Enhance Targeted Messages

Answers to questions submitted by vendors attached on 7/29/2019.

Office of the Assistant Secretary for Health (OASH)
Office of Regional Health Administrator (ORHA)-Region VII (MO, IA, NE, KS)

Performance of
Tailored Messaging to Address Racial and Ethnic Disparities in
Adult Immunization using the Health Belief Model
1.0 SCOPE
a. Purpose
The purpose of this contract is to increase community demand for pneumococcal and herpes zoster vaccination by utilizing the Health Belief Model (HBM) to enhance targeted messages based on feedback from non-Hispanic African American Community Health Workers (CHW). This purpose aligns with the NVPO priority area of adult immunization and goal three of the National Adult Immunization Plan, "increase community demand for adult immunization". The project goal is to increase community demand for pneumococcal and herpes zoster vaccinations among non-Hispanic African American CHWs over the age of 50 through the development of targeted promotional materials utilizing the HBM as a guiding framework.

b. Background
The Office of Regional Health Administrators (ORHA) promotes real-world implementation of HHS's broad prevention mission and specific prevention initiatives in the field, such as:
• The National Prevention Strategy
• Seasonal influenza outreach activities
• New national strategic action plans for HIV/AIDS prevention
• Tobacco control
• Public health systems quality

Each regional health office is led by a Regional Health Administrator (RHA), who serves as the senior federal public health official and scientist in the region and as a liaison with federal, state, tribal, territorial, and local health officials and entities on all matters of public health and prevention. Jointly, the ten RHAs, their staff and OASH's Regional Liaison comprise the Office of the Regional Health Administrators within OASH. An important focus of the activities of the ORHA is to provide traction and field support for the implementation of the specific initiatives, programs and directives of the HHS operating and staff divisions, and OASH program offices.
The US Department of Health and Human Services released the National Vaccine Plan in 2010. In an effort to address low vaccination and immunization rates in adults, the National Adult Immunization Plan was proposed to address four key goal areas: 1) strengthen the adult immunization infrastructure, 2) improve access to adult vaccines, 3) increase community demand for adult immunization, and 4) foster innovation in adult vaccine development and vaccination related technology. This plan advises stakeholders on the importance of increasing adult vaccination/ immunization rates within the US.
According to CDC, vaccination rates for adults are low, and disparities persist among racial and ethnic minority populations. Disparities in vaccine coverage for non-Hispanic African Americans have widened with pneumococcal and herpes zoster vaccination. African Americans at increased risk for pneumococcal were lower (55.5%) compared to Whites (71.0%) [CDC, 2015]. Whites between the ages of 60 and 64 years reported higher herpes zoster vaccination coverage (37.7%) compared to African Americans (15.7%) [CDC, 2015]
Research around best practices for increasing adult immunization among racial and ethnic minorities is limited. Factors related to understanding the cause for the racial and ethnic disparities remains inconclusive. However, some articles and research suggest identifying factors that are responsible for the racial and ethnic disparities within adult immunizations as a promising approach .
Health Belief Model (HBM) is a health promotion and disease prevention framework utilized to predict and change health behaviors . Utilizing HBM, there is potential to assess an individual's perceived threat of sickness (perceived susceptibility), belief of consequence (perceived severity), potential positive benefits of action (perceived benefits), perceived barriers to action, and exposure to factors that prompt action (cues to action). Several communication and campaign efforts have utilized the HBM to develop personalized and targeted messaging . These efforts yielded between a 70% to 90% change in positive behavior. For purposes of this project, HBM will provide insight related to barriers such as trust, threats, and motivators for adult immunizations among non-Hispanic African American CHWs.
The proposed project goal is to increase community demand for pneumococcal and herpes zoster vaccinations among non-Hispanic African American CHWs through the development of targeted promotional materials utilizing the HBM as a guiding framework.
The project will utilize a sample population of non-Hispanic African American CHWs and community members over the ages of 50 living within two major metropolitan areas located within Region 7 - Omaha, NE and Kansas City, MO. The targeted populations were selected based on supporting data from the CMS Mapping Medicare Disparities Tool .
2.0 SCHEDULE OF DELIVERABLES
a) Specification of Task
Working with the Region VII Office of the Assistant Secretary for Health (OASH), the contractor shall develop targeted health messages to increase the uptake of pneumococcal and herpes zoster vaccination among non-Hispanic African American Community Health Workers (CHWs) within Region VII. Efforts should include an evaluation of existing health messages around pneumococcal and herpes zoster vaccination, and the utilization of the Health Belief Model (HBM) to assess barriers such as trust, threats, and motivators, related to obtaining adult immunization among non-Hispanic African American CHWs.
1. Evaluate existing and accessible health messages
Contractors shall research existing health messages related to pneumococcal and herpes zoster vaccination targeting non-Hispanic African Americans over 50 years of age. Contractors must include health messages from federal agencies such as the Centers for Disease Control and Prevention (CDC), National Vaccine Program (NVPO), etc. Contractors must compile existing health messages to be utilize for the focus groups (FG).

