption to the electronic submission requirement. Failure to follow Grants.gov instructions to ensure software compatibility will not be grounds for receiving an exemption to the electronic submission requirement.

The HHS/OASH OGM will only accept applications via alternate methods (hardcopy paper via U.S. mail or other provider or PDF via email) from applicants obtaining prior written approval.

If you receive an exemption, you must still submit your application by the deadline. Only applications submitted through the Grants.gov portal or alternate format (hardcopy paper via U.S.

mail or other service or PDF via email) with an approved written exemption will be accepted. See

Section F.8 (“Other Submission Requirements”) for information on application submission mechanisms.

To ensure adequate time to submit your application successfully, HHS/OASH recommends that you register as early as possible in Grants.gov since the registration process can take up to one month. You must register an authorizing official for your organization. HHS/OASH does not determine your organization’s authorizing official; your organization makes that designation. For information on registering for Grants.gov, refer to http://www.grants.gov or contact the Grants.gov mailto:ogm.oash@hhs.gov http://www.grants.gov/

Contact Center 24 hours a day, 7 days a week (excluding Federal holidays) at 1-800-518-4726 or support@grants.gov.

Your organization is strongly encouraged to register multiple authorized organization representatives in Grants.gov to ensure someone is available to submit your application.

2. Technical Assistance

A technical assistance webinar for potential applicants will be held on Monday, Feb. 24th at

2:30 PM Eastern. Information on how to log-on to the technical assistance webinar will be available on the OPA website at www.hhs.gov/opa.

We recommend you review the entire announcement promptly so you can have any questions answered well in advance of the application due date. We also recommend you subscribe to this announcement in Grants.gov so you receive any amendments, question and answer documents, or other updates.

B. PROGRAM DESCRIPTION:

The Office of the Assistant Secretary for Health, Office of Population Affairs announces the availability of funds for Fiscal Year (FY) 2020 cooperative agreement awards under the authority of Division A, Title II of the Further Consolidated Appropriations Act, 2020 (Public Law No. 116-

94).

The primary focus of the Office of the Assistant Secretary for Health is leading America to healthier lives, especially for those who are most vulnerable, including those who have suffered historic disparities. In support of this vision, the Office of Population Affairs promotes health across the reproductive lifespan through innovative, evidence-based adolescent health and family mailto:support@grants.gov http://www.hhs.gov/opa planning programs, services, strategic partnerships, evaluation, and research. The Teen Pregnancy

Prevention (TPP) Program is designed to give youth the information and skills to promote optimal health and prevent teen pregnancy across the United States, especially among those who are most vulnerable, including those who have suffered historic disparities.

1. Background

While there has been great progress in reducing teen pregnancy and sexual risk taking, the current teen birth rate in 2018 of 17.4 per 1,000 females aged 15-191 is still much higher than other western industrialized nations,2 young people ages 15 to 24 account for nearly one-half of all new cases of sexually transmitted diseases (STDs), 3 and we continue to see disparities by race, ethnicity,4 and among our most vulnerable populations, including youth who are experiencing homelessness,5,6 living in foster care,7,8 involved with the juvenile justice system,9-10,11,12,13 and expectant and/or parenting.14-15,16 Incidence and prevalence estimates suggest that young people aged 15–24 years acquire half of all new STDs and that one in four sexually active adolescent females has an STD, such as chlamydia or human papillomavirus (HPV). Compared with older adults, sexually active adolescents aged 15–19 years and young adults aged 20–24 years are at higher risk of acquiring STDs.17

OPA is especially interested in targeting resources to populations and communities of young people inordinately impacted by teen pregnancy and STIs, behavioral risk factors underlying teen pregnancy, or other associated risk factors (e.g., exposure to violence, substance abuse) as mentioned above, and aims to transform their adolescent health outcomes by promoting equity in reaching optimal health. Equity, as it relates to health, is the attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing efforts to address avoidable inequalities and the elimination of health and healthcare disparities.18 Prioritizing equity versus equality allows programs to be more in tune with the needs of the community and/or population and provides resources to overcome challenges.

