**Amendments to this announcement can be found in red and pink.**

**Billing Code: 4163-18-P**

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**Centers for Disease Control and Prevention**

**Racial and Ethnic Approaches to Community**

**Health across the US (REACH US)**

**Announcement Type:** New

**Funding Opportunity Number:** CDC-RFA-DP07-707

**Catalog of Federal Domestic Assistance Number:** CFDA \# 93.283

**Key Dates:**

**Letter of Intent Deadline:** March 29, 2007

**Application Deadline:** May 7, 2007

**Technical Assistance Conference Calls:**

Technical assistance will be available for potential applicants on three
conference calls.

The first call will be for [eligible applicants]{.underline} (see
section III) that are in Atlantic, Eastern, or Central time zones, and
will be held on Wednesday, March 14, 2007 from 9:30 a.m. to 11:30 a.m.
(Eastern time). The conference can be accessed by calling
1-888-928-9122. The leader for this call is Thi Lockhart and the
passcode is 54362. The passcode and leader's name is required to join
the call.

The second call will be for [eligible applicants]{.underline} (see
section III) that are in Mountain or Pacific time zones, and will be
held on Wednesday, March 14, 2007 from 3:30 p.m. to 5:30 p.m. (Eastern
time). The conference can be accessed by calling 1-888-790-1711, the
leader's name is Thi Lockhart and the passcode is 62971. The passcode
and leader's name is required to join the call.

While all information disseminated will be consistent throughout the
calls**,** a third call will be held particularly for [tribal and
territorial organizations]{.underline} on Thursday, March 15, 2007 from
3:30 p.m. to 5:30 p.m. (Eastern Time). The conference can be accessed by
calling 1-888-677-1801, the leader's name is Thi Lockhart and the
passcode is 41067.

The passcode and leader's name is required to join the call.

A fourth call will be held particularly for [tribal, territorial
organizations, and potential applicants located in Pacific Time
Zone]{.underline} on Thursday, March 29, 2007 from 7:00 p.m. to 9:00
p.m. (Eastern Time). The conference can be accessed by calling
1-888-791-1856, the leader's name is Thi Lockhart and the passcode is
4411359.

The passcode and leader's name is required to join the call.

The purpose of the conference call is to help potential applicants to:

> Understand the scope and intent of the Program Announcement for the
> Racial and Ethnic Approaches to Community Health across the U.S.
> (REACH US) Program;
>
> Be familiar with the Public Health Services funding policies and
> application and review procedures.

Participation in a conference call is not mandatory. Potential
applicants are requested to call in using only one telephone line. If
during the call you need technical assistance, press \*0 to speak to an
operator. Please note, restrictions may exist when accessing
freephone/toll free numbers using a mobile telephone. A Q&A document
from these calls will not be made available. Since this is a competitive
process, applicants should following the requirements for this program
as they are laid out in the funding opportunity announcement and any
related amendments. Should applicants find they have additional
questions or need clarification after this call, please see section VII
Agency Contacts.

This announcement contains the following information:

I. Funding Opportunity Description

Authority

Executive Summary

Background

Purpose

Activities

II\. Award Information

III\. Eligibility Information

Eligible Applicants

Cost Sharing or Matching

Other Eligibility Requirements

IV\. Application and Submission Information

Address to Request Application Package

Content and Form of Submission

Letter of Intent

Application

Submission Dates and Times

Explanation of Deadlines

Intergovernmental Review of Applications

Funding Restrictions

Other Submission Requirements

V. Application Review Information

Criteria

Review and Selection Process

Anticipated Announcement and Review Dates

VI\. Award Administration Information

Award Notices

Administration and National Policy Requirements

Reporting Requirements

VII\. Agency Contacts

VIII\. Other Information

# I. Funding Opportunity Description

**Authority:** This program is authorized under section 301(a) and
317(k) (2) of the Public Health Service Act, 42 U.S. Code 241(a) and
247b (k) 2

**Executive Summary:** The National Center for Chronic Disease
Prevention and Health Promotion, at the Centers for Disease Control and
Prevention (CDC), announces the opportunity to apply for funds to
advance evidence and practice based programs and culturally based
community practices to eliminate racial and ethnic health disparities
through implementation, evaluation, and dissemination of state of the
art knowledge. This initiative, Racial and Ethnic Approaches to
Community Health across the US (REACH US), addresses racial and ethnic
differences in health disparities, rather than focusing primarily on a
disease perspective. It builds on the body of knowledge initiated by
projects funded under Racial and Ethnic Approaches to Community Health
2010 (REACH 2010). Current funding for REACH US will move into
establishing a national multilevel program through two levels of
interlinked funding: 1) Centers of Excellence in the Elimination of
Disparities (CEEDs) will serve as national expert centers by providing
the infrastructure to implement, coordinate, refine, and disseminate
programmatic activities, and 2) Action Communities (ACs) will implement
and evaluate successful practice-based or evidence-based
approaches/programs to impact population groups rather than individuals.
Both levels of funding will target one or more racial and ethnic groups,
including African American/Black, American Indian/Alaska Native, Asian,
Native Hawaiian/Other Pacific Islander, and Hispanic/Latino as well as
one or more health priority area(s): breast and cervical cancer;
cardiovascular disease; diabetes mellitus; adult/older adult
immunization, hepatitis B, and/or tuberculosis; asthma; and infant
mortality. Communities and organizations with functioning coalitions
that consist of, at minimum, 1) tribes or local or state health
departments, 2) community based organizations, and 3)
university/academic institutions may apply for one or both of the
programs funded under this cooperative agreement. However, only one
proposal per applicant will be funded. Approximately 12 CEEDs, with
average awards of \$1,000,000 per year, and approximately 20 ACs, with
average awards of \$400,000 per year will be funded. The awards will
begin on or about September 30, 2007 for a 12 months budget period with
anticipated funding up to five years.

**Background:** While several initiatives directed to the elimination of
racial and ethnic health disparities have made significant progress over
the past few years, disparities still exist, and in some cases, are
widening. For example, the recently released National Healthcare
Disparities Report by the Agency for Healthcare Research and Quality
noted that while health disparities for most US minorities compared to
the general population are narrowing, Hispanic/Latinos are falling
further behind. Not only are there disparities between racial and ethnic
groups and Whites, but also disparities exist among and within various
racial and ethnic subgroups. (See Attachment A for additional
information on racial and ethnic population groups.)

Current work in the area of racial and ethnic health disparities point
to various conditions and extant social and organizational structures
that impact disparities among racial and ethnic groups, such as
healthcare systems/institutional conditions (e.g., quality, access,
levels of care, culturally appropriate care); policy decisions at the
local, state, and national levels; and the social, environmental, and
cultural contexts in which disparities persist. A social-ecological
perspective (see Attachment B) can be used to identify individual,
community, societal, cultural, and environmental factors that must be
changed in order to eliminate racial and ethnic disparities. Current
work in this area has shown the need for multilevel systemic approaches
within communities to develop appropriate programs to address these
complex and deeply engrained influences on racial and ethnic health
disparities.

Community based participatory approaches (CBPA) are a means to address
these issues. CBPA unites public health partners from various
disciplines with communities to address racial and ethnic health
disparities by balancing improvement in public health practice with
responsiveness to community needs. As a result, many communities are
already in the intermediate stages of understanding how to build and
sustain long-term successful partnerships, implement and evaluate
culturally appropriate programs and other CBPA endeavors, define
promising approaches based on CBPA, and translate outcomes for use in
other racial and ethnic communities. By using a social-ecological
perspective and CBPA within sound public health practice, and evaluating
these approaches to improve health at the community level as well as
better understand the social, cultural, political, and environmental
systems that impact disparities, systematic approaches to the
elimination of the root causes of racial and ethnic health disparities
can be made.

The current initiative funded under this cooperative agreement, Racial
and Ethnic Approaches to Community Health across the US (REACH US),
addresses racial and ethnic differences in health disparities, rather
than focusing primarily on a disease perspective. It builds on the body
of knowledge initiated by projects funded under Racial and Ethnic
Approaches to Community Health 2010 (REACH 2010). Current funding for
REACH US will move into establishing a national multilevel program that
approaches the elimination of racial and ethnic health disparities
through the application, synthesis, and dissemination of promising
approaches within public health practice. By establishing a national
infrastructure to promote programmatic efforts, evidence- and
practice-based public health approaches, community-based participatory
approaches, and the integration of systemic influences, REACH US is
prepared to support and disseminate those programmatic activities that
are successful in the elimination of racial and ethnic health
disparities.

**Purpose:** The National Center for Chronic Disease Prevention and
Health Promotion, at the Centers for Disease Control and Prevention
(CDC), announces the availability of fiscal year (FY) 2007 funds for
cooperative agreements to advance evidence- and practice-based programs
and culturally based community practices to eliminate racial and ethnic
health disparities through implementation, evaluation, and dissemination
of state of the art knowledge.

In order to develop a comprehensive national program that supports a
more systematic approach to the elimination of racial and ethnic health
disparities, two levels of interlinked funding will be supported under
this announcement: 1) Centers of Excellence in the Elimination of
Disparities (CEEDs) will serve as national expert centers by providing
the infrastructure at a systems level to implement, coordinate, refine,
and disseminate programmatic activities, and 2) Action Communities (ACs)
will implement and evaluate successful practice-based or evidence-based
approaches/programs within a racial and ethnic community to impact
population groups rather than individuals, also along selected health
priority areas.

Proposals should focus on the elimination of racial and ethnic health
disparities in one or more of the following racial and ethnic groups and
one or more of the following health priority areas. Racial and ethnic
groups targeted in this announcement include: African American/Black,
American Indian/Alaska Native, Asian, Native Hawaiian/Other Pacific
Islander, and Hispanic/Latino. Health priority areas include: breast and
cervical cancer; cardiovascular disease; diabetes mellitus; adult/older
adult immunization, hepatitis B, and/or tuberculosis; asthma; and infant
mortality. Additionally, related conditions such as oral health and
behavioral health (i.e., mental health, alcohol use, physical activity,
nutrition, and tobacco use) may be considered as intervening factors
when addressing the above health disparities.

### This program addresses the second "Healthy People 2010"goal: to eliminate health disparities among segments of the population, including differences that occur by race or ethnicity, education or income, or geographic location. Work will focus within the priority area(s) of heart disease and stroke; breast and cervical cancer; diabetes; adult/older adult immunization, hepatitis B, and/or tuberculosis; asthma; and infant mortality. 

The program also addresses the Healthy Communities goal: Healthy People
in Healthy Places: The places where people live, work, learn, and play
will protect and promote their health and safety, especially those at
greater risk of health disparities. This site can be accessed at:
[[http://www.cdc.gov/osi/goals/places/placesCommunities.html]{.underline}](http://www.cdc.gov/osi/goals/places/placesCommunities.html)

Measurable outcomes of the program will be in alignment with the
following performance goal for the National Center for Chronic Disease
Prevention and Health Promotion (NCCDPHP): Improve the lives of racial
and ethnic populations who suffer disproportionately from the burden of
disease and disability, and develop tools and strategies that will
enable the nation to eliminate health disparities.

This program focuses on the Centers for Disease Control and Prevention's
Health Protection Goal of Healthy People in Every Stage of Life which
states that "all people, and especially those at greater risk of health
disparities, will achieve their optimal lifespan with the best possible
quality of health in every stage of life."

Measurable outcomes of the program will be in alignment with the
following performance goal(s) for the National Center for Chronic
Disease's Government Performance Results Act (GPRA) Performance Goal:
Improve the lives of racial and ethic populations who suffer
disproportionately from the burden of disease and disability, and
develop tools and strategies that will enable the nation to eliminate
these health disparities by 2010; as well as the Performance Goal:
Improve the lives of American Indian and Alaska Native populations who
suffer disproportionately from the burden of disease and disability, and
develop tools and strategies that will enable the nation to eliminate
these health disparities by 2010.