2. Conduct focus group to assess existing health messages
Contractors shall conduct focus groups to assess the effectiveness of health messages in increasing community demand for pneumococcal and herpes zoster. Contractors shall develop a FG protocol and assist with recruitment of participants. Contractors shall utilized the Health Belief Model to inform the FG protocol. Contractors must include research of existing health messages within focus group protocol. Contracts shall utilize the FG as an opportunity to gain important information to assist with the development of enhanced targeted health messages for updated promotional materials.

3. Develop targeted health messages based on FG feedback
Contractor shall develop targeted health messages based on the FG feedback provided by CHWs. Contractors shall develop promotional materials with targeted health messages to include electronic flyers, social media promotional kit, web badges, etc.

4. Evaluate targeted health messages
Contractor shall provide an evaluative assessment related to the existing health messages compared to the enhanced targeted health messages, and its impact on non-Hispanic African Americans over the age of 50 within Region VII. Contractor shall assess CHWs likelihood to seek further information about adult immunization, and the likelihood to obtain pneumococcal and herpes zoster vaccination based on the enhanced targeted health messages.

5. Draft Report and Final Report
Contractor shall provide a draft and final report highlighting the project, lessons learned, and recommendations.

b) Reporting requirements
Contractor shall meet with the Project Officer to establish a regular schedule of meetings and/or conference calls. The contractor shall communicate with the Project Officer on a regular basis to discuss project efforts related to research, focus groups, message development, and evaluation. Contractor shall submit draft (six weeks) and final reports (three weeks) including deliverables to the COR.

c) Deliverables
Contractor shall provide the following deliverables to the COR and Project Officer: promotional materials with targeted health messaging, evaluation assessment, and draft and final report.

d) Period of Performance and Delivery Schedule
The performance period is June 1, 2019 to September 30, 2020. Contractor must submit an invoice to receive partial payment within the first 30 days of award detailing work to be completed. Contractor must submit a final invoice and final report to the COR before September 30, 2020. Contractor will receive final payment upon successful completion of the work.

Table 1 Schedule of Deliverables
Deliverables Date Due (timeline should be outlined within your plan)
Research existing health messaging 30 from receipt of award
Compile a list of existing health messages to be screened 60 days upon receipt of award
Develop FG Protocol 90 days upon receipt of award
Recruit CHWs in Omaha, NE and Kansas City, MO 90 days upon receipt of award
Conduct FG 180 days upon receipt of award
Analyze and assess FG data 240 days upon receipt of award
Develop enhanced targeted health messages and promotional materials 300 days upon receipt of award
Develop evaluation assessment 320 days upon receipt of award
Submit invoice Three weeks prior to final day of contract
Draft and Final Report Draft report shall be submitted six weeks prior to final day of contract
Final report be submitted three weeks prior to final day of contract