OPA promotes health across the reproductive lifespan through innovative, evidence-based adolescent health and family planning programs, services, strategic partnerships, evaluation, and research. The Teen Pregnancy Prevention (TPP) Program is designed to give youth the information and skills to promote optimal health and prevent teen pregnancy across the United States through lifestyle change. “Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice.”19

Many risky behaviors associated with teen pregnancy have a shared set of risk and protective factors.20 Protective factors or youth assets work by reducing exposure to risk or encouraging behaviors that prevent adverse outcomes. The U.S. Department of Health and Human Services sought the input of professionals who, through their work in out-of-school, community-based, faith-based, education, healthcare, public health, and social services settings, reach a large number of adolescents. Together these national leaders identified five essential components of adolescent health. The Adolescent Health: Think, Act, Grow® (TAG) 21 five essentials for adolescent health are: (1) Positive connections with supportive people; (2) Safe and secure places to live, learn, work and play; (3) Access to high quality and teen friendly health care; (4) Opportunities to engage as learners, leaders, team members, and workers; and (5) Coordinated adolescent and family centered services.22 These five essentials provide a framework for promoting healthier communities within which adolescents live and serve as protective factors.

Research shows the more protective factors or assets a youth has, the more resilient the youth becomes, and the less likely they are to engage in risky behaviors.22 Addressing youth risk factors is fundamental, but defining goals only in terms of the negative risks is limiting. To have a more significant impact on teen pregnancy and STIs and to achieve optimal health, it is crucial to utilize a systems thinking approach; to identify multiple leverage points in the “system” within which a community or specific population is working to reach optimal health.

The optimal health 23 model and systems thinking approach are two concepts that are complementary of each other in that the purpose of the optimal health model is to bring individuals and communities to a place of optimal health and systems thinking provides an approach by which opportunities can be created that open access to environments that make optimal health attainable. The optimal health model focuses on population-level interventions that promote the best possible health outcome for the community while also meeting individuals where they are to provide them with the knowledge, skills and motivation to make appropriate changes that will lead them towards a position of increasingly lower risk.24 The optimal health model can be applied to a broad range of programs proven effective at preventing teen pregnancy, and associated risk behaviors, including positive youth development, sex education, abstinence education, and programs designed for diverse populations and settings.

A systems thinking approach helps us to see the “big picture” in which the issue of teen pregnancy and STIs exists. It provides a framework to help examine the factors involved in the problem, the relations between these factors, and changes over time. With an understanding of the system, public health practitioners can then identify multiple leverage points where great impacts can be made in an effort to create a healthier system and achieve optimal health. As such, the solutions often require multi-level, multi-faceted approaches to help the system to function in a better and more sustainable way for our youth, communities, and populations. As part of this approach, it’s vital to engage organizations with a shared purpose and seek opportunities to collaborate in order to expand the impact on teen pregnancy and STIs. No one person or organization has a full understanding of the issue of teen pregnancy and STIs or all the resources necessary to achieve optimal health.

The integration of optimal health and systems thinking with an equitable lens will effectively deliver solutions that eliminate health disparities and achieve optimal health for adolescents and prevent teen pregnancy, STIs, and associated risk behaviors, while also increasing protective factors. Utilizing optimal health and the TAG five essentials with a systems thinking approach, projects are expected to:

(a) Ensure areas of greatest need are targeted in an effort to promote equity in reaching optimal health and preventing teen pregnancy and STIs.

(b) Utilize a systems thinking approach to identify multiple leverage points to maximize impact on promoting optimal health and preventing teen pregnancy and STIs.

(c) Replicate with fidelity effective programs and supportive services that are culturally appropriate, age-appropriate, medically accurate, and trauma-informed.

(d) Apply the power of youth and community voice to ensure the project is of the highest quality and best fit for the community(ies) and population(s) to be served.

(e) Monitor, evaluate, and improve the project; uses key performance measures to document the project.

(f) Communicate and disseminate information, successes, lessons learned, and knowledge.

2. Expectations

Successful applicants are expected to:

a. Ensure areas of greatest need are targeted in an effort to promote equity in reaching optimal health and preventing teen pregnancy and STIs.