This announcement is for non-research activities supported by CDC. For
the definition of research, please see the CDC Web site at the following
Internet address:

[[http://www.cdc.gov/od/science/regs/hrpp/researchDefinition.htm]{.underline}](http://www.cdc.gov/od/science/regs/hrpp/researchDefinition.htm)

**Activities:**

Awardee activities for this program are as follows:

Two types of programs will be funded under this request for
applications: Centers of Excellence in Eliminating Disparities (CEEDs)
or Action Communities (ACs). Applicants may apply for one or both of
these programs. CEED applicants are responsible for activities listed
under Section 1. AC applicants are responsible for activities listed
under Section 2. CDC activities for this program are listed in Section
3.

Awardee Activities

1\. Center of Excellence in Eliminating Disparities (CEED) Activities

Overall Characteristics

Each CEED is expected to function as a multidisciplinary national leader
and expert center focused on the elimination of racial and ethnic health
disparities. Each CEED will implement a program of activity with a
population focus in at least one of the following racial/ethnic groups:
African American/Black, American Indian/Alaska Native, Asian, Native
Hawaiian/Other Pacific Islander, or Hispanic/Latino.

Focus on the elimination of racial and ethnic health disparities in one
or more of the following health priority area(s): breast and cervical
cancer; cardiovascular disease; diabetes mellitus; adult/older adult
immunization, hepatitis B, and/or tuberculosis; asthma; and infant
mortality. Additionally, related conditions such as oral health and
behavioral health (i.e., mental health, alcohol use, physical activity,
nutrition, and tobacco use) may be considered as intervening factors
when addressing the above health disparities.

The focus of a CEED is expertise on an identified racial and ethnic
population. The health priority area serves as a basis for the
development of culturally appropriate parameters for community-based
systems or policy approaches or interventions to eliminate health
disparities. Examples of CEED applications can be found in Attachment C.

Develop a comprehensive program to promote the elimination of racial and
ethnic health disparities and intervene at multiple levels of the social
ecologic model by providing expertise on identified racial and ethnic
population(s) within health priority area(s); maintain and expand
existing local efforts to systems change or policy approaches or
interventions at multiple levels of the social ecological model -
allocate approximately 50 percent of the direct cost budget to these
activities; identify and integrate cultural dynamics into health
interventions at all systems level; coordinate existing resources (e.g.,
training programs or national organizations that target the selected
population) to better focus them on the elimination of health
disparities; work with CDC on specified activities, such as determining
key determinants of community health; and conduct other relevant
activities to promote promising practices/programs in the elimination of
racial and ethnic health disparities. These activities are to be
coordinated through an established coalition (3-5 years minimum) that
has the ability to perform these functions at the time the application
is submitted. At this level of funding, it is expected that
community/coalition capacity already is in place; funds are not
available for capacity building.

[]{.mark}

Building on the body of work initiated by the CEED in Years 01-02,
develop a comprehensive model program beginning at least in Year 03
through the end of the five years of funding. The model program should
be based on levels of the social ecological model, CBPA, and incorporate
and refine knowledge from the field and similar Action Communities.
Model programs should be grounded in the programmatic efforts (see
Attachment E) as well as the Healthy People 2010 objectives. The models
can then be disseminated and implemented both nationally and regionally
to communities or organizations with an interest in the elimination of
racial and ethnic health disparities.

Organization and Partnerships

Identify and hire staff with appropriate qualifications to implement and
manage all levels of activity within the CEED. Minimum staffing
requirements include a Program Manager, administrative support, and a
lead evaluator who is experienced in CBPA.

Maintain an established coalition that develops and sustains linkages
and collaborations with such entities as tribes or local or state health
departments; community based organizations; health care service
industry; faith-based organizations; tribal organizations; national
organizations with a focus on a racial or ethnic population or the
elimination of health disparities; or university/academic institutions.
At least, the coalition should include members from: 1) tribes or local
or state health departments, 2) community-based organizations, and 3)
university/academic institutions. The coalition should be in place and
well-functioning and include individuals with ties to the community. The
coalition should have evidence of its successful functioning, its
ability to move into the multi-state/regional setting expected of a CEED
as well as its ability to function as a national expert in the
elimination of racial and ethnic health disparities.

The grantee, as the Central Coordinating Organization (CCO), is expected
to work with the coalition and all key partners to collaborate on all
CEED activities.

Implement a culturally appropriate Community Action Plan (CAP) that
presents a program of integrated activities and is consistent with
relevant stages of the REACH logic model, programmatic efforts, and
selected Healthy People 2010 objectives. Describe how the CAP and
related activities are grounded in social-ecological and other relevant
theories (e.g., empowerment theory), incorporate multiple systems
levels, and utilize community-based participatory approaches and sound
public health practice. Develop logic models to guide activities;
include relevant partnerships; selected REACH US programmatic efforts
and SMART (Specific, Measurable, Attainable, Relevant, Time-phased)
objectives; a program of activities consistent with these goals; and a
timeline for execution of proposed activities over the five year funding
period, including a detailed plan for the first two years of funding.
Applicants should refer to the appropriate Healthy People 2010
objectives
([www.healthypeople.gov/document/tableofcontents.htm#parta](http://www.healthypeople.gov/document/tableofcontents.htm#parta))
to ensure that the application is consistent with these objectives and
to develop SMART objectives. Update the CAP in the yearly continuation
reports to reflect programmatic progress and plan of activity (see
section VI.3 Reporting Requirements).

Establish and maintain external partnerships with relevant organizations
at the national, multi-state, or regional level, and include these
partners, when applicable, in CEED activities. CEEDs are highly
encouraged to partner with national or multi-geographical organizations
that have an interest in the elimination of racial and ethnic health
disparities. Interactions among CEEDs and Action Communities in the
collection, analysis, and interpretation of evaluation data, as well as
in training, translation, and dissemination are highly encouraged.
Collaborate with appropriate partners to publish and disseminate
evaluation results to communities and to improve public health practice.

Provide expertise and assistance to ensure that Legacy Projects (see
below), proposed CEED activities, and Action Communities, are grounded
in promising approaches that will prove successful in furthering
community-based participatory approaches to eliminate racial and ethnic
health disparities. Integrate evaluation outcomes, promising practices,
and other related activities from their own work and that of the Action
Communities and Legacy Projects.

Provide selection, pilot funding, support, local training, and guidance
to Legacy Projects to encourage them to initiate or enhance work to
eliminate racial and ethnic health disparities. Members of communities
may apply to the CEED for Legacy funds to conduct activities that may
consist of, but are not limited to, conducting a community needs
assessment, community asset mapping, health impact assessment, training
or enhancement of skills, initiation of relevant community-based or
systems level activities, local start-up activities of a community
coalition, synthesis of evidence or practice-based approaches in a
specific area, or development or use of culturally appropriate
assessment instruments or methodologies. Each Legacy Project must be
consistent with one or more of the identified programmatic efforts of
REACH US and the program activities and expertise of the CEED.

No less than ten percent of the total award should be set aside each
year for Legacy Projects. Funding for each project should be consistent
with the proposed work and total approximately \$25,000 - \$50,000 for a
maximum time period of one year. All projects must undergo a specified
selection process. It is expected that communities will use these pilot
funds to initiate or further develop capacity to develop initiatives or
programs to eliminate health disparities.

Dissemination and Training

Serve as a national resource and expert center in selected areas of
expertise by coordinating training and dissemination activities (e.g.,
conferences, workshops, web-based training, translation of evidenced-
and practice-based approaches, guidance on the selection and application
of promising practices in the community, various publications,
development of innovative training and dissemination activities). These
activities should be geared to a wide range of audiences as appropriate,
such as staff, community members, partners, students, policy makers, or
legislators. Additionally, specific training programs on adapting and
implementing culturally-appropriate interventions to Legacy Projects and
Action Communities should be offered. Approximately 25 percent of the
direct cost budget should be set aside for training and dissemination
purposes.

Support training activities for students who are interested in
furthering work in the elimination of racial and ethnic disparities.
Such training activities may include support for students who are
interested in working on specific projects related to the goals of the
CEED, creation of or collaboration with graduate student training
programs, or provision of training and experience for community members
or individuals new to the study of health disparities.

Serve as an information warehouse of culturally appropriate
interventions, implementation tools, promising approaches, and
strategies for addressing social and cultural determinants of health.
Utilize existing or create new evidence reviews, expert recommendations,
and reports of promising approaches from the field of health disparities
to identify effective interventions that are feasible and compatible
with public health practice and are ready for dissemination. This
information should be available or readily adapted to a wide range of
audiences, such as communities, students, legislators, policy makers,
and other decision makers.

Participate in up to three annual CDC workshops for technical
assistance, planning, evaluation, and other essential programmatic
issues as well as one relevant national conference.

Evaluation and Data Management

Conduct a comprehensive evaluation using CDC's *Framework for Program
Evaluation in Public Health* (see Attachment F) to evaluate all CEED and
related activities; monitor progress in achieving goals and SMART
objectives; integrate evaluation and reporting tools required by CDC;
and develop a multi-level evaluation plan that includes coalition,
community, cultural, social, and environmental activities as well as
systems or policy level change. Provide evaluation leadership nationally
and in the designated geographic area. Consolidate evidence and
practice-based approaches that not only serve to guide Legacy Projects,
Action Communities, and other community based work, but also improve
public health practice. Include adequate funds, at least ten percent of
the total award, to participate fully in the substantial data collection
and evaluation activities associated with this award.

Evaluation activities must be lead by an evaluator who is experienced in
community-based participatory approaches. Develop a comprehensive
evaluation plan that includes well-articulated programmatic efforts that
are consistent with those of REACH US, a logic model that delineates
evaluation activities and SMART objectives that are linked to goals and
activities. Collaborate with CDC to shape and coordinate evaluation
activities.

Maintain an internal database to collect data necessary to monitor and
fully capture the process and outcomes of all CEED evaluation
activities. Interface with CDC's web-based data management system to
transfer data, report progress of program activities (e.g., achievement
of goals and SMART objectives, publications and presentations, etc.),
and generate other aggregate data to be shared electronically with CDC,
other CEEDs, or organizations requiring information. If selected,
participate in a national REACH US evaluation and similar activities in
the community.

2\. Action Community Activities

Overall Characteristics

Action Communities are expected to implement evidence- or practice-based
promising approaches in the field that are consistent with one or more
of the REACH US programmatic efforts and Healthy People 2010 objectives.
Activities may include, but are not limited to, application of promising
approaches in a racial and ethnic community that have been shown to be
effective in the general population or with one or more different racial
and ethnic groups, or in the refinement of culturally appropriate
assessment methodologies or practices. ACs are expected to have an
impact on population groups rather than individuals.

In addition, each Action Community will:

Implement an intervention with a population focus on at least one of the
following five racial/ethnic groups: African American/Black, American
Indian/Alaska Native, Asian, Native Hawaiian/ Pacific Islander, or
Hispanic/Latino. Justify the rationale for focusing on any subgroups.

Focus on the elimination of racial and ethnic health disparities in one
or more of the following health priority area(s): breast and cervical
cancer; cardiovascular disease; diabetes mellitus; adult/older adult
immunization, hepatitis B, and/or tuberculosis; asthma; and infant
mortality. Additionally, related conditions such as oral health and
behavioral health (i.e., mental health, alcohol use, physical activity,
nutrition, and tobacco use) may be considered as intervening factors
when addressing the above health disparities. Provide justification if
focusing on multiple health priority areas.

Examples of Action Community applications can be found in Attachment C.

Organization and Partnerships

Identify and hire staff with appropriate qualifications to implement and
manage all levels of activity within the AC. Minimum staffing
requirements include a Program Manager, administrative support, and an
evaluator who is experienced in CBPA.

