[Federal Register: June 6, 2003 (Volume 68, Number 109)]
[Notices]
[Page 33952-33955]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr06jn03-79]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Program Announcement 03030]
Controlling Asthma in American Cities Project Phase II-
Intervention Implementation; Notice of Availability of Funds
Application Deadline: July 7, 2003.
A. Authority and Catalog of Federal Domestic Assistance Number
This program is authorized under section 301 and 317 of the Public
Health Service Act, (42 U.S.C. 241 and 247b), as amended. The Catalog
of Federal Domestic Assistance number is 93.283.
B. Purpose
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 2003 funds for a cooperative agreement
program for the Controlling Asthma in American Cities Project (CAACP).
This program addresses the ``Healthy People 2010'' focus area of
Respiratory Diseases.
The purpose of the program is to build on the planning phase of
CAACP (including the experience and skills gained from the pilot
testing of intervention approaches) to improve overall asthma
management and decrease asthma-related morbidity among children (0-18
years) in a previously defined urban population with a large and unmet
asthma control need.
Measurable outcomes of the program will be in alignment with the
following performance goal for the National Center for Environmental
Health: Reduce the burden of asthma.
C. Eligible Applicants
Assistance will only be provided to currently funded recipients
from CDC Program Announcement Number 01117, Controlling Asthma in
American Cities Project, Phase I Planning. Refer to Attachment II for a
list of currently funded recipients. All attachments referenced in this
announcement are posted with the announcement on the CDC Web site,
Internet address: http://www.cdc.gov. Click on ``Funding,'' then
``Grants and Cooperative Agreements.''
Program Announcement Number 01117 was for the two-year planning
phase of this project, while this announcement is competitive among
planning phase awardees for implementation of intervention activities.
Program Announcement Number 01117 stated: ``Depending on the
availability of funds, a new competitive announcement, limited to Phase
I awardees, may be announced in the future that will implement the
intervention activities.'' No other applications are solicited.
Note: Title 2 of the United States Code section 1611 states that
an organization described in section 501(c)(4) of the Internal
Revenue Code that engages in lobbying activities is not eligible to
receive Federal funds constituting an award, grant or loan.
D. Funding
Availability of Funds
Approximately $4 million is available in FY 2003 to fund
approximately five to seven awards. It is expected that the average
award will be $700,000, ranging from $500,000 to $800,000. It is
expected that the awards will begin on or about September 15, 2003 and
will be made for a 12-month budget period within a project period of up
to five years. Funding estimates may change.
Continuation awards within an approved project period will be made
on the basis of satisfactory progress as evidenced by required reports
and the availability of funds.
Recipient Financial Participation
Matching funds are not required for this program.
Funding Preferences
Funding preferences may include: (1) Geographic distribution; (2)
minority populations with disproportionate asthma burden; and (3) a
balance of proposed intervention strategies.
E. Program Requirements
In conducting activities to achieve the purpose of this program,
the recipient will be responsible for the activities under 1. Recipient
Activities, and CDC will be responsible for the activities listed under
2. CDC Activities.
1. Recipient Activities
a. Describe and implement the community asthma action plan
developed during the planning period. The plan should be detailed and
include time-phased intervention objectives that are tied to the asthma
objectives in Healthy People 2010. The plan should be feasible from a
programmatic implementation perspective and from a cost perspective.
The plan should address sustainability issues (i.e., the
institutionalization of intervention activities), as well as encourage
community capacity building and empowerment.
b. Conduct a comprehensive evaluation of the entire project using
CDC's framework for program evaluation as a guide. As part of this,
recipients will monitor and evaluate progress in implementing the
community-based asthma action plan and measure the long-term
population-based impact of the project on the health of the communities
of focus.
c. Continue collaboration with broad community representation and
support in implementing, modifying, evaluating, and ultimately
sustaining the project.
d. Serve as a resource for other asthma control projects.
e. Document and disseminate experiences in working as a
collaborative/coalition and in implementing the project interventions.
f. Formally summarize project activities, progress in reaching
project objectives, and general insights/lessons every six months to
local partners and to CDC.
g. Work with CDC or its contractors to package and disseminate
effective
[[Page 33953]]
interventions developed and/or tested as part of CAACP.
h. Participate annually in a CDC-organized meeting of CAACP
grantees and key stakeholders.