The goal of this FOA is to have a significant impact on improving the optimal health of adolescents and reducing rates of teen pregnancy and STIs through saturation of communities with the greatest needs and disparities with effective programs and supportive services utilizing a systems thinking approach. The intent of targeting limited resources to serving communities with the greatest need is to ensure equity and improve health outcomes. Providing equal resources to all is not the answer to reducing the health disparities gap. Instead, the underlying issues and individual needs of underserved and vulnerable populations must be effectively addressed in an effort to support such communities and populations.

Applicants may propose, within a single application, serving a single community, multiple communities, or specific population(s) within a defined community that demonstrate the greatest need for resources. Multiple communities could include communities within the same state, communities across states, etc. The applicant should also describe the target population(s) for the proposed program. The target population for funded projects should be adolescents 19 years of age or under at the time of program entry. OPA is especially interested in projects that will focus on those specific populations inordinately impacted by teen pregnancy and STIs, behavioral risk factors underlying teen pregnancy, or other associated risk factors (e.g., exposure to violence, substance abuse, and mental health). This includes youth with juvenile justice involvement, youth in the child welfare system/foster care, youth experiencing homelessness, and/or expectant and parenting youth. It is expected that each community and/or population(s) served be defined by clear geographic boundaries. Identifying the geographical boundaries of the community involves a balance between drawing a boundary wide enough to fully understand why the issue of teen pregnancy and STIs persist in creating barriers to optimal health and what multiple leverage points may be most effective to intervene, but narrow enough to make the task of understanding and acting within the community feasible.

In order to ensure equity and improve outcomes within communities and populations with the greatest need, applicants need to understand where the greatest need is, what the specific needs and resources are, who the key stakeholders are, and the relationship between all of these components. In other words, applicants must understand the “system.” For the purposes of this

FOA, the factors involved in the problem, relationship among these factors, and the patterns of behavior identified, are considered the “system”. A system may be identified at a regional, state, or local level, and is not restricted to any particular setting (e.g., school, juvenile detention center, clinic).

Applicants are expected to gather data on the community and/or population to be served within the defined geographic area(s) through various means that will ensure they understand the systems within which they will be working to prevent teen pregnancy. There are various resources and tools available to collect all this data. This may include but is not limited to mapping the system to represent system elements and connections, stakeholder analysis, utilization of geographical information systems (GIS), traditional community needs and resource assessment, and concept mapping. At a minimum, applicants are expected to use data at the geographically defined level to:

• Identify the needs of the community related to teen pregnancy, teen births, prevalence of STIs including HIV among youth, sexual risk behaviors, and existing disparities;

• Identify areas of elevated need within the community;

• Provide data on social determinants of health and co-occurring risk behaviors that impact teen pregnancy, STIs, and sexual risk taking; and

• Describe resources currently available in the community to prevent teen pregnancy.

Prove the community wants a solution to promote optimal health for all adolescents (including preventing teen pregnancy and STIs) and believes that these issues (teen pregnancy and STIs) are a priority for their community (i.e., demonstrated demand).

Note that the information collected through assessments is critical for applications, however, such assessments are expected to occur on a frequent basis throughout the life of the project and not be limited to this one occurrence.

b. Utilize a systems thinking approach to identify multiple leverage points to maximize impact on promoting optimal health and preventing teen pregnancy and STIs.

Applicants are expected to use the data they’ve gathered to demonstrate an understanding of the system within which a community or specific population exists (see Expectation #1) to identify multiple leverage points that can be addressed to saturate communities with effective programs and supportive services focused at changing individual attitudes, efficacy, and behaviors, as well as community-level knowledge and attitudes, especially as it pertains to promoting the optimal health of adolescents. Leverage points are those places where we can apply pressure to move the drive for change forward25 or reduce the barriers to change. Examples of leverage points include organizational policies and procedures, coordination among multiple partners working in a community, programming for youth, programming for parents and caregivers, training for youth-serving professionals, coordination and referral to support services, etc. The multiple leverage points selected should have the potential to have a significant impact on improving optimal health and preventing teen pregnancy and STIs in the systems, communities, and populations served.