Maintain an established coalition (approximately 3-5 years) that
develops and sustains linkages and collaborations, as necessary, with
such entities as local or state health departments; community health
centers; faith-based organizations; tribal organizations; national
organizations that target the selected population or health disparities;
or university/academic institutions. The coalition must have
representation from individuals with ties to the community. The grantee,
as the Central Coordinating Organization (CCO), works with key partners
and the coalition to collaborate on all AC activities. At this level of
funding, it is expected that community/coalition capacity already is in
place; funds are not available for capacity building.

Implement a culturally appropriate Community Action Plan (CAP). The CAP
and related activities should be grounded in social ecological theory
and utilize a community-based participatory approach (i.e., equal and
collaborative partnerships between experts who are traditionally trained
and community experts). Describe relevant partnerships; selected REACH
US programmatic efforts, REACH logic model, and SMART objectives;
evidence- or practice-based interventions or activities; and a timeline
for execution of proposed activities over the five year funding period,
including a detailed plan for the first two years of funding. Applicants
should refer to the appropriate Healthy People 2010 objectives
([www.healthypeople.gov/document/tableofcontents.htm#parta](http://www.healthypeople.gov/document/tableofcontents.htm#parta))
to ensure that the application is consistent with these objectives and
to develop SMART objectives. Update the CAP in the yearly continuation
report to reflect the AC's progress and plan of activity (see section
VI.3 Reporting Requirements). Initiate activities to assure the
interventions and other activities are administered effectively,
appropriately, and in a timely manner.

Interact with CDC and CEEDs with similar goals to ensure that all
proposed activities are grounded in practices that are methodologically
sound and have been shown to be successful in furthering the field of
community-based participatory practice in other areas; and work on
related activities to advance public health practice in the elimination
of racial and ethnic health disparities.

Evaluation

Develop a means of systematic evaluation using CDC's *Framework for
Program Evaluation in Public Health* (see Attachment F) to assess
process and outcomes of all activities and interventions. Describe how
the project's evaluation will contribute to CDC's REACH US program
evaluation. Integrate reporting tools required by CDC. Work closely with
CDC staff to develop logic models with specific inputs, activities,
outputs, and outcomes of the project; and SMART objectives. Evaluation
activities must be lead by an evaluator who is experienced in
community-based participatory approaches.

Maintain an internal database to collect data necessary to monitor and
fully capture the process and outcomes of all project evaluation
activities. Interface with CDC's web-based data management system to
transfer evaluation data, report progress of program activities (e.g.,
achievement of goals and SMART objectives, publications and
presentations, etc.), and generate other aggregate data to be shared
electronically with CDC, CEEDs, other projects, or organizations
requesting information. If selected, be prepared to participate in a
national REACH US evaluation and related activities in the community as
well as work with CDC on specified activities, such as determining
appropriate core performance indicators and social determinants of
health.

Include adequate funds, at least ten percent of the total award, to
participate fully in the substantial data collection and evaluation
activities associated with this award.

Technical Assistance and Training

Participate in conferences and workshops, including those sponsored by
CEEDs with similar targeted interests, to inform and be educated
regarding the experiences and lessons learned from the project.
Collaborate with appropriate partners to analyze data and disseminate
results of the project to communities and to improve public health
practice. Work with a relevant CEED to integrate evaluation outcomes
into the development of promising approaches and other work to advance
the elimination of racial and ethnic health disparities. If selected,
participate in a national REACH US evaluation and similar activities in
the community.

Participate in two annual CDC REACH US workshops for technical
assistance, planning, evaluation, and other essential programmatic
issues as well as one relevant national conference.

3\. CDC activities for this program are as follows:

In a cooperative agreement, CDC staff is involved substantially in the
program activities, above and beyond routine grant monitoring. CDC
activities for this program are as follows:

Technical Assistance and Coordination

Provide ongoing guidance, consultation, technical assistance, training,
and support to grantees in the areas of evaluation, epidemiology,
community assessment and planning, community based participatory
approaches, evidence-based and practice-based approaches, community
mobilization and partnership development, data management, program
sustainability, program strategies, evaluation of system level change,
and other areas as needed.

Assist grantees with developing and revising their Community Action
Plan; collaborating with tribes and state or local health departments,
organizations with an interest in health disparities, tribal
organizations, community planning groups, foundations and other funding
institutions, and other potential partners; and disseminating and
marketing of information. Assist CEEDs with the integration of
evaluation results from Action Communities and Legacy Projects.

Foster the transfer of successful evidence and practice-based
interventions, program models, and other forms of technical assistance
by convening meetings of grantees, workshops, web forums, conferences,
and conference calls.

Lead work with grantees to develop special projects, such as key
determinants of community health.

Conduct on-site visits to grantees.

Project Monitoring and Evaluation

Provide expert resources to assist in the design, collection, analysis,
and use of comparable evaluation data to assess and strengthen programs.

Provide assistance to CEEDs to develop comprehensive model programs
based on their activities.

Fund a national evaluation of selected REACH US communities and/or
activities.

Provide consistency in measurement; and ensure comparability across
grantee programmatic activities, racial and ethnic groups as well as the
identified health priority areas. Coordinate multi-site evaluation
activities, including interactions among the CEEDs and ACs to share
evaluation data.

Maintain an electronic communication center for information sharing
among grantees that includes a web-site, web-board, and a management
information system for down-loading progress reports.

[]{.mark}

# II. Award Information

**Type of Award:** Cooperative Agreement

**Award Mechanism:** U58

**Fiscal Year Funds:** 2007

**Approximate Current Fiscal Year Funding:** \$23,000,000

**Approximate Total Project Period Funding**: \$115,000,000 (This amount
is an estimate, and is subject to availability of funds.) Funding
includes both direct and indirect costs.

**[Centers of Excellence in the Elimination of
Disparities:]{.underline}**

**Approximate Number of Awards:** 12

**Approximate Average Award:** \$1,000,000

**Floor of Individual Award Range**: \$800,000

**Ceiling of Individual Award Range:** \$1,200,000

These amounts are for the first 12-month budget period, and include both
direct and indirect costs.

When completing the grant application package use the budget information
for non-construction programs (SF-424A) form located in mandatory
documents.

**[Action Communities:]{.underline}**

**Approximate Number of Awards:** 20

**Approximate Average Award:** \$400,000

**Floor of Individual Award Range:** \$350,000

**Ceiling of Individual Award Range:** \$450,000

These amounts are for the first 12-month budget period, and include both
direct and indirect costs.

If applying for both CEED and AC use the following link:
<http://www.acf.hhs.gov/programs/ofs/grants/sf424a.pdf> to complete a
second SF-424A for AC, save as PDF file with the following name: Action
Community 424A Budget. **W**hen completing the grant application package
use the other attachments form located in mandatory documents to upload
this file.

**Anticipated Award Date:** September 30, 2007

**Budget Period Length:** 12 months

**Project Period Length:** 5 years

Throughout the project period, CDC's commitment to continuation of
awards will be conditioned on the availability of funds, evidence of
satisfactory progress by the recipient (as documented in required
reports), and the determination that continued funding is in the best
interest of the Federal government. CDC funds are not expected to be the
sole source of funding for a CEED.

# III. Eligibility Information

**III.1. Eligible Applicants**

Eligible applicants that can apply for this funding opportunity are
listed below:

[**Only one applicant per each organization will be awarded**.]{.mark}

-   Public nonprofit organizations

```{=html}
<!-- -->
```
-   Private nonprofit organizations

-   For profit organizations

-   Small, minority, women-owned businesses

-   Universities

-   Colleges

-   Hospitals

-   Community-based organizations

-   Faith-based organizations

-   Federally recognized or state recognized American Indian/Alaska
    Native tribal governments

-   American Indian/Alaska Native tribally designated organizations

-   Alaska Native health corporations

-   Urban Indian health organizations

-   Tribal epidemiology centers

-   State and local governments or their Bona Fide Agents (this includes
    the District of Columbia, the Commonwealth of Puerto Rico, the
    Virgin Islands, the Commonwealth of the Northern Marianna Islands,
    American Samoa, Guam, the Federated States of Micronesia, the
    Republic of the Marshall Islands, and the Republic of Palau)

-   Political subdivisions of States (in consultation with States)

A Bona Fide Agent is an agency/organization identified by the state as
eligible to submit an application under the state eligibility in lieu of
a state application. If applying as a bona fide agent of a state or
local government, a letter from the state or local government as
documentation of the status is required. Place this documentation behind
the first page of the application form.

**III.2. Cost Sharing or Matching**

Cost Sharing or Matching funds are not required for this program.

**III.3. Other**

If a funding amount greater than the ceiling of the award range is
requested, the application will be considered non-responsive and will
not be entered into the review process. The applicant will be notified
that the application did not meet the submission requirements.

Special Requirements:

If the application is incomplete or non-responsive to the special
requirements listed in this section, it will not be entered into the
review process. The applicant will be notified the application did not
meet submission requirements.

Late applications will be considered non-responsive. See section "IV.3
Submission Dates and Times" for more information on deadlines.

An applicant may apply for either a CEED or AC or both. However, only
one application will be funded [per organization]{.mark}.

The applicant must include evidence that the coalition's membership is
tied to the community.

Race/ethnic-specific disease prevalence rates and disease burden should
be described for the health priority area(s) that are selected by the
applicant.

If the applicant is a non-profit organization, then proof of 501(c) 3
status must be provided in the application's Attachment section
according to the specifications outlined in AR-15.

Letters of support or memorandum of agreement should also be placed in
the application's Attachment section.

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 a grant, loan, or an award.

# IV. Application and Submission Information

**IV.1. Address to Request Application Package**

To apply for this funding opportunity use application form PHS 5161-1.

Electronic Submission:

CDC strongly encourages the applicant to submit the proposal
electronically by utilizing the forms and instructions posted for this
announcement on [www.Grants.gov](http://www.Grants.gov/), the official
Federal agency wide E-grant Web site. Only applicants who apply on-line
are permitted to forego paper copy submission of all application forms.

Registering your organization through
[www.Grants.gov](http://www.Grants.gov/) is the first step in submitting
applications online. Registration information is located in the "Get
Registered" screen of [www.Grants.gov](http://www.Grants.gov/). While
application submission through [www.Grants.gov](http://www.Grants.gov/)
is optional, we strongly encourage you to use this online tool.

Please visit [www.Grants.gov](http://www.Grants.gov/) at least 30 days
prior to filing your application to familiarize yourself with the
registration and submission processes. Under "Get Registered," the
one-time registration process will take three to five days to complete.
We suggest submitting electronic applications prior to the closing date
so if difficulties are encountered, you can submit a hard copy of the
application prior to the deadline.

Paper Submission:

Application forms and instructions are available on the CDC Web site, at
the following Internet address:
http://www.cdc.gov/od/pgo/funding/forms.htm

If access to the Internet is not available, or if there is difficulty
accessing the forms on-line, contact the CDC Procurement and Grants
Office Technical Information Management Section (PGO-TIM) staff at
770-488-2700 and the application forms can be mailed.

**IV.2. Content and Form of Submission**

**Letter of Intent (LOI):**

Your LOI must be written in the following format:

> Maximum number of pages: 2
>
> Font size: 12-point unreduced
>
> Single spaced
>
> Paper size: 8.5 by 11 inches
>
> Page margin size: One inch
>
> Printed only on one side of page
>
> Written in plain language, avoid jargon

The LOI must contain the following information:

> Number and Title of this RFA
>
> Whether application is made for a CEED or Action Community, or both
>
> Title of the proposed activities
>
> Name, address, telephone number, and email address of the Central
> Executive Officer or Lead Investigator
>
> Racial and ethnic group(s) and health priority area(s) that will be
> targeted

**Components of the Application:**

**[Project Abstract]{.underline}**

A Project Abstract must be submitted with the application forms. The
abstract must be submitted in the following format:

> Maximum of one page
>
> Font size: 12 point unreduced, Times New Roman
>
> Single spaced
>
> Printed only on one side of page
>
> Paper size: 8.5 by 11 inches
>
> Page margin size: One inch
>
> PDF file only
>
> If applying for both CEED and AC when completing the grant application
> package submit one project abstract using two paragraphs - one
> paragraph to address CEED and 1one paragraph to address AC.