2. CDC Activities
a. Provide technical assistance in the development of intervention
strategies, communication and policy issues, and the interpretation of
the scientific literature related to asthma management and control.
b. Provide liaison among grantees and identify potential sources of
information and assistance.
c. Coordinate activities among sites, when appropriate.
d. Provide leadership in development of a comprehensive evaluation
plan of CAACP as a whole and provide technical assistance to all
grantee sites regarding appropriate evaluation strategies and specific
evaluation tools.
e. Convene meetings among grantees, collaborators, and key
stakeholders to discuss findings and improve outcomes.
f. Assist with the interpretation and dissemination of interim and
final project findings and lessons. This may include coordinating one
or more publishable reports related to project activities/findings.
g. If applicable, assist in the development of a research protocol
for Institutional Review Board (IRB) review by all cooperating
institutions participating in the research project. If applicable, the
CDC IRB will review and approve the protocol initially and on at least
an annual basis until the research project is completed.
F. Content
Applications
The Program Announcement title and number must appear in the
application. Use the information in the Program Requirements, Other
Requirements, Evaluation Criteria, and this Content section to develop
the application content. Additional guidance/clarification is provided
in Attachment III. The application will be evaluated on the criteria
listed, so it is important to follow them in laying out the program
plan. The narrative should be no more than 25 pages, double-spaced,
printed on one side, with one-inch margins, and unreduced 12-point
font. In addition to the application forms, the application must
contain the following in this order:
1. Table of Contents: A table of contents that provides page
numbers for each of the following sections should be included.
2. Project Narrative: The narrative must contain the following
sections:
a. Overview of the assets, attributes, and deficiencies of the
communities of focus (i.e., describing the public health and community
environment in which CAACP is working, including a description of any
community assessments or asset mapping done in the past three years).
b. Summary of asthma-related activities and issues unique to your
communities of focus that directly or indirectly impact CAACP planning
and implementation activities (i.e., a description of asthma-specific
activities not directly funded by CAACP that have occurred or are
ongoing in the communities of focus).
c. Description of project organization, staffing, active
collaboration, and community support.
d. Summary of the activities of the two-year planning period.
e. Description and justification of the community-based,
intervention-phase asthma action plan to be implemented over the next
five years.
f. Description of the comprehensive evaluation plan including a
summary of the baseline data already collected during the planning
phase.
G. Submission and Deadline
Application Forms
Submit the signed original and two copies of PHS 5161-1 (OMB Number
0920-0428). Forms are available at the following Internet address:
www.cdc.gov/od/pgo/forminfo.htm.
If you do not have access to the Internet, or if you have
difficulty accessing the forms on-line, you may contact the CDC
Procurement and Grants Office Technical Information Management Section
(PGO-TIM) at: 770-488-2700. Application forms can be mailed to you.
Submission Date, Time, and Address
The application must be received by 4 p.m. Eastern Time, July 7,
2003.
Submit the application to: Technical Information Management-
PA03030, Procurement and Grants Office, Centers for Disease
Control and Prevention, 2920 Brandywine Rd., Atlanta, GA 30341-4146.
Applications may not be submitted electronically.
CDC Acknowledgement of Application Receipt
A postcard will be mailed by PGO-TIM, notifying you that CDC has
received your application.
Deadline
Applications shall be considered as meeting the deadline if they
are received before 4 p.m. Eastern Time on the deadline date. Any
applicant who sends their application by the United States Postal
Service or commercial delivery services must ensure that the carrier
will be able to guarantee delivery of the application by the closing
date and time. If an application is received after closing due to (1)
carrier error, when the carrier accepted the package with a guarantee
for delivery by the closing date and time, or (2) significant weather
delays or natural disasters, CDC will upon receipt of proper
documentation, consider the application as having been received by the
deadline.
Any application that does not meet the above criteria will not be
eligible for competition, and will be discarded. The applicant will be
notified of their failure to meet the submission requirements.