For each leverage point identified, applicants are expected to identify effective programs and services that clearly align with the results of the assessments completed within the community and/or population(s) to be served. Programs and services should not solely focus on risk factors but also on protective factors by integrating, to the best extent possible, the TAG five essentials for adolescent health: (1) Positive connections with supportive people; (2) Safe and secure places to live, learn, work and play; (3) Access to high quality and teen friendly health care; (4)

Opportunities to engage as learners, leaders, team members, and workers; and (5) Coordinated adolescent and family centered services.

c. Replicate with fidelity effective programs and supportive services that are culturally appropriate, age appropriate, medically accurate, and trauma-informed.

Recipients will be expected to saturate each community and/or population(s) served by replicating effective programs and services that support effective programs. In order to have the largest impact possible, recipients are expected to saturate their communities by replicating effective programs with as many youth and families as possible. OPA expects that, at a minimum, recipients will replicate effective programs with at least 25% of the adolescents within the defined geographic area(s) and/or population(s) within the defined geographic area on an annual basis. For the purposes of this FOA, saturation is the percentage of participants from the community and/or population who receive effective programs relative to the number of those from the community and/or population who could have received programs. Saturation requires geographical boundaries in order to determine the accurate number of youth within the community who are eligible to receive effective programs (see more on defining geographical boundaries in

Section B.2.a).

1) Replication of Effective Programs

Programs to be replicated are those that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors. Recipients are expected to apply information gained from implementation research and science to ensure replication of effective programs are of the highest quality and implemented with fidelity. This includes ensuring that staff and partners involved in the overall project are trained, not only on the effective program, but also on the skills and competencies needed to ensure the program is replicated with quality and fidelity (see more on training and professional development under Project Management). Slight modifications or adaptations may be made to the effective program if such changes are aimed at improving the fit and relevancy of the program to the community and population served and do not compromise fidelity integrity (i.e., compromise the underlying elements/components of the program). To ensure quality implementation, it is expected that all staff, including sub-awardees and partner staff, be well trained and prepared to successfully fulfill their roles and responsibilities. Recipients should assess the professional development needs of staff on a regular basis and use the results to develop a plan for providing ongoing professional development.

For purposes of this FOA, rigorous evaluation results come from robust evaluation designs, particularly experiments or quasi-experiments (see Appendix B – Selected Glossary of Terms and

Definitions for more information about evaluation design).

(a) Experiments

Experimental design studies using random control trials (RCTs) assign program participants to two distinct groups (at random): the treatment group, which receives program services, and the control group, which does not. The control group is called the “counterfactual,” representing the condition in which the program or intervention is absent. Random assignment ensures that the treatment and control groups are initially similar and do not differ on background characteristics or other factors. Random assignment, thus, creates an evaluation design where any observed differences between the two groups after the program intervention takes place can be attributed to the intervention with a high degree of confidence.

(b) Random Assignment

A process that uses randomly generated numbers or other approaches to assign study units to groups in ways that are unaffected by the characteristics of the study units. With random assignment, any differences between the groups at pre-test can be attributed only to chance. The use, or lack of use, of this process differentiates experimental designs from non-experimental designs.

(c) Quasi-Experiments

A design that forms a counterfactual group by means other than random assignment. This approach is used for conducting impact evaluations where observed changes in the treatment group are compared with a comparison group (as a counterfactual representing an absence of intervention) to assess and estimate the impact of the program on participants. However groups formed in these designs typically differ for reasons other than chance, and these differences may influence the impact estimate. There are different types of approaches used in quasi-experimental designs such as those using Propensity Score Matching (PSM), Regression Discontinuity, Interrupted Time Series (ITS) and others.

When selecting program(s) for replication under this FOA, the following criteria must be met:

• The program model has been proven effective through a rigorous experimental or quasi-experimental evaluation study to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or associated risks;

• Rigorous evaluation of the program model demonstrates at least one statistically significant positive outcome on a relevant behavioral outcome, and no statistically significant negative outcomes, from a study (or studies) that meets the definition of rigorous evaluation;

• The research has been published in a peer reviewed medium such as an academic journal, published Federal Government report, published evidence review clearinghouse, or a National Institutes of Medicine report;

• The research was conducted by an independent evaluator who was/is neither part of the publishing team, nor an author of the curriculum; and

• The research is no older than twenty (20) years.