The Project Abstract must contain an abstract of the proposed activity
suitable for dissemination to the public. It should be a self-contained
description of the project and should contain a statement of objectives
and methods to be employed. It should be informative to other persons
working in the same or related fields and insofar as possible
understandable to a technically literate lay reader. This abstract must
not include any proprietary/confidential information.

**[Project Narrative]{.underline}**

A narrative component of the proposal must be submitted with the
application forms. The narrative must be submitted in the following
format:

> Maximum number of pages: **25 pages for CEED applicants**; **20 pages
> for Action Community applicants (excluding budget pages and
> attachments)**. If your narrative exceeds the page limit, only the
> first pages which are within the page limit will be reviewed.
>
> Font size: 12 point unreduced, Times New Roman
>
> Double spaced
>
> Paper size: 8.5 by 11 inches
>
> Page margin size: One inch
>
> Printed only on one side of page
>
> PDF file only
>
> If applying for both CEED and AC when completing the grant application
> package use the add mandatory project narrative file button to upload
> the CEED narrative and use the add optional project narrative file
> button to upload the AC narrative.
>
> Number project narrative pages at the bottom, including charts,
> figures, tables
>
> Printed only on one side of page
>
> Held together only by rubber bands or metal clips; not bound in any
> other way
>
> Executive Summary describing overall project, population(s) of focus,
> health priority area(s), coalitions, and intervention strategies. The
> executive summary should be included in the project narrative and must
> be limited to 2 pages.

**[CEED Project Narrative]{.underline}**

The project narrative for CEED applications should address activities to
be conducted over the entire project period and must include the
following items in the order listed:

Executive Summary describing overall project, population(s) of focus,
health priority area(s), coalitions, and intervention strategies.
(Limited to 2 pages)

Statement of the Problem, including: intervention level (i.e., CEED), in
the identified multi-state/regional area that grounds the CEED as well
as continues existing work, description of the racial/ethnic
population(s) and health priority area(s) of focus which includes
evidence of the disease burden within the population of focus;
contextual aspects of race; environmental conditions (i.e., social,
economic, cultural, health, physical, and political) that contribute to
the disparity; description of evidence or practice-based interventions
which have been or are being used by the lead agency to address the
population(s) of focus; how activities are culturally tailored; and
summary of findings from community assessments or programmatic
evaluations conducted within the past 3 years to identify community
assets and deficiencies.

Demonstrate the capacity to function as a national resource expert
center in terms of expertise in the selected racial and ethnic
population(s) and health priority area(s) of focus, collecting and
synthesizing information, and translating and disseminating promising
practices and novel approaches to the elimination of racial and ethnic
health disparities.

Address the burden of disease faced by each racial/ethnic group within
an identified multi-state/regional area; the contextual aspects of race
that include a definition of race, brief history of demographics of the
region (including but not limited to census data), and social contexts
of the relationship between race and the selected health priority areas
in the region; the targeted REACH US program priorities and Healthy
People 2010 objectives for each racial/ethnic group, and how progress in
each of these areas will be measured.

Describe experience and relationships in a given multi-state/regional
geographical area.

Describe the potential impact of the programmatic activities or
intervention(s) on reducing racial and ethnic health disparities through
increased community-based participatory approaches resulting from
community partnerships (i.e., coalition activities) and improved
methodologies.

Describe prior achievements and how the proposal continues this work in
systems or policy level interventions. Demonstrate how the proposal
challenges existing public health practice paradigms and moves beyond
the status quo to address the culture of the community and summary of
findings from community assessments or programmatic evaluations
conducted within the past 3 years to identify community assets and
deficiencies.

Develop a better understanding of influences that affect the elimination
of health disparities at various system levels.

Describe the work proposed appropriate to the experience level of the
Program Director and other key coalition members. Describe the team
complementary and integrated expertise to the project. Clearly identify
the fiduciary agency. Describe the CCO capacity to ensure accountability
for expenditures in relationship to performance of all key partners.

Provide information indicating that the training, CBPA qualifications,
experience and commitment of key members are appropriate and well suited
to the project. Describe clearly defined roles and qualifications of
project staff, and an appropriate percent of time each is committing to
REACH US.

Describe strategies for establishing and maintaining external
partnerships in various CEED activities including collection and
interpretation of evaluation data, as well as training and translation
and dissemination efforts.

Provide letters of support and memoranda of understanding (as
appropriate) with key partner agencies and organizations. (**Actual
documentation should be placed in Grants.gov as an Attachment)**

Document that the established infrastructure is appropriate to the level
of work proposed and maximizes funding for programmatic activities and
interventions.

Describe the ability to allocate and disperse funds as a national expert
center to Legacy Projects.

Description of any financial and/or in-kind resources that will be
contributed toward activities implemented as a part of REACH US should
be provided. Describe a plan to sustain the project long term.

Provide information on a well-developed coalition that includes the
knowledge and expertise of community members in all aspects of the
project. The coalition include members from: 1) tribes or local or state
health departments, 2) community based organizations, and 3)
university/academic institutions. Demonstrate that the coalition has
been functioning effectively. Describe the means to translate
evidence-based practices into sustainable community change. Provide
documentation the investigators are well-

versed in CBPA. Provide documentation that the funds and resources are
consistent with the work of coalition members.

Provide a conceptual framework, design, methods, and analyses adequately
developed, concise, well integrated, culturally tailored, and
appropriate to the goals and objectives of the project and CBPA.
Describe potential problem areas and alternative tactics.

Describe strategies which reflect and build upon a substantiated and
comprehensive understanding of the assets, attributes, and deficiencies
of the participating communities.

Provide evidence that shows community involvement in all aspects of
decision making, including identification of health priority area,
development of CEED goals and objectives, and execution of appropriate
CEED activities.

Document the functioning of the coalition to eliminate racial and ethnic
disparities over the past 3-5 years, such as a summary of contributions
of the coalition, novel approaches to the problems identified, cultural
tailoring of activities, ability to work with partners, or empower the
community.

Community Action Plan (CAP) should provide a conceptual framework for
potential strategies and approaches for interventions to be implemented
over the entire five-year project period. Interventions should be
conducted at the systems or policy level and could address several
levels of the social-ecologic model. Each intervention strategy must be
linked to a logic model that includes specific, measurable, attainable,
realistic, and time-phased (SMART) objectives that are expected to
produce short-term and intermediate outcomes that align with CDC REACH
programmatic efforts, REACH logic model, and Healthy People 2010
objectives, and address the needs of the community. Activities described
in the first two years of the CAP should be developed in depth, and
subsequent years should be outlined. It is expected that the CAP, logic
model, and SMART objectives will be adapted over the course of the
funding period to reflect evaluation outcomes regarding changes,
barriers, and lessons learned. The CAP should include a plan to ensure
long-term sustainability of programmatic efforts and outcomes.

Demonstrate how the interventions will apply evidence and practice-based
approaches to translate programmatic findings into practice.

Provide CBPA strategies for how Legacy Projects will be identified and
selected, develop relationships with communities that are motivated to
address racial and ethnic health disparities, and progress to the next
level of development (e.g., additional funding, application in other
communities, dissemination to relevant audiences).

Document prior training, translation, and dissemination activities of
the coalition (over the last 3-5 years) and how these activities were
culturally tailored to the racial and ethnic dynamics of the community.

Conduct trainings and translate and disseminate information on cultural
relevance to community members, partners, students, health care
providers, and other appropriate audiences.

Dissemination plan should describe proposed strategies to communicate
outcomes and lessons learned to the community, coalition, external
partners, elected officials, and the public health communities, and
include presentation and publication efforts over the past 3-5 years.

Identify opportunities to provide comprehensive training activities,
including cultural competence, evaluation of CBPA, and advancing the
public health workforce.

Provide strategies for collaboration among CEEDs and with Action
Communities to translate and disseminate findings and other information
to racial and ethnic communities.

Develop novel training, translation, and dissemination activities.

Provide strategies for developing and maintaining a national information
warehouse of culturally appropriate and evidence and practice-based
approaches.

Demonstrate how prior community activities have been evaluated.
Demonstrate how past evaluation impacts have been incorporated into the
current evaluation plan. Provide an evaluation plan that is well
developed, comprehensive, and articulated through selected REACH US
programmatic efforts, Healthy People 2010 objectives, logic models,
SMART objectives, and related activities. Provide information on
appropriate evaluation used to monitor and track changes in such areas
as racial and ethnic health disparities, community capacity, and systems
change. Demonstrate how the plan is tied to CBPA.

Demonstrate how the proposed activities and SMART objectives to
programmatic activities will advance knowledge of evidence or
practice-based approaches to eliminate racial and ethnic health
disparities.

Utilize evaluation staff that is experienced in CBPA.

Develop a comprehensive evaluation plan that encompasses all relevant
aspects of CEED activities. Evaluation plans should be consistent with
measurement of activities and interventions at systems or policy levels
that address several levels of the social ecological model.

Provide an explicit agreement with respect to ownership of the
programmatic data and dissemination of results between the non-community
and community members.

**[CEED Budget (Not Scored)]{.underline}**

The following guidelines should be used to develop the budget for CEED
applicants:

Provide a detailed budget reasonable and consistent with the proposed
activities and intent of the program.

No less than ten percent of the total award should be set aside each
year for Legacy Projects.

Include adequate funds, at least ten percent of the total award, to
participate fully in the substantial data collection and evaluation
activities associated with this award.

Allocate approximately 50 percent of the direct cost budget to maintain
and expand existing local efforts to systems change or policy approaches
or interventions at multiple levels of the social ecological model.

Approximately 25 percent of the direct cost budget should be set aside
for training and dissemination purposes.

**[Action Communities Project Narrative]{.underline}**

The project narrative for AC applications should address activities to
be conducted over the entire project period and must include the
following items in the order listed:

Executive Summary describing overall project, population(s) of focus,
health priority area(s), coalitions, and intervention strategies.
(Limited to 2 pages)

Statement of the Problem, including: intervention level (i.e., Action
Community), description of the racial/ethnic population(s) and health
priority area(s) of focus should include evidence of the disease burden
within the population of focus; contextual aspects of race;
environmental conditions (i.e., social, economic, cultural, health,
physical, and political) that contribute to the disparity; description
of evidence or practice-based interventions which have been or are being
used by the lead agency to address the population(s) of focus; how
activities are culturally tailored; and summary of findings from
community assessments or programmatic evaluations conducted within the
past 3 years to identify community assets and deficiencies.

Proposal should include culturally tailor evidence- or practice-based
approaches to improve community programs and better understand the
levels of the social ecological model and their impact on health
disparities for each targeted racial and ethnic group or subgroups
selected by the applicant?

Demonstrate the extent to which the application of proposal activities
and SMART objectives to programmatic activities will advance knowledge
of evidence or practice-based approaches to eliminate racial and ethnic
health disparities.

Describe the potential impact of the programmatic activities or
intervention(s) on reducing racial and ethnic health disparities through
increased community-based participatory approaches resulting from
community partnerships (i.e., coalition activities) and improved
methodologies. Present specific goals and objectives which are
culturally tailored to community programs.

Describe the work proposed appropriate to the experience level of the
Program Director and other key coalition members. Describe the team
complementary and integrated expertise to the project. Clearly identify
the fiduciary agency. Describe the CCO capacity to ensure accountability
for expenditures in relationship to performance of all key partners.