H. Evaluation Criteria
Applicants are required to provide measures of effectiveness that
will demonstrate the accomplishment of the various identified
objectives of the cooperative agreement. Measures of effectiveness must
relate to the performance goals as stated in the purpose section of
this announcement. Measures must be objective and quantitative and must
measure the intended outcome. These measures of effectiveness shall be
submitted with the application and shall be an element of evaluation.
A peer review group appointed by CDC may conduct site visits or
reverse site visits, as a part of their review of the applications and,
if conducted, will use the results of these visits as well as
application content addressing the following criteria:
1. The Community-focused, Intervention-phase Asthma Action Plan (40
percent).
The aim of this plan should be to reduce the burden of asthma among
children ranging from newborn to 18 years of age, throughout the pre-
selected communities of focus. The plan will be evaluated on the
following criteria.
a. The detail to which the plan is described.
b. The likely effectiveness of the individual intervention
strategies as well as the plan as a whole. This includes the estimated
efficacy of each intervention (how much it will reduce asthma morbidity
and/or improve quality of life), the likely reach of each intervention
(percentage of the community under 18 years of age likely to be
engaged/impacted by the intervention), and the potential synergy
created by the intertwining of interventions. While all are essential,
the project is especially interested in determining the combined
effectiveness
[[Page 33954]]
of interventions that together have a high degree of community reach
and participation.
c. The feasibility of the plan from a program implementation
perspective, and from a cost/economic perspective. Included in this
should be an estimate of how long it will take to fully implement the
plan, with the idea that the quicker the intervention can be
implemented effectively and efficiently, the better.
d. The degree to which pilot testing, previous community
experience, and/or the science of effective asthma interventions were
used/are being used to create the plan and its details.
e. The degree to which the plan reflects and builds on a mature and
comprehensive understanding of the assets, attributes, and deficiencies
of the communities of focus including non-CAACP asthma activities
completed or ongoing in these communities.
f. The degree of community participation in the plan. The following
questions should be addressed: Is there documentation of community
participation in the development of the plan? Does the plan encourage
community capacity building and empowerment? Do community partners play
a large role in the implementation period and does this empower or
build capacity within the community?
g. Approach to sustainability issues. This includes a discussion of
what needs to happen to make the intervention strategies sustainable
after project funding is finished, how likely it is that this will
occur, and what project staff and partners are doing or planning to do
to make this happen.
h. The value of the community asthma action plan and the individual
intervention strategies from a broader scientific and community public
health perspective. In other words, are the strategies innovative and
ambitious enough to stretch our understanding of asthma control and
community health?
i. Ability to replicate the community asthma action plan in other
cities or expand into new neighborhoods within the same city. This
includes the degree to which the individual intervention strategies
will likely be attractive to other communities (i.e., cost-feasible,
resource-feasible, and reproducible).
2. Project organization, staffing, active collaboration and
community support (30 percent). Projects will be judged on the
following:
a. The diversity of individuals and organizations involved in the
project.
b. The competence and community leadership potential of those
actively engaged and participating in the project.
c. The depth of expertise (both formal expertise and significant
past hands-on experience) in all areas critical to the project's
success.
d. The overall competence, leadership, and vision of the principal
investigator(s) and project coordinator(s). This is based, in part, on
their individual skills/experience with a community-based team approach
to decision-making and problem solving.
e. The ability of project staff and collaborators to communicate
openly and easily, to understand each other's roles, and to make
optimal project-related decisions. This will be based, in part, on the
project's organizational structure and decision-making procedures
developed and practiced over the two-year planning period.
f. The commitment of the collaborating individuals and especially,
organizations. This includes the degree to which project collaborators
have taken ownership or plan to take ownership of the project.
g. The effort made by project staff and collaborators to involve
grassroots community members and/or representatives in a meaningful
way.
h. The project's effectiveness in creating community awareness and
interest in asthma and the project, in particular.
i. The prospect of sustaining the collaborative partnership beyond
the project period and even beyond childhood asthma as the public
health focus. This includes an assessment of how the project interacts
with other existing community projects and coalitions in the region.