While selecting programs is important, it is assumed that recipients will use the first several months at the start of the project as a planning period to revisit the community assessments and engage in piloting to ensure that all programs proposed for replication are the best fit to address the needs and demand identified, the implementation setting, the capacity of the implementing organization, and the intended outcomes. The duration of the planning period is contingent upon each recipient’s demonstrated readiness, but will not exceed six months. It is assumed that work is already underway with the submission of this application and therefore the planning period is the time in which recipients are checking the assumptions made in the application, refining their plan for the project, and getting ready for implementation.

2) Supportive Services

Recipients are expected to engage partners to provide a network of cohesive services that support the needs of adolescents, parents/caregivers, and the community in order to achieve optimal health and prevent teen pregnancy and STIs. The optimal health model provides a holistic focus with the aim of attaining the best possible health outcomes by promoting healthier behaviors and not merely the absence of disease. This cannot be accomplished through effective programs alone nor should it be addressed in a silo. A systems thinking approach, by nature, cannot be completed without collaboration and representation from the system that is intended to change.

Recipients are to identify an active network of partners with whom to collaborate to offer coordinated, multi-modal, youth-friendly and trauma-informed services to address the multiple leverage points identified in Section B.2.b. Such services should support the needs of adolescents, parents/caregivers, and the community while also complementing the implementation of effective programs. Services should balance the need to address risk factors while also building on protective factors in an effort to foster resiliency and support adolescents, their parents/caregivers, and the community to reach optimal health.

Identified partners for this approach should be reflective of the stakeholders in the system, representing various sectors and disciplines influencing teen pregnancy and STIs. This should include, but is not limited to, healthcare professionals who can provide high-quality, youth-friendly healthcare services for youth participants and their parents/caregivers. Partnerships should be based on a relationship built on trust and respect in which all involved are ultimately committed to meeting youth and the community where they are and providing services that are culturally appropriate, age appropriate, medically accurate and trauma-informed to ensure youth and the community reach optimal health. This also requires partners to be very clear about their roles and responsibilities as well as the level of collaboration required.

For partnerships that already exist, the application should include a signed Memorandum of

Understanding (MOU) or Letter of Agreement (LOA) that describes how the partner will contribute to the project and clearly outlines roles, responsibilities, and expectations. For partnerships that have not been forged prior to the application submission, the applicant should describe which partners are needed and why, their roles and responsibilities, and how they plan to forge the partnership.

3) Culturally Appropriate, Age-Appropriate, Medically Accurate, and Trauma-informed

All materials used in the funded project and in the replication of effective program(s), are required to be age appropriate and medically accurate, and are expected to be culturally appropriate and trauma-informed.

(a) Culturally appropriate assures that materials and language used is respectful of and responsive to the cultural and linguistic needs of the population being served.

(b) Age appropriateness assures that topics and themes are appropriate for the age group and other specific characteristics of the target audience. Age appropriate means it will be appropriate for the general developmental and social maturity of the targeted age group. The ability to cognitively understand a concept is not evidence that the concept is age appropriate.

(c) Medical accuracy assures that statements neither understate nor overstate the facts and/or best medical evidence. For purposes of this announcement, the term

“medically accurate” means the information will be referenced to peer reviewed publications by educational, scientific, governmental, or health organizations.

(d) A trauma-informed approach refers to how a program, agency, organization, or community thinks about and responds to those who have experienced or may be at risk for experiencing trauma. Traumatic events come in many forms, from unpreventable natural disasters, motor vehicle crashes, and loss of loved ones, to more preventable child maltreatment and neglect or community violence that affect not only the individual, but also the family, community, and general society: We are all affected by trauma.26 Given the presence of trauma in the lives of many youth, a trauma-informed approach to providing services is critical. A trauma-informed approach includes: (1) Realizing the widespread impact of trauma and potential paths for recovery; (2) Recognizing the signs and symptoms of trauma in youth, families, staff, and others; (3) Responding by fully integrating knowledge about trauma into policies, procedures, and practices; and (4) Seeking to actively resist re-traumatization. 27 In this approach, all components of the organization incorporate a thorough understanding of the prevalence and impact of trauma, the role that trauma plays, and the complex and varied paths in which people recover and heal from trauma.