e) Inspection and acceptance
Deliverables described in the SOW shall be subject to review by the Government. Acceptance of the final deliverables shall be made in writing by the contract COR.
Table 2 Pricing
Direct Labor Category Hours Rate/ Hr Total
Conduct (2) focus groups
- Recruitment, facility, and incentive
- 2 site; Omaha, NE and Kansas City, MO 2 to 4 hours per site
Data analysis from focus group research
- Data Analysis tool
- Consultant/ Researcher Fee 300
Administrative logistical support
- Staff, printing, etc. 1538.5
Subtotal
Direct Material Cost
Promotional materials, reports, survey, mailing, media access tools, focus group materials
Travel and Lodging
Grand Total

3.0 TECHNICAL CONSIDERATION
a. Technical Consideration
Contractor should demonstrate knowledge and solid understanding of healthcare marketing, program evaluation, and implementation.

4.0 QUALITY ASSURANCE
a. Quality Assurance Approach
The contractor shall establish and provide a quality assurance approach that details the contractor's proposed approach to quality assurance on deliverable elements and how quality surveillance is implemented.

5.0 Government Furnished Property
Not applicable

6.0 Restrictions on Disclosure of Information and Rights in Data
Information made available to the contractor by the Government for the performance or administration of this effort shall be used only for those purposes and shall not be used in any other way without the written agreement of the Contracting Officer.

The contractor agrees to assume responsibility for protecting the confidentiality of Government records, which are not public information. Each contractor or employee of the contractor to whom information may be made available or disclosed shall be notified in writing by the contractor that such information may be disclosed only for a purpose and to the extent authorized herein.

Contractor and/or contractor personnel shall not divulge or release data or information developed or obtained in performance of this effort, until made public by the Government, except to authorize Government personnel or upon written approval of the Contracting Officer. The contractor shall not use, disclose, or reproduce proprietary data that bears a restrictive legend, other than as required in the performance of this effort. Nothing herein shall preclude the use of any data independently acquired by the contractor without such limitations or prohibit an agreement at no cost to the Government between the contractor and the data owner which provides for greater rights to the contractor.

7.0 REFERENCES
National Vaccine Plan: is the nation's roadmap for a 21st century vaccine and immunization enterprise. It includes strategies for advancing vaccine research and development, financing, supply, distribution, safety, global cooperation, and informed decision-making among consumers and health care providers. https://www.hhs.gov/nvpo/national-vaccine-plan/index.html
Healthy People 2020: Healthy People 2020 continue in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation's health. https://www.healthypeople.gov/
8.0 INSTRUCTIONS TO QUOTERS

Evaluation will be based on lowest price technically acceptable (LPTA).

All quotes shall contain GSA PRICING ONLY. Interested quoters must certify that the proposed items are on their GSA schedule. Each item shall be clearly identified as GSA Pricing Items.

Questions should be sent to Adam Sweeney at adam.sweeney@psc.hhs.gov no later than 5:00 pm EST on July 24, 2019.

Quotes are due by 12:00 pm EST on July 26, 2019. Quotes received by the government after the submission deadline will not be accepted.

AUTHORITIES OF GOVERNMENT PERSONNEL

Notwithstanding the Contractor's responsibility for total management during the performance of this contract, the administration of this contract will require maximum coordination between the Government and the Contractor. The following individuals will be the Government's points of contact during the performance of this contract:

All communications pertaining to contractual and/or administrative matters under this contract shall be sent to:

Contract Specialist
Name: Adam Sweeney
Progaram Support Center
U.S. Departmnet of Health and Human Service
Adress: 7700 Wisconsin Avenue,
Bethesda, MD 20857
Email: adam.sweeney@PSC.hhs.gov

Contracting Officer's Representative

Name: TBD
Address: TBD
Email: TBD

Note: The Contracting Officer is the only individual authorized to modify the contract.