Describe the lead agency, and current infrastructure should be provided,
including description of staff qualifications and responsibilities, as
well as financial resources, partnerships, and/or projects related to
conducting community-based participatory approaches.

Describe the coalition and included a list of key partners; evidence of
prior (3-5 years minimum) successful collaborations in conducting
community-based participatory approaches; and details of the structure,
decision-making processes, and methods for accountability of its
members.

[]{.mark}

Provide Letters of Support and/or Memoranda of Understanding from
partnering agencies and key members of the coalition, highlighting
specific roles, responsibilities, and resources contributed to the
project, should be summarized in the narrative section. (**Actual
documentation should be placed in Grants.gov as an Attachment)**

Provide information indicating that the training, CBPA qualifications,
experience and commitment of key members of the coalition are
appropriate and well suited to the project.

Describe prior relationships and the degree to which key coalition
members and community partners have collaborated in the past.

Describe clearly defined roles and qualifications of project staff, and
an appropriate percent of time each is committing to REACH US.

Provide a detailed budget reasonable and consistent with the proposed
activities and intent of the program.

Provide evidence of a well-developed coalition that includes the
knowledge and expertise of community members in all aspects of the
project. Describe the level to which the coalition has been functioning
effectively. Describe a means to translate evidence-based practices into
sustainable community change. Provide documentation that the
investigators are well-versed in CBPA. Provide documentation that the
distribution of funds and resources are consistent with the work of
coalition members.

Provide a conceptual framework, design, methods, and analyses adequately
developed, well integrated, and appropriate to the goals and objectives
of the project. Describe potential problem areas and alternative
tactics.

Describe community involvement in all phases of the conceptualization,
design, methods, and analysis of the proposal.

The CAP and related activities should be are grounded in social
ecological theory, incorporate multiple systems levels, and utilize
community-based participatory approaches and sound public health
practice. The CAP should include objectives and activities that are
specific, measurable, attainable, realistic, and time-phased (SMART) and
integrated into a logic model.

Describe the selection and implementation of evidence- or practice-based
interventions that have a population focus and address specific levels
of the social-ecologic model. Present strong arguments for the proposed
interventions as the best possible balance of evidence or practice-based
interventions, implementation constraints, and inclusion of community
partners.

Describe the strategies which reflect and build upon a substantiated and
comprehensive understanding of the assets, attributes, and deficiencies
of the participating communities.

Describe how barriers to participation will be addressed, with
consideration for those who have been under-represented or
misrepresented in the past.

Describe how the goals and objectives of the program will facilitate
empowerment processes with communities to address some combination of
environmental factors (i.e., social, physical, political) on a long-term
basis.

Provide an explicit agreement with respect to ownership of the
programmatic data and dissemination of results between the non-community
and community members.

Demonstrate how the interventions will apply evidence and practice-based
approaches in the community setting to translate programmatic findings
into practice.

Dissemination plan describe proposed strategies to communicate outcomes
and lessons learned to the community, coalition, external partners,
elected officials, and the public health communities, and include
presentation and publication efforts.

Provide an evaluation plan that is well developed, comprehensive, and
articulated through selected REACH US programmatic efforts, Healthy
People 2010 objectives, logic models, SMART objectives, and related
activities. Provide information on appropriate evaluation used to
monitor and track changes in such areas as racial and ethnic health
disparities, intervention activities, and community change. Demonstrate
how the plan is tied to CBPA.

Describe logic model, SMART objectives, processes, and outcomes to
monitor success and evaluate overall impact of programmatic activities.

Provide documentation that evaluation staff are experienced in CBPA.

Maintain an internal evaluation database. Be prepared to work and share
evaluation efforts with CDC and other similar CEEDS and ACs.

**[AC Budget (Not Scored)]{.underline}**

The following guidelines should be used to develop the budget for AC
applicants:

Include adequate funds, at least ten percent of the total award, to
participate fully in the substantial data collection and evaluation
activities associated with this award.

[Attachments]{.underline}

Additional information may be included in the application attachments
only if it is pertinent to the application. Do not use the attachments
to extend the page limitation of the application. Limit the attachments
to a maximum of 150 pages. The attachments will not be counted toward
the narrative page limit. This additional information includes:

> Curriculum Vitae/Resumes (key personnel only)
>
> Organizational charts
>
> Logic Models
>
> Letters of Support and/or Memoranda of Understanding or Agreement
>
> Evidence of prior work
>
> Official Transmittal Letter (from the Central Executive Officer or
> Principal Investigator which identifies the lead agency and cites the
> amount requested)
>
> Table of Contents
>
> Indirect cost rate agreement (if applicable)
>
> 501(c)3 Document (if applicable)
>
> Other relevant documents or publications

All information included in the attachments should be clearly referenced
within the narrative of the application. Any additional materials
submitted in the attachments that are not listed above will not be
reviewed. Additional information submitted via Grants.gov should be
labeled as attachments.

The lead agency or organization is required to have a Dun and Bradstreet
Data Universal Numbering System (DUNS) number to apply for a grant or
cooperative agreement from the Federal government. The DUNS number is a
nine-digit identification number, which uniquely identifies business
entities. Obtaining a DUNS number is easy and there is no charge. To
obtain a DUNS number, access
[http://www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or
call 1-866-705-5711.

# 

# IV.3. Submission Dates and Times

**Letter of Intent (LOI) Deadline Date: March 29, 2007**

CDC requests that an applicant submit an LOI if the applicant intends to
submit a full application for this funding opportunity. Although the LOI
is not required, not binding, and does not enter into the review of the
subsequent application, it will be used to gauge the level of interest
in this program and to allow CDC to plan the application review.

**Application Deadline Date: May 7, 2007**

Explanation of Deadlines: Applications must be received in the CDC
Procurement and Grants Office by 4:00 p.m. Eastern Time on the deadline
date.

Applications may be submitted electronically at
[www.Grants.gov](http://www.Grants.gov/). Applications completed on-line
through Grants.gov are considered formally submitted when the applicant
organization's Authorizing Official electronically submits the
application to [www.Grants.gov](http://www.Grants.gov/). Electronic
applications will be considered as having met the deadline if the
application has been submitted electronically by the applicant
organization's Authorizing Official to Grants.gov on or before the
deadline date and time.

When submittal of the application is done electronically through
Grants.gov (http://www.grants.gov), the application will be
electronically time/date stamped, which will serve as receipt of
submission. Applicants will receive an e-mail notice of receipt when
HHS/CDC receives the application.

If submittal of the application is by the United States Postal Service
or commercial delivery service, the applicant must ensure that the
carrier will be able to guarantee delivery by the closing date and time.
The applicant will be given the opportunity to submit documentation of
the carrier's guarantee, if HHS/CDC receives the submission after the
closing date 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. If the
documentation verifies a carrier problem, HHS/CDC will consider the
submission as having been received by the deadline.

If a hard copy application is submitted, HHS/CDC will not notify the
applicant upon receipt of the submission. If questions arise on the
receipt of the application, the applicant should first contact the
carrier. If the applicant still has questions, contact the PGO-TIM staff
at (770) 488-2700. The applicant should wait two to three days after the
submission deadline before calling. This will allow time for submissions
to be processed and logged.

This announcement is the definitive guide on LOI and application
content, submission address, and deadline. It supersedes information
provided in the application instructions. If the application submission
does not meet the deadline above, it will not be eligible for review,
and will be discarded by HHS/CDC. The applicant will be notified the
application did not meet the submission requirements.

**IV.4. Intergovernmental Review of Applications**

Executive Order 12372 does not apply to this program.

**IV.5. Funding Restrictions**

Restrictions, which must be taken into account while writing the budget,
are as follows:

> Recipients may not use funds for research.
>
> Recipients may not use funds for clinical care.
>
> Recipients may not use funds for capacity building.
>
> Funds may not be used for minor promotional materials.
>
> Recipients may only expend funds for reasonable program purposes,
> including personnel, travel, supplies, and services, including
> contracts.
>
> Awardees may not generally use HHS/CDC/ATSDR funding for the purchase
> of furniture, equipment, or construction. Any such proposed spending
> must be identified in the budget.
>
> The direct and primary recipient in a cooperative agreement program
> must perform a substantial role in carrying out project objectives and
> not merely serve as a conduit for an award to another party or
> provider who is ineligible.
>
> Reimbursement of pre-award costs is not allowed.

If requesting indirect costs in the budget, a copy of the indirect cost
rate agreement is required. If the indirect cost rate is a provisional
rate, the agreement should be less than 12 months of age.

The recommended guidance for completing a detailed justified budget can
be found on the CDC Web site, at the following Internet address:

<http://www.cdc.gov/od/pgo/funding/budgetguide.htm>.

PDF file only

If applying for both CEED and AC when completing the grant application
package use the add mandatory budget narrative button to upload the CEED
budget narrative and use the add optional budget narrative button to
upload the AC budget narrative.

**IV.6. Other Submission Requirements**

LOI Submission Address: Submit the LOI by express mail, delivery
service, fax, or E-mail to:

Alexandria Stewart

> Centers for Disease Control and Prevention
>
> National Center for Chronic Disease Prevention and Health Promotion
>
> 3005 Chamblee-Tucker Road, Mailstop K-30
>
> Atlanta, GA 30341
>
> Telephone Number: (770) 488-5426
>
> Fax: (770) 488-5974
>
> E-mail address: ALStewart@cdc.gov

Application Submission Address:

Electronic Submission:

HHS/CDC strongly encourages applicants to submit applications
electronically at [www.Grants.gov](http://www.grants.gov/). The
application package can be downloaded from
[www.Grants.gov](http://www.Grants.gov/). Applicants are able to
complete it off-line, and then upload and submit the application via the
Grants.gov Web site. E-mail submissions will not be accepted. If the
applicant has technical difficulties in Grants.gov, customer service can
be reached by E-mail at <http://www.grants.gov/CustomerSupport> or by
phone at 1-800-518-4726 (1-800-518-GRANTS). The Customer Support Center
is open from 7:00a.m. to 9:00p.m. Eastern Time, Monday through Friday.

HHS/CDC recommends that submittal of the application to Grants.gov
should be early to resolve any unanticipated difficulties prior to the
deadline. Applicants may also submit a back-up paper submission of the
application. Any such paper submission must be received in accordance
with the requirements for timely submission detailed in Section IV.3. of
the grant announcement. The paper submission must be clearly marked:
"BACK-UP FOR ELECTRONIC SUBMISSION." The paper submission must conform
to all requirements for non-electronic submissions. If both electronic
and back-up paper submissions are received by the deadline, the
electronic version will be considered the official submission.

The applicant must submit all application attachments using a PDF file
format when submitting via Grants.gov. Directions for creating PDF files
can be found on the Grants.gov Web site. Use of file formats other than
PDF may result in the file being unreadable by staff.

OR

Paper Submission:

Applicants should submit the original and two hard copies of the
application by mail or express delivery service to:

Technical Information Management -- DP07-707

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Road

Atlanta, GA 30341

# V. Application Review Information

**V.1. Criteria**

If an applicant chooses to submit proposals for both a CEED and AC, the
proposals will be reviewed independently.

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
Healthy People 2010 objectives, the REACH logic model, and the REACH US
programmatic efforts. Measures must be objective and quantitative and
must measure the intended outcome. The measures of effectiveness must be
submitted with the application and will be an element of evaluation.

The application will be evaluated against the following criteria:

Only the review criteria described below will be considered in the
review process and making funding decisions:

Merit of the proposed work as determined by objective review

Relevance to program priorities and CDC REACH US programmatic efforts

Commitment to CBPA and degree of coalition involvement

Availability of funds

**Review Criteria for Overall Program:**

Objective review panels will be appointed by CDC to evaluate the quality
of each application against the following criteria. Evaluation criteria
are listed separately for CEED and Action Communities.