Recipients are expected to conduct their own review of all materials as well as implementation practices and services related to the project to ensure they are culturally appropriate, age appropriate, medically accurate, and trauma-informed. Recipients will certify that all materials have been reviewed prior to use. OPA may review for medical accuracy, if deemed necessary. Any necessary modifications should be made by the recipient to ensure materials are culturally appropriate, age appropriate, medically accurate, and trauma-informed.

Recipients are also expected to work with their partners and take the appropriate measures needed to ensure services are culturally appropriate, age appropriate, medically accurate, and trauma-informed. OPA expects recipients to continuously assess materials, implementation, and services related to the project to ensure they remain culturally appropriate, age appropriate, medically accurate, and trauma-informed.

d. Apply the power of youth and community voice to ensure the project is of the highest quality and best fit for the community(ies) and population(s) to be served.

Recipients are expected to engage youth, parents/caregivers, and the community in the planning, implementation and evaluation of the project to ensure effective programs and supportive services are of the highest quality and best fit for the community(ies) and population(s) to be served. Meaningful and authentic youth engagement can be time consuming as it requires preparation, dedicated resources, support, and opportunity. An important component of youth engagement is creating equitable opportunities for youth to express themselves, voice their ideas, and provide input for projects or programs. It is critical for youth to be heard. 28 Equitable engagement of youth means that youth of all backgrounds and lived experiences, particularly those who are the most vulnerable, have opportunities to participate, be empowered, and have their voices heard in decisions that affect their lives.

It is important that any youth engagement strategy carefully think through how to ensure engagement strategies include youth who are often marginalized or disconnected. Adults who work with the youth should understand contextual factors and barriers that may inhibit full participation, which would enhance their ability to engage them.

It's also important to engage those individuals with a meaningful and significant role in youths’ lives; this includes parents/caregivers and community stakeholders, in order to create an environment in which youth may achieve optimal health. Research also shows that, overall, public health interventions using community engagement strategies for disadvantaged groups are effective in terms of health behaviors, health consequences, health behavior self-efficacy, and perceived social support. As the goal of optimal health is to create a healthier system (i.e., a community in which youth are supported in their efforts to reduce and ideally avoid risk), then engagement of family/caregivers and the community must be a central tenet of the project.

Engagement strategies for parents/caregivers should demonstrate a commitment to reaching out to engage parents/caregivers in meaningful ways in order to support parents/caregivers role in their children’s and adolescents’ healthy decision-making. It should reinforce adolescents’ health and learning in multiple settings—at home, in school, in out-of-school programs, and in the community.29 Strategies for engaging the community should reflect a process by which organizations and individuals build a long term relationship with a collective vision for the benefit of the community.30

e. Monitor, evaluate, and improve the project; and use key performance measures to document the project.

Recipients are expected to have a Monitoring, Evaluation, and Improvement Plan for the project. The plan should reflect how the recipient will continuously monitor, evaluate, and improve the project and include a learning agenda for the overall project. The plan should be flexible and adaptable to ensure the most critical programmatic questions are addressed as the need arises. For this FOA, the purpose of monitoring and evaluation is to focus on implementation evaluation and ensuring the quality of all aspects of the project. A learning agenda may include outcomes related to the quality of implementation, fidelity of implementation, participant engagement and satisfaction, assessing if the project or program is meeting the needs of the community, etc.

Recipients will also be required to include fidelity as part of their Monitoring, Evaluation, and Improvement Plan that includes, at a minimum, collecting data on fidelity and quality from program facilitators as well as from observations of at least 10% of all program sessions and 100% of all program facilitators, reviewing and analyzing data on a regular basis, using data to provide feedback to facilitators, and using the data to make continuous quality improvements to the program and its implementation. Recipients should also establish procedures to maintain improvements and assure quality. It is expected that the recipient will document and monitor the project overall, using performance measures and other relevant data to track progress.