CONTRACTING OFFICER'S REPRESENTATIVE (COR) AUTHORITY

(a) Performance of work under this contract must be subject to the technical direction of the Contracting Officer's Representative identified above, or a representative designated in writing. The term "technical direction" includes, without limitation, direction to the contractor that directs or redirects the labor effort, shifts the work between work areas or locations, fills in details and otherwise serves to ensure that tasks outlined in the work statement are accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement.

The Contracting Officer's Representative does not have authority to issue technical direction that:

(1) constitutes a change of assignment or additional work outside the specification(s)/statement of work;

(2) Constitutes a change as defined in the clause entitled "Changes";

(3) In any manner causes an increase or decrease in the contract price, or the time
Required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the
Contract;

(5) Interferes with the contractor's right to perform under the terms and conditions of the
Contract; or
(6) Directs, supervises or otherwise controls the actions of the contractor's employees.

(c) Technical direction may be oral or in writing. The Contracting Officer's Representative shall confirm oral direction in writing within five work days, with a copy to the Contracting Officer.

(d) The contractor shall proceed promptly with performance resulting from the technical direction issued by the Contracting Officers, Representative. If, in the opinion of the contractor, any direction of the Contracting Officers, Representative, or his/her designee, falls within the limitations in (b), above, the contractor shall immediately notify the Contracting Officer no later than the beginning of the next Government work day.

(e) Failure of the contractor and the Contracting Officer to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled "Disputes."

INVOICE SUBMISSION - COMMERCIAL

The Contractor shall submit invoices once per month. A complete invoice with all required back-up documentation shall be sent electronically, via email, to:

1. Contract Specialist via DAM mailbox: pscsas.invoices@psc.hhs.gov
2. Contracting Officer's Representative (COR): TBD
3. Financial Management Service (FMS): psc_invoices@psc.hhs.gov

* No other non-invoice related documents (i.e. deliverables, reports, balance statements) shall be sent to the DAM and FMS mailboxes. Invoices Only.
The subject line of your email invoice submission shall contain the contract number, contract line item number, the order number, if applicable, and the number of invoices. The contractor shall provide a single itemized billing for all teleconferencing services used monthly. Invoices must be in the following formats: PDF, TIFF, or Word. No Excel formats will be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF or TIFF or Word).

Invoices shall be submitted in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

All calls concerning contract payment shall be directed to the COR.

In accordance with FAR 52.212-4, Contract Terms and Conditions-Commercial Items, a proper invoice must include the following items:
FAR 52.212-4(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include:
(i) Name and address of the Contractor;
(ii) Invoice date and number;
(iii) Contract number, contract line item number and, if applicable, the order number;
(iv) Description, quantity, unit of measure, unit price and extended price of the items
delivered;
(v) Shipping number and date of shipment, including the bill of lading number and
weight of shipment if shipped on Government bill of lading;
(vi) Terms of any discount for prompt payment offered;
(vii) Name and address of official to whom payment is to be sent;
(viii) Name, title, and phone number of person to notify in event of defective invoice; and
(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the
invoice only if required elsewhere in this contract.
(x) Electronic funds transfer (EFT) banking information.
(A) The Contractor shall include EFT banking information on the invoice only if
required elsewhere in this contract.
(B) If EFT banking information is not required to be on the invoice, in order for
the invoice to be a proper invoice, the Contractor shall have submitted correct
EFT banking information in accordance with the applicable solicitation provision,
contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer, System
for Award Management, or 52.232-34, Payment by Electronic Funds Transfer,
Other Than System for Award Management), or applicable agency procedures.
(C) EFT banking information is not required if the Government waived the
requirement to pay by EFT.
(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

Additionally, the FMS requires the contractor to include its Dun & Bradstreet Number (DUNS) on each invoice.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as "Small Business."

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this order will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - System for Award Management.
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