3. Evaluation Plan (20 percent).
Projects will be judged on the following:
a. Outcome-based Evaluation Strategies. The overall evaluation plan
should be designed to measure the impact of the project's activities
and interventions as a whole on the targeted communities' population of
children and/or teens with asthma. Evaluation strategies aimed at
measuring the impact of a single, specific intervention are important
but remain secondary to measuring the project's overall population-
based impact. Evaluation strategies that incorporate some or all of the
following outcome measures (but not necessarily limited to the
following) are suggested:
(1) Hospitalization data (ideally starting a minimum of three years
prior to the onset of intervention activities to allow for trend
analyses, and with comparable data from outside the communities of
focus for comparison).
(2) Emergency care data (as above if possible).
(3) School absenteeism (all causes in those identified as having
asthma or asthma-specific absenteeism).
(4) Quality of life and/or asthma symptom surveys (if a non-biased
sample can be identified and obtained).
(5) Asthma medications (i.e., the ratio of rescue to controller
medication prescriptions filled).
(6) Asthma care visits (i.e., ratio of scheduled to unscheduled
visits, or number of asthma maintenance visits per year).
(7) Changes in community empowerment and/or active participation in
community health (as measured by a validated instrument in a non-biased
sample of the community).
b. Comprehensive Evaluation Plan: Applicants will be judged on how
well they have articulated an evaluation plan that complements the
outcome-based measures described above (section H2a) and is likely to
be useful in understanding and/or measuring the following: (1) The
dynamics of the collaborative process, including decision making; (2)
the general effectiveness of the collaborative in helping to create,
implement, and sustain community interventions; (3) the relationship
between the project/collaborative and the community it seeks to serve;
(4) the reach of project activities in the communities of focus; (5)
the effectiveness of specific intervention components; (6) the cost and
resource feasibility of specific intervention components; and (7) the
impacts of the project and/or collaborative on the community outside of
its specific impacts on asthma.
The evaluation plan will be additionally judged on the degree to
which: (1) The project's stakeholders have been identified; (2) their
perspectives and evaluation needs are reflected in the plan; and (3)
the evaluation plan is cost and resource feasible.
c. Baseline comprehensive evaluation data collected, organized,
and/or analyzed during the two-year planning phase with an emphasis on
the following: (1) The proportion of baseline data needed for the
proposed comprehensive evaluation already collected and analyzed; (2)
the likelihood that the baseline data not yet collected will be
collected and analyzed in the near future; (3) the quality of the data
and the data analysis reports already collected and/or analyzed; and
(4) the adequacy of the collected or soon-to-be collected data as a
baseline for the proposed comprehensive evaluation.
d. Does the application adequately address the CDC Policy
requirements
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regarding the inclusion of women, ethnic, and racial groups in the
proposed research? These include:
(1) The proposed plan for the inclusion of both sexes and racial
and ethnic minority populations for appropriate representation.
(2) The proposed justification when representation is limited or
absent.
(3) A statement as to whether the design of the study is adequate
to measure differences when warranted.
(4) A statement as to whether the plans for recruitment and
outreach for the study participants includes the process of
establishing partnerships with community(s) and recognition of mutual
benefits.
4. Use of the Planning Period (10 percent).
The project will be judged on how well it made use of the two-year
planning period (accountability). The following planning period
activities should be considered in this overall evaluation of the
activities undertaken to date. (Of note: Planning phase activities
specifically related to the organization of the collaborative aspects
of the project will not be included in this section. These activities
will instead be incorporated into the score for section 2. ``Project
organization, staffing, active collaboration, and community support''
above).
a. The development of a well-articulated, plausible vision for the
project that meets the needs of stakeholders and collaborators.
b. The degree to which planning phase goals and objectives were
clearly defined, improved upon (as needed), and achieved.
c. The degree to which piloting of project ideas took place and
were well focused and well designed.
d. The degree to which the project staff and partners learned from
these piloting experiences (i.e., were they evaluated in a way
meaningful to the project).