The Monitoring, Evaluation, and Improvement Plan should reflect a team approach in which an evaluator or evaluation staff is/are an integral member along with staff reflecting implementation of programs and services; such a partnership is critical to the success of the plan and project overall. Implementation and evaluation staff are expected to work together to decide the questions to ask, determine the data to collect, and translate the findings to improve the project.

All recipients are expected to collect a common set of performance measures to assess project implementation, make improvements, and learn. Furthermore, recipients will be expected to collect data to monitor ongoing implementation, and to use the data to make continuous quality improvements to the project to ensure that high-quality programming and high-levels of participant engagement are maintained. Recipients must collect all performance measures and report to OPA on a semi-annual basis. Final performance measures will be provided to recipients during the first six months of funding and may include measures on reach, dosage (i.e., “how much” of the program a participant received), implementation quality, sustainability, partnerships, trainings, and dissemination.

Recipients should review relevant state laws, organizational policies, and other administrative procedures of their sites or partner organizations to ensure the feasibility of data collection. Recipients should obtain any necessary permissions to collect required data. The applicant is expected to navigate and receive IRB approval, if needed. Further, as a condition of the award, all successful recipients will be required to participate in any OPA-directed Federal evaluation, if selected, and if funding for such an evaluation becomes available. Any costs associated with evaluation data collection for the Federal evaluation will be paid for by the Federal evaluation contractor.

f. Communicate and disseminate information, successes, lessons learned, and knowledge.

Communication and dissemination of information is vitally important to maintaining relationships with partners as well as with the community. Stakeholders (including youth, parents/caregivers, and the community) and partners should be informed on the progress made in the project and in tackling the issue of optimal health, teen pregnancy, and STIs. To ensure projects have the greatest impact, a strategic dissemination and communications plan is needed. Such plans should communicate the issue of teen pregnancy and STIs within the community to educate and gain buy-in and disseminate information about the project and organizations involved to establish legitimacy and increase access to services and resources. Messages created through this plan are meant to: (1) raise awareness of optimal health and the issue of teen pregnancy and STIs; (2) inspire change; and (3) inform youth, parents/caregivers and the community about the services/interventions available.

3. Award Type

Awards will be in the form of a cooperative agreement with the recipient. Cooperative agreements are a form of assistance that allows for substantial involvement between OPA and the recipient during the project period. In addition to the usual monitoring and technical assistance provided under the cooperative agreement (e.g., assistance from assigned Federal project officer, frequent monitoring calls, site visits, ongoing review of plans and progress, participation in relevant meetings, provision of training and technical assistance). OPA substantial programmatic involvement may include:

(a) Prior approval for change of time that Key Personnel are dedicated to the project and for replacement of Key Personnel. Key Personnel includes any position that is responsible for the day-to-day management and oversight of the project, as well as the lead evaluator for the project and those assisting the awardee to establish, review, and update priorities for activities conducted under the auspices of this cooperative agreement.

(b) Consulting with the awardee throughout the preparation and dissemination of materials related to the award.

(c) Review of recipient progress during the planning period and approval to move forward with full implementation.

(d) Review and approval of programs selected for replication, implementation plans prior to replication, and proposed adaptations to effective programs.

(e) Ensuring review of all program materials prior to use in the project to ensure the materials are medically-accurate, age appropriate, culturally appropriate, and trauma-informed.

(f) Review and approval of Monitoring, Evaluation, and Improvement

Plan; specifically as it relates to evaluation.

C. AUTHORITY

Division A, Title II of the Further Consolidated Appropriations Act, 2020 (Public Law No.

116-94).

D. FEDERAL AWARD INFORMATION

The Office of Population Affairs intends to make funds available for competing cooperative agreements.

We will fund awards in annual increments (budget periods) and generally for a project period up to 3 years, although we may approve shorter project periods. Budget periods may also vary from the estimate indicated below due to timing of award issuance or other administrative factors.