**Review Criteria for CEED Proposals**

A. Significance and Cultural Relevance -- 25 points. Does the proposal
address an important problem? Statement of the Problem, including:
intervention level (i.e., Action Community), description of the
racial/ethnic population(s) and health priority area(s) of focus should
include evidence of the disease burden within the population of focus;
contextual aspects of race; environmental conditions (i.e., social,
economic, cultural, health, physical, and political) that contribute to
the disparity; description of evidence or practice-based interventions
which have been or are being used by the lead agency to address the
population(s) of focus; how activities are culturally tailored; and
summary of findings from community assessments or programmatic
evaluations conducted within the past 3 years to identify community
assets and deficiencies.

[The extent to which the applicant]{.mark} demonstrate the capacity to
function as a [national]{.mark} [resource]{.mark} expert center in terms
of expertise in the selected racial and ethnic population(s) and health
priority area(s) of focus, collecting and synthesizing information, and
translating and disseminating promising practices and novel approaches
to the elimination of racial and ethnic health disparities.

[The extent to which the applicant adequately]{.mark} addresses: the
burden of disease faced by each racial/ethnic group within an identified
multi-state/regional area; the contextual aspects of race that include a
definition of race, brief history of demographics of the region
(including but not limited to census data), and social contexts of the
relationship between race and the selected health priority areas in the
region; the targeted REACH US program priorities and Healthy People 2010
objectives for each racial/ethnic group, and how progress in each of
these areas will be measured.

[The extent to which the applicant demonstrates]{.mark} experience and
relationships in a given multi-state/regional geographical area.

[The extent to which the applicant describes]{.mark} the potential
impact of the programmatic activities or intervention(s) on reducing
racial and ethnic health disparities through increased community-based
participatory approaches resulting from community partnerships (i.e.,
coalition activities) and improved methodologies.

[The extent to which the applicant describes]{.mark} prior achievements
and how the proposal continues this work in systems or policy level
interventions; how the proposal challenges existing public health
practice paradigms and moves beyond the status quo to address the
culture of the community and summary of findings from community
assessments or programmatic evaluations conducted within the past 3
years to identify community assets and deficiencies.

[The extent to which the applicant develops]{.mark} a better
understanding of influences that affect the elimination of health
disparities at various system levels.

B. Leadership and Management -- 20 points. Is the work proposed
appropriate to the experience level of the Program Director and other
key coalition members? Does the team bring complementary and integrated
expertise to the project? Is the fiduciary agency clearly identified?
Does the CCO have the capacity to ensure accountability for expenditures
in relationship to performance of all key partners?

[The extent to which the applicant provides]{.mark} information
indicating that the training, CBPA qualifications, experience and
commitment of key members are appropriate and well suited to the
project. Describe clearly defined roles and qualifications of project
staff, and an appropriate percent of time each is committing to REACH
US.

[The extent to which the applicant describes]{.mark} strategies for
establishing and maintaining external partnerships in various CEED
activities including collection and interpretation of evaluation data,
as well as training and translation and dissemination efforts.

[The extent to which the applicant provide]{.mark} letters of support
and memoranda of understanding (as appropriate) with key partner
agencies and organizations.

[The extent to which the applicant]{.mark} that the established
infrastructure is appropriate to the level of work proposed and
maximizes funding for programmatic activities and interventions.

[The extent to which the applicant describes]{.mark} the ability to
allocate and disperse funds as a national expert center to Legacy
Projects.

[The extent to which the applicant adequately provided a]{.mark}
description of any financial and/or in-kind resources that will be
contributed toward activities implemented as a part of REACH US should
be provided. Describe a plan to sustain the project long term.

C. Community-Based Participatory Approaches -- 20 points. Is there a
well-developed coalition that includes the knowledge and expertise of
community members in all aspects of the project? Does the coalition
include members from: 1) tribes or local or state health departments, 2)
community based organizations, and 3) university/academic institutions?
Has it been shown that the coalition has been functioning effectively?
Is there a means to translate evidence-based practices into sustainable
community change? Are the investigators well-versed in CBPA? Is the
distribution of funds and resources consistent with the work of
coalition members?

Are the conceptual framework, design, methods, and analyses adequately
developed, concise, well integrated, culturally tailored, and
appropriate to the goals and objectives of the project and CBPA? Does
the applicant acknowledge potential problem areas and consider
alternative tactics?

[The extent to which the applicant describe]{.mark} the strategies which
reflect and build upon a substantiated and comprehensive understanding
of the assets, attributes, and deficiencies of the participating
communities.

[The extent to which the applicant]{.mark} provide evidence that shows
community involvement in all aspects of decision making, including
identification of health priority area, development of CEED goals and
objectives, and execution of appropriate CEED activities.

[The extent to which the applicant documented]{.mark} the functioning of
the coalition to eliminate racial and ethnic disparities over the past
3-5 years, such as a summary of contributions of the coalition, novel
approaches to the problems identified, cultural tailoring of activities,
ability to work with partners, or empower the community.

Community Action Plan (CAP) should provide a conceptual framework for
potential strategies and approaches for interventions to be implemented
over the entire five-year project period. Interventions should be
conducted at the systems or policy level and could address several
levels of the social-ecologic model. Each intervention strategy must be
linked to a logic model that includes specific, measurable, attainable,
realistic, and time-phased (SMART) objectives that are expected to
produce short-term and intermediate outcomes that align with CDC REACH
programmatic efforts, REACH logic model, and Healthy People 2010
objectives, and address the needs of the community. Activities described
in the first two years of the CAP should be developed in depth, and
subsequent years should be outlined. It is expected that the CAP, logic
model, and SMART objectives will be adapted over the course of the
funding period to reflect evaluation outcomes regarding changes,
barriers, and lessons learned. The CAP should include a plan to ensure
long-term sustainability of programmatic efforts and outcomes.

[The extent to which the applicant]{.mark} demonstrate how the
interventions will apply evidence and practice-based approaches to
translate programmatic findings into practice.

[The extent to which the applicant]{.mark} provide CBPA strategies for
how Legacy Projects will be identified and selected, develop
relationships with communities that are motivated to address racial and
ethnic health disparities, and progress to the next level of development
(e.g., additional funding, application in other communities,
dissemination to relevant audiences).

D. Training, Translation, and Dissemination -- 20 points

[The extent to which the applicant documented]{.mark} prior training,
translation, and dissemination activities of the coalition (over the
last 3-5 years) and how these activities were culturally tailored to the
racial and ethnic dynamics of the community.

[The extent to which the applicant has conducted]{.mark} trainings and
translate and disseminate information on cultural relevance to community
members, partners, students, health care providers, and other
appropriate audiences.

[The extent to which the applicant]{.mark} dissemination plan describe
proposed strategies to communicate outcomes and lessons learned to the
community, coalition, external partners, elected officials, and the
public health communities, and include presentation and publication
efforts over the past 3-5 years.

[The extent to which the applicant]{.mark} identify opportunities to
provide comprehensive training activities, including cultural
competence, evaluation of CBPA, and advancing the public health
workforce.

[The extent to which the applicant]{.mark} provide strategies for
collaboration among CEEDs and with Action Communities to translate and
disseminate findings and other information to racial and ethnic
communities.

[The extent to which the applicant]{.mark} develop novel training,
translation, and dissemination activities.

[The extent to which the applicant]{.mark} provide strategies for
developing and maintaining a national information warehouse of
culturally appropriate and evidence and practice-based approaches.

E. Plan for Project Evaluation and Monitoring -- 15 points. How have
prior community activities been evaluated? How have past evaluation
impacts been incorporated into the current evaluation plan? Is the
evaluation plan well developed, comprehensive, and articulated through
selected REACH US programmatic efforts, Healthy People 2010 objectives,
logic models, SMART objectives, and related activities? Is appropriate
evaluation used to monitor and track changes in such areas as racial and
ethnic health disparities, community capacity, and systems change? Is
the plan tied to CBPA?

[The degree to which the applicant demonstrates]{.mark} the extent to
which the application of proposal activities and SMART objectives to
programmatic activities will advance knowledge of evidence or
practice-based approaches to eliminate racial and ethnic health
disparities.

[The extent to which the applicant]{.mark} use evaluation staff that is
experienced in CBPA.

[The extent to which the applicant]{.mark} develop a comprehensive
evaluation plan that encompasses all relevant aspects of CEED
activities. Evaluation plans should be consistent with measurement of
activities and interventions at systems or policy levels that address
several levels of the social ecological model.

[The extent to which the applicant]{.mark} provide an explicit agreement
with respect to ownership of the programmatic data and dissemination of
results between the non-community and community members.

F. Budget (Not Scored)

The following guidelines should be used to develop the budget for CEED
applicants:

[The extent to which the applicant provided a]{.mark} detailed budget
reasonable and consistent with the proposed activities and intent of the
program.

[The extent to which the applicant use no less than ten percent of the
total award to set]{.mark} aside each year for Legacy Projects.

[The extent to which applicant]{.mark} include adequate funds, at least
ten percent of the total award, to participate fully in the substantial
data collection and evaluation activities associated with this award.

[The extent to which the applicant allocated]{.mark} approximately 50
percent of the direct cost budget to maintain and expand existing local
efforts to systems change or policy approaches or interventions at
multiple levels of the social ecological model.

[The extent to which the applicant set aside]{.mark} approximately 25
percent of the direct cost budget should be set aside for training and
dissemination purposes.

**Review Criteria for AC Proposals**

A. Significance and Cultural Relevance -- 25 points. [Statement of the
Problem, including: intervention level (i.e., Action Community),
description of the racial/ethnic population(s) and health priority
area(s) of focus should include evidence of the disease burden within
the population of focus; contextual aspects of race; environmental
conditions (i.e., social, economic, cultural, health, physical, and
political) that contribute to the disparity; description of evidence or
practice-based interventions which have been or are being used by the
lead agency to address the population(s) of focus; how activities are
culturally tailored; and summary of findings from community assessments
or programmatic evaluations conducted within the past 3 years to
identify community assets and deficiencies.]{.mark}

Does the proposal culturally tailor evidence- or practice-based
approaches to improve community programs and better understand the
levels of the social ecological model and their impact on health
disparities for each targeted racial and ethnic group or subgroups
selected by the applicant?

[The extent to which the applicant]{.mark} demonstrate the extent to
which the application of proposal activities and SMART objectives to
programmatic activities will advance knowledge of evidence or
practice-based approaches to eliminate racial and ethnic health
disparities.

[The extent to which the applicant]{.mark} describe the potential impact
of the programmatic activities or intervention(s) on reducing racial and
ethnic health disparities through increased community-based
participatory approaches resulting from community partnerships (i.e.,
coalition activities) and improved methodologies. Present specific goals
and objectives which are culturally tailored to community programs.

B. Leadership and Management -- 20 points. Is the work proposed
appropriate to the experience level of the Program Director and other
key coalition members? Does the team bring complementary and integrated
expertise to the project? Is the fiduciary agency clearly identified?
Does the CCO have the capacity to ensure accountability for expenditures
in relationship to performance of all key partners?

[The extent to which the applicant]{.mark} describe the lead agency, and
current infrastructure should be provided, including description of
staff qualifications and responsibilities, as well as financial
resources, partnerships, and/or projects related to conducting
community-based participatory approaches.

[The extent to which the applicant]{.mark} describe the coalition and
included a list of key partners; evidence of prior (3-5 years minimum)
successful collaborations in conducting community-based participatory
approaches; and details of the structure, decision-making processes, and
methods for accountability of its members.

[]{.mark}

[The extent to which the applicant]{.mark} provided Letters of Support
and/or Memoranda of Understanding from partnering agencies and key
members of the coalition, highlighting specific roles, responsibilities,
and resources contributed to the project, should be summarized in the
narrative section. Actual documentation should be placed in an
Attachment.