e. The quality and usefulness of project-related materials
(educational materials, training manuals, resource banks, clinical
referral lists, etc.) created, identified, and/or organized during the
planning period.
f. The degree to which the staff/collaborators acquired clearly
defined skills (i.e., via training) that helped or will help in the
creation and/or implementation of intervention strategies.
g. The degree to which baseline assessments (i.e., community health
assessments, asset mapping, focus groups, key informant interviews,
survey data, utilization data, etc.) and/or process evaluation (of the
planning period) were effectively utilized by project staff, partners,
and other community stakeholders.
h. The degree to which the planning period was useful in developing
a more accurate and richer understanding of the assets, attributes, and
deficiencies of the communities of focus as well as the asthma-related
activities/issues in these communities (outside of CAACP).
5. Budget (not scored)
The extent to which the budget is clearly detailed, justified, and
appropriate for the activities proposed.
The applicant should include costs for one person to travel to
Atlanta, GA to attend the sixth National Environmental Health
Conference, December 3-5, 2003. Review the CDC/NCEH Web site for
additional information concerning this conference: http://www.cdc.gov/nceh/default.htm
.
6. Human Subjects (not scored)
Does the application adequately address the requirements of Title
45 CFR part 46 for the protection of human subjects? (Not scored;
however, an application can be disapproved if the research risks are
sufficiently serious and protection against risks is so inadequate as
to make the entire application unacceptable.)
I. Other Requirements
Technical Reporting Requirements
Provide CDC with original plus two copies of:
1. Interim progress report, no less than 90 days before the end of
the budget period. The progress report will serve as the non-competing
continuation application, and must contain the following elements:
a. Current Budget Period Activities Objectives.
b. Current Budget Period Financial Progress.
c. New Budget Period Program Proposed Activity Objectives.
d. Detailed Line-Item Budget and Justification.
e. Additional Requested Information.
2. Financial status report, no more than 90 days after the end of
the budget period.
3. Final financial and performance reports, no more than 90 days
after the end of the project period.
Send all reports to the Grants Management Specialist identified in
the ``Where To Obtain Additional Information'' section of this
announcement.
Additional Requirements
The following additional requirements are applicable to this
program. For a complete description of each, see Attachment I of the
program announcement as posted on the CDC Web site.
AR-1 Human Subjects Requirements
AR-2 Requirements for Inclusion of Women and Racial and Ethnic
Minorities in Research
AR-7 Executive Order 12372 Review
AR-8 Public Health System Reporting Requirements
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2010
AR-12 Lobbying Restrictions
Office of Management and Budget Clearance
Projects that involve the collection of information from 10 or more
individuals and funded by cooperative agreement will be subject to
review and approval by the Office of Management and Budget (OMB) under
the Paperwork Reduction Act.
J. Where To Obtain Additional Information
This and other CDC announcements, the necessary applications, and
associated forms can be found on the CDC Web site, Internet address:
http://www.cdc.gov.
Click on ``Funding'' then ``Grants and Cooperative Agreements''.
For general questions about this announcement, contact: Technical
Information Management, CDC Procurement and Grants Office, 2920
Brandywine Rd., Atlanta, GA 30341-4146, Telephone: (770) 488-2700.
For business management and budget assistance, contact: Mildred
Garner, Grants Management Officer, Procurement and Grants Office,
Centers for Disease Control and Prevention, 2920 Brandywine Road,
Atlanta, GA 30341-4146, Telephone: (770) 488-2745, e-mail address:
Mgarner@cdc.gov. For program technical assistance, contact: Michael Friedman, M.D.,
Air Pollution and Respiratory Health Branch, National Center for
Environmental Health, Centers for Disease Control and Prevention, 1600
Clifton Road, NE., MS E-17, Atlanta, GA 30333, Telephone Number: (404)
498-1028, e-mail address: mff7@cdc.gov.
Dated: June 2, 2003.
Edward Schultz,
Acting Director, Procurement and Grants Office, Centers for Disease
Control and Prevention.
[FR Doc. 03-14271 Filed 6-5-03; 8:45 am]
BILLING CODE 4163-18-P