Funding for all approved budget periods beyond the first is generally level with the initial award amount and is contingent upon the availability of funds, satisfactory progress of the project, and adequate stewardship of Federal funds.

Award Information

Estimated Federal Funds Available: $54,750,000

Anticipated Number of Awards: 54-65

Award Ceiling (Federal Funds including indirect costs): $1.5 million per budget period

Award Floor (Federal Funds including indirect costs):$500,000 per budget period

Anticipated Start Date: July 1, 2020

Estimated Period of Performance: Not to exceed 3 years

Anticipated Initial Budget Period Length: 12 months

Type of Award: Cooperative Agreement. Agency substantial involvement outlined above in Program Description.

Type of Application Accepted: Electronic via Grants.gov ONLY unless an exemption is granted

E. ELIGIBILITY INFORMATION

1. Eligible Applicants.

Any public or private entity, including faith-based, community-based, and Indian Tribes or

Tribal organizations are eligible to apply

2. Cost Sharing or Matching

You are not required to provide cost sharing or matching in your proposed budget.

3. Other Eligibility Information

None

4. Application Disqualification Criteria

If you successfully submit an application, we will screen it to ensure it meets the below requirements. If we determine your application fails to meet the criteria described below we will disqualify it, that is, we will not review it and will give it no further consideration.

(a) You must submit your application electronically via www.grants.gov (unless an exemption was granted 2 business days prior to the deadline) by the date and time indicated in the DATES section (A.1) of this announcement.

(b) If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline.

(c) HHS/OASH/OGM deems your application eligible according to section E.1 Eligible

Applicants.

(d) You must complete the required forms in the application package: SF-424, SF-424A, SF-424B, SF-LLL, and Project Abstract Summary.

(e) Your Project Narrative section of the application must be double-spaced, on the equivalent of 8 ½ ” x 11” inch page size, with 1” margins on all sides (top, bottom, left and right) and font size not less than 12 points.

(f) Your Project Narrative must not exceed 50 pages. NOTE: The following items do not count toward the Project Narrative page limit: all required forms, including SF-424, SF-424A, SF-424B, SF-LLL, Project Abstract Summary, and Budget Narrative

(including budget tables).

(g) Your total application, including the Project Narrative plus Appendices, must not exceed 100 pages. NOTE: items listed in “(f)” immediately above do not count toward total page limit.

(h) Your Federal funds request including indirect costs must not exceed the maximum indicated in Award Ceiling.

(i) Your Federal funds request including indirect costs must not be below the minimum indicated in Award Floor.

(j) Your application must meet the Application Responsiveness Criteria outlined above.

F. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package

You may obtain an application package electronically by accessing Grants.gov at http://www.grants.gov/. You can find it by searching on the CFDA number shown on page 1 of this funding opportunity announcement. If you have problems accessing the application or difficulty downloading, contact:

Office of Grants Management

Phone: 240-453-8822

Email: ogm.oash@hhs.gov

2. Content and Form of Application Submission

a. Application Format

Your application must be prepared using the forms and information provided in the online application package.

The Project Narrative, and total application including appendices, must adhere to the page limit indicated in Application Disqualification Criteria listed in Section C. The page limit does not include the Budget Narrative (including budget tables), required forms, assurances, and certifications as described in the Application Disqualification Criteria. Please do not number pages mailto:ogm.oash@hhs.gov or include a table of contents. Our grants management system will generate page numbers once your application is complete. If your application exceeds the specified page limits for the Project

Narrative or Project Narrative plus Appendices when printed on 8.5” X 11” paper by

HHS/OASH/OGM, we will not review it. We recommend you print out your application before submitting electronically to ensure that it is within the page limits and is easy to read.

You must double-space the Project Narrative pages.

You should use an easily readable typeface, such as Times New Roman or Arial. You must use 12-point font. You may single-space tables or use alternate fonts but you must ensure the tables are easy to read.

b. Appendices Format

Your Appendices should include any specific documents outlined in Section D.2.iii., under the heading “Appendices” in the Application Content section of this funding opportunity announcement. Your documents should be easy to read. You should use the same formatting specified for the Project Narrative.