[The extent to which the applicant]{.mark} provided information
indicating that the training, CBPA qualifications, experience and
commitment of key members of the coalition are appropriate and well
suited to the project.

[The extent to which the applicant]{.mark} describe prior relationships
and the degree to which key coalition members and community partners
have collaborated in the past.

[The extent to which the applicant]{.mark} describe clearly defined
roles and qualifications of project staff, and an appropriate percent of
time each is committing to REACH US.

[The extent to which the applicant]{.mark} provided a detailed budget
reasonable and consistent with the proposed activities and intent of the
program.

C. Community-Based Participatory Approaches -- 20 points. Is there a
well-developed coalition that includes the knowledge and expertise of
community members in all aspects of the project? Has it been shown that
the coalition has been functioning effectively? Is there a means to
translate evidence-based practices into sustainable community change?
Are the investigators well-versed in CBPA? Is the distribution of funds
and resources consistent with the work of coalition members?

[The extent to which the applicant]{.mark} provided a conceptual
framework, design, methods, and analyses adequately developed, well
integrated, and appropriate to the goals and objectives of the project?
Does the applicant acknowledge potential problem areas and consider
alternative tactics?

[The extent to which the applicant]{.mark} describe community
involvement in all phases of the conceptualization, design, methods, and
analysis of the proposal.

[To the extent the applicant CAP and related activities are
grounded]{.mark} in social ecological theory, incorporate multiple
systems levels, and utilize community-based participatory approaches and
sound public health practice. The CAP include objectives and activities
that are specific, measurable, attainable, realistic, and time-phased
(SMART) and integrated into a logic model.

[The extent to which the applicant]{.mark} describe the selection and
implementation of evidence- or practice-based interventions that have a
population focus and address specific levels of the social-ecologic
model. Present strong arguments for the proposed interventions as the
best possible balance of evidence or practice-based interventions,
implementation constraints, and inclusion of community partners.

[The extent to which the applicant]{.mark} describe the strategies which
reflect and build upon a substantiated and comprehensive understanding
of the assets, attributes, and deficiencies of the participating
communities.

[The extent to which the applicant]{.mark} describe how barriers to
participation will be addressed, with consideration for those who have
been under-represented or misrepresented in the past.

[The extent to which the applicant]{.mark} describe how the goals and
objectives of the program will facilitate empowerment processes with
communities to address some combination of environmental factors (i.e.,
social, physical, political) on a long-term basis.

[The extent to which the applicant]{.mark} provide an explicit agreement
with respect to ownership of the programmatic data and dissemination of
results between the non-community and community members.

D. Training, Translation, and Dissemination -- 20 points.

[The extent to which the applicant]{.mark} demonstrate how the
interventions will apply evidence and practice-based approaches in the
community setting to translate programmatic findings into practice.

[The extent to which the applicant]{.mark} dissemination plan describe
proposed strategies to communicate outcomes and lessons learned to the
community, coalition, external partners, elected officials, and the
public health communities, and include presentation and publication
efforts.

E. Plan for Project Evaluation and Monitoring -- 15 points. Is the
evaluation plan well developed, comprehensive, and articulated through
selected REACH US programmatic efforts, Healthy People 2010 objectives,
logic models, SMART objectives, and related activities? Is appropriate
evaluation used to monitor and track changes in such areas as racial and
ethnic health disparities, intervention activities, and community
change? Is the plan tied to CBPA?

[The extent to which the applicant]{.mark} describe logic model, SMART
objectives, processes, and outcomes to monitor success and evaluate
overall impact of programmatic activities.

Use evaluation staff that is experienced in CBPA.

[The extent to which the applicant]{.mark} maintain an internal
evaluation database. Be prepared to work and share evaluation efforts
with CDC and other similar CEEDS and ACs.

[The extent to which the applicant]{.mark} include adequate funds, at
least ten percent of the total award, to participate fully in the
substantial data collection and evaluation activities associated with
this award.

F. Budget (Not Scored)

The following guidelines should be used to develop the budget for AC
applicants:

[The extent to which the applicant]{.mark} include adequate funds, at
least ten percent of the total award, to participate fully in the
substantial data collection and evaluation activities associated with
this award.

**V.2. Review and Selection Process**

Applications will be reviewed for completeness by the Procurement and
Grants Office (PGO) staff and for responsiveness jointly by The National
Center for Chronic Disease Prevention and Health Promotion and PGO.
Incomplete applications and applications that are non-responsive to the
eligibility criteria will not advance through the review process.
Applicants will be notified the application did not meet submission
requirements.

Multiple objective review panels will evaluate the volume of
applications that are expected according to the criteria listed in the
"V.1 Criteria" section above. The objective review process will follow
policy requirements as stated in GPD 2.04
\[http://198.102.218.46/doc/gpd204.doc\]. Reviewers will consist of CDC
employees outside of the funding center, other relevant federal
employees (e.g., from the Indian Health Service, Office of Minority
Health, etc.), and external experts.

CDC reserves the right to consider the applicant's rank on the objective
review panel and/or a calculated standardized score. Standardized scores
are used to normalize variations in scoring among the review panels.
These scores take into account the average and standard deviation of the
panel scores, thereby setting each panel's average score equal to zero.
This procedure allows direct comparisons across panels.

If an applicant submits proposals for both a CEED and an AC, evaluation
for funding of each proposal will be made independently. If both
proposals receive a fundable score, CDC will select one for funding [per
organization]{.mark}.

In addition, the following factors may affect the funding decision:

> Maintaining geographic diversity across the United States;
>
> Ensuring that each racial/ethnic group that is specified in this
> announcement is represented;
>
> Ensuring that health priority areas that are specified in this
> announcement are represented;
>
> Ensuring that communities with evident health disparities are
> represented; and
>
> Ensuring communities who currently lack access to health priority
> area-related resources and/or with high levels of poverty are
> represented.
>
> CDC will provide justification for any decision to fund out of rank
> order.

**V.3. Anticipated Announcement Award Dates**

September 30, 2007

# 

# VI. Award Administration Information

**VI.1. Award Notices**

Successful applicants will receive a Notice of Award (NoA) from the CDC
Procurement and Grants Office. The NoA shall be the only binding,
authorizing document between the recipient and CDC. The NoA will be
signed by an authorized Grants Management Officer and emailed to the
program director and a hard copy mailed to the recipient fiscal officer
identified in the application.

Unsuccessful applicants will receive notification of the results of the
application review by mail.

**VI.2. Administrative and National Policy Requirements**

Successful applicants must comply with the administrative requirements
outlined in 45 CFR Part 74 and Part 92, as appropriate. The following
additional requirements apply to this project:

> 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
>
> AR-13 Prohibition on Use of CDC Funds for Certain Gun Control
> Activities
>
> AR-14 Accounting System Requirements
>
> AR-15 Proof of Non-profit status
>
> AR-21 Small, Minority, and Women-Owned Business
>
> AR-23 Compliance with C.F.R. Part 87
>
> AR-25 Release and Sharing of Data

Additional information on the requirements can be found on the CDC Web
site at the following Internet address:
http://www.cdc.gov/od/pgo/funding/Addtl_Reqmnts.htm.

For more information on the Code of Federal Regulations, see the
National Archives and Records Administration at the following Internet
address: <http://www.access.gpo.gov/nara/cfr/cfr-table-search.html>

**VI.3. Reporting Requirements**

Use CDC's management information system for down-loading the following
progress reports:

1.  Interim progress report, due April 30^th^ of each year. The interim
    progress report will serve as the non-competing continuation
    application and should contain information on accomplishments of the
    first six months as well as projections for the next budget year,
    and must contain the following elements:

    a.  Current Budget Period Activities and Objectives, including 1)
        program goals and related logic model(s), 2) SMART
        objectives, 3) status of attaining objectives, 4) objective
        timeline, 5) discussion of progress toward various activities
        (including strategies for addressing barriers, outcomes linked
        to performance indicators, lessons learned, and next steps), 6)
        evaluation plan, 7) dissemination plan, and 8) sustainability
        plan

    b.  Current Budget Period Financial Progress

    c.  New Budget Period Program with Proposed Activity and Objectives
        (as above)

    d.  Budget

    e.  Additional Requested Information

2\) Annual progress report, due December 30^th^ of each year. This
report should contain information on the entire reporting period,
including updated information on the first six months.

a.  Current Budget Period Activities and Objectives, including 1)
    program goals and related logic model(s), 2) SMART objectives, 3)
    status of attaining objectives, 4) objective timeline, 5) discussion
    of progress toward various activities (including strategies for
    addressing barriers, outcomes linked to performance indicators,
    lessons learned, and next steps), 6) evaluation plan, 7)
    dissemination plan, and 8) sustainability plan

b.  Current Budget Period Financial Progress

c.  New Budget Period Program with Proposed Activity and Objectives (as
    above)

d.  Budget

e.  Additional Requested Information

3\) Financial status report due December 30^th^ of each year

4\) Final performance and Financial Status reports, due December 30^th^
of the final year

The reports must be mailed to the Grants Management Specialist listed in
the "Agency Contacts" section of this announcement.

# VII. Agency Contacts

CDC encourages inquiries concerning this announcement.

For general questions, contact:

Technical Information Management Section

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Road

Atlanta, GA 30341

Telephone: 770-488-2700

For program technical assistance, contact:

Alexandria Stewart, Team Lead

Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

3005 Chamblee-Tucker Road, Mailstop K-30

Atlanta, GA 30341

Telephone Number: (770) 488-5426

Fax: (770) 488-5974

E-mail address: ALStewart@cdc.gov

For financial, grants management, or budget assistance, contact:

> Patricia French, Grants Management Specialist

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Road, Mail stop: E-14

Atlanta, GA 30341

Telephone: (770) 488-2758

E-mail: patricia.french@cdc.gov

CDC Telecommunications for the hearing impaired or disabled is available
at: TTY 770-488-2783.

**VIII. Other Information**

Other CDC funding opportunity announcements can be found on the CDC Web
site, [***Internet address:
http://www.cdc.gov/od/pgo/funding/FOAs.htm.***](../Internet%20address:%20http:/www.cdc.gov/od/pgo/funding/FOAs.htm.)

The REACH 2010 website can be found at:

[www.cdc.gov/REACH](http://www.cdc.gov/REACH)

Other available resources can be found in Attachment F and a glossary of
terms is located in Attachment G.

Attachment A

Racial and Ethnic Subgroups

Attachment A

Racial and Ethnic Subgroups

African American/Black: African Americans or Blacks are people having
origins in any of the black racial groups of
Africa.[^1^](http://www.cdc.gov/omh/Populations/BAA/BAA.htm#1%231) According
to the 2000 U.S. Census, those who identify only as African American
constitute approximately 12 percent of the American population \--
almost 35 million individuals. The Census Bureau projects that by the
year 2035 there will be more than 50 million African American
individuals in the United States, comprising 14.3 percent of the
population.  The health disparities between African Americans and other
racial groups are striking and are apparent in life expectancy, infant
mortality, and other measures of health status. For example, in 1999 the
average American could expect to live 76.9 years, the average African
American could only expect to live 71.4
years.[^2^](http://www.cdc.gov/omh/Populations/BAA/BAA.htm#4%234)
Factors contributing to poor health outcomes among African Americans
include discrimination, cultural barriers, and lack of access to health
care.[^3^](http://www.cdc.gov/omh/Populations/BAA/BAA.htm#4%234)

American Indian/Alaska Native: American Indians and Alaska Natives
(AI/ANs) are people having origins in any of the original peoples of
North and South America (including Central America), and who maintain
tribal affiliation or community
attachment.[^4^](http://www.cdc.gov/omh/Populations/AIAN/AIAN.htm#1%231) 
According to the 2000 U.S. Census, those who identify only as AI/AN
constitute 0.9 percent of the United States population, or approximately
2.5 million individuals.  The Census Bureau projects modest growth by
AI/AN communities in the next few decades, topping 5 million individuals
by the year 2065 and comprising 1.1 percent of the population. AI/ANs
have a unique relationship with the federal government due to historic
conflict and subsequent treaties. Tribes exist as sovereign entities,
but federally recognized tribes are entitled to health and educational
services provided by the federal government. Though the Indian Health
Service (IHS) is charged with serving the health needs of these
populations, more than half of the AI/AN population does not permanently
reside on a
reservation,[^5^](http://www.cdc.gov/omh/Populations/AIAN/AIAN.htm#3%233)
and therefore have limited or no access to IHS services. Geographic
isolation, economic factors, and differences between western versus
traditional spiritual beliefs are some of the reasons why health among
AI/ANs is poorer than other groups.  Other factors that contribute to
poorer health outcomes for AI/ANs include cultural barriers, geographic
isolation, inadequate sewage disposal, and economic
factors.[^6^](http://www.cdc.gov/omh/Populations/AIAN/AIAN.htm#4%234)

Asian: Asians are people having origins in any of the original peoples
of the Far East, Southeast Asia, or the Indian
subcontinent.[^7^](http://www.cdc.gov/omh/Populations/AsianAm/AsianAm.htm#3%233)
According to the 2000 U.S. Census, those who identify only as Asian
comprise 3.6 percent of the American population, approximately 10
million individuals. The Census Bureau projects that the Asian
population will grow to 37.6 million individuals by the year 2050,
comprising 9.3 percent of the population. Asian populations are
generally concentrated in the western states, the Northeast, and parts
of the South. Asian represent both extremes of socioeconomic and health
indices: while more than a million Asian live at or below the federal
poverty level, Asian women have the highest life expectancy of any other
group. Asians suffer disproportionately from certain types of cancer,
tuberculosis, and Hepatitis B.  Factors contributing to poor health
outcomes for Asians include language and cultural barriers, stigma
associated with certain conditions, and lack of health insurance.

Native Hawaiian/other Pacific Islander: Native Hawaiian and Other
Pacific Islanders (NHOPIs) are people having origins in any of the
original peoples of Hawaii, Guam, Samoa, or other Pacific
Islands,[^8^](http://www.cdc.gov/omh/Populations/NHOPI/NHOPI.htm#1%231)
even if they do not live in the Pacific Islands. According to the 2000
Census, those who identify only as NHOPI comprise 0.1 percent of the
American population, or almost 400,000 individuals.  Until 2000, NHOPIs
were grouped with Asians in studies of race and ethnicity.  For this
reason, there are no population growth projections for NHOPIs at this
time. Though historically grouped with Asians for data collection, NHOPI
was assigned as a distinct category for the 2000 Census.  NHOPIs
generally experience poorer health than the American population as a
whole: they are more at risk for developing and dying from cancer, heart
disease, diabetes, and other diseases.  Factors contributing to poor
health outcomes among NHOPIs include cultural barriers, limited access
to health care, and poor nutrition and
lifestyle.[^9^](http://www.cdc.gov/omh/Populations/NHOPI/NHOPI.htm#3%233)

Hispanic/Latino: Hispanics or Latinos are persons of Cuban, Mexican,
Puerto Rican, South or Central-American, or other Spanish culture or
origin, regardless of race.  The federal government considers race and
Hispanic origin to be two separate and distinct concepts; Hispanic
Americans may be any
race.[^10^](http://www.cdc.gov/omh/Populations/HL/hl.htm#1%231)
 According to the 2000 U.S. Census, Hispanics of all races represent
13.3 percent of the U.S. population, about 37.4 million
individuals.[^11^](http://www.cdc.gov/omh/Populations/HL/hl.htm#2%232)
The Census Bureau projects that by the year 2040 there will be 87.5
million Hispanic individuals, comprising 22.3 percent of the
population.^[12](http://www.cdc.gov/omh/Populations/HL/hl.htm#3%233)^
Though they share many aspects of a common heritage such as language and
emphasis on extended family, Hispanic cultures vary significantly by
country of origin. Hispanics tend to be younger than the white
non-Hispanic population (except for Cubans, who have a higher proportion
of elderly than other Hispanic groups). Their health profiles are also
unique: Puerto Ricans suffer disproportionately from asthma, and infant
mortality,[^13^](http://www.cdc.gov/omh/Populations/HL/hl.htm#50%2350)
while Mexican Americans suffer disproportionately from
diabetes.[^14^](http://www.cdc.gov/omh/Populations/HL/hl.htm#6%236)
Factors that contribute to poor health outcomes among Hispanics include
language and cultural barriers, lack of access to preventive care, and
lack of health
insurance.[^15^](http://www.cdc.gov/omh/Populations/HL/hl.htm#7%237)

Attachment [B]{.smallcaps}

Socio-ecological Models

Attachment [B]{.smallcaps}

Socio-ecological Models (Figures)

![](media/image1.wmf){width="4.995833333333334in"
height="3.7472222222222222in"}

![](media/image2.wmf){width="4.995833333333334in"
height="3.7472222222222222in"}

![](media/image3.wmf){width="4.995833333333334in"
height="3.7472222222222222in"}

![](media/image4.wmf){width="4.995833333333334in"
height="3.7472222222222222in"}

Attachment C

Examples of CEED and Action Communities

Attachment C

Examples of Centers of Excellence in Eliminating Disparities

> Evaluate and make policy recommendations for improvement of local,
> state, and national policies that affect racial and ethnic health
> disparities among Hispanic/Latinos with cardiovascular disease;
>
> Examine access, quality, barriers to care, and other characteristics
> of health care systems that affect disparities among Native
> Hawaiian/Other Pacific Islanders with breast and cervical cancer;
>
> Develop and disseminate community-based approaches to capture and
> evaluate social ecological based program activities that improve
> disparities among American Indians/Alaska Natives with diabetes;
>
> Evaluate and recommend strategies and interventions at local, state,
> and national levels to reduce the "digital divide" by assisting
> African Americans with asthma to gain assess to technology and digital
> information relevant to their healthcare

Examples of Action Communities

> Identify and evaluate targeted aspects of the healthcare system and
> social-ecological environment that facilitate disparities among Asians
> with hepatitis B;
>
> Advance a better understanding of the development, interactions, and
> impact of community economic development on the elimination of health
> disparities among American Indians/Alaska Natives in the area of
> infant mortality;
>
> Implement and evaluate promising approaches in Hispanic/Latino
> populations to decrease rates of tuberculosis in; and
>
> Identify and evaluate selected aspects of the health system, including
> issues of cultural competency, that contribute to older adult African
> Americans with low levels of immunization

Attachment D

REACH Logic Model

Attachment D

REACH Logic Model

![](media/image5.wmf)

REACH Logic Model:
[[http://www.cdc.gov/pcd/issues/2006/jan/05_0131.htm]{.underline}](http://www.cdc.gov/pcd/issues/2006/jan/05_0131.htm)

Attachment E

REACH US Programmatic Efforts

Attachment E

REACH US Programmatic Efforts

> Implement promising approaches to evaluate how changes at the
> community level influence individual behaviors work to eliminate
> racial and ethnic health disparities;
>
> Apply and evaluate promising approaches that lead to changes in how
> decision makers develop programs and policies to eliminate racial and
> ethnic health disparities;
>
> Promote promising approaches to achieve change in systems,
> communities, and broader environmental contexts within which
> individuals and groups interact to eliminate racial and ethnic health
> disparities;
>
> Characterize, evaluate, and promote cultural competence across
> programmatic activities;
>
> Provide training to a variety of audiences to promote promising
> practices and cultural competence to eliminate racial and ethnic
> health disparities as well as contribute to the number of individuals
> who are engaged in such activities; and
>
> Translate and disseminate promising approaches that contribute to the
> elimination of racial and ethnic health disparities and the
> advancement of public health practice and program efforts.

Attachment F

Resources and Tools

**\
**

Attachment F

Resources and Tools

> This list is not an exhaustive inventory of resources or data, but
> serves only as a guide.

I. DATA

Accessing State and Local Data on Healthy Behaviors and Other Risk
Factors

> Search for data from your state - Behavioral Risk Factor Surveillance
> System (BRFSS): <http://www.cdc.gov/brfss/>
>
> Search for data for over 200 metro areas and for counties - SMART
> BRFSS data: <http://apps.nccd.cdc.gov/brfss-smart/index.asp>
>
> Search for youth data from your state -- Youth Risk Behavior
> Surveillance System (YRBSS):
> <http://www.cdc.gov/healthyyouth/yrbs/index.htm> OR
> http://www.cdc.gov/healthyyouth/
>
> Contacts for your state - Behavioral Risk Factor Surveillance System
> State Coordinators (many states have done county-level and other local
> analyses): <http://www2.cdc.gov/nccdphp/brfss2/coordinator.asp>
>
> Search for diabetes data from your state **--** National Diabetes
> Surveillance System:
> <http://www.cdc.gov/diabetes/statistics/index.htm#prevalence>
>
> Search for national or state diabetes data - Diabetes Indicators and
> Data Source Internet Tool (DIDIT): (38 essential diabetes indicators
> and associated national and state-level data source)
> <http://www.cdc.gov/diabetes/statistics/didit/index.htm>
>
> Search for national or state diabetes data- Kaiser Family Foundation
> Statehealthfacts.org is a project of the Henry J. Kaiser Family
> Foundation and is designed to provide free, up-to-date, and
> easy-to-use health data on all 50 states and on more than 500 health
> topics. <http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi>

II\. STATE AND LOCAL PROGRAMS

Contacts for Chronic Disease Prevention and Health Promotion Programs in
Your State

> Chronic Disease Directors -- contacts in your State Health Department
> for Heart Disease, Diabetes, Tobacco, Nutrition, Physical Activity,
> School Health, Cancer, and Arthritis
> <http://www.chronicdisease.org/NEW/cdd_members.htm>
>
> Minority Health Directors:
>
> National Association of State Offices of Minority Health
>
> c/o OH Commission on Minority Health
>
> http://[www.state.oh.us.mih](http://www.state.oh.us.mih/)
>
> REACH 2010 Communities (Racial and Ethnic Approaches to Community
> Health): <http://www.cdc.gov/reach2010/index.htm> Contacts:
> <http://www.cdc.gov/reach2010/grantees.htm>
>
> Steps to Healthier U.S. Communities
>
> <http://www.healthierus.gov/steps/grantees.html>
>
> WISEWOMAN State Contacts

<http://www.cdc.gov/wisewoman/project_locations/index.htm>

III\. RESOUCRES & GUIDES

Guide to Community Preventive Services:

Includes web-available chapters providing proven interventions in
physical activity, nutrition, obesity, tobacco use, cancer, diabetes,
oral health, and many other areas.

<http://www.thecommunityguide.org/>

US Preventive Services Task Force:

Includes screening and preventive services recommendations for specific
conditions.

[http://www.ahcpr.gov/clinic/cps3dix.htm]{.underline}

The Burden of Chronic Disease and their Risk Factors: National and State
Perspectives 2004:

Data on the prevalence of selected chronic diseases and their factors in
the 50 states and the District of Columbia; can be examined by state,
disease, or specific risk factor.

http://www.cdc.gov/nccdphp/burdenbook2004/

The Chronic Disease Prevention (CDP) Databases:

Provides bibliographic citations and abstracts for various materials
ranging from health journal articles to proceedings.

<http://www.cdc.gov/cdp>

Morbidity and Mortality Weekly Report (MMWR):

Interactive access to data summaries and documentation.

<http://www.cdc.gov/mmwr>

A Portrait of the Chronically Ill in America, 2001:

Survey results from Robert Wood Johnson Foundation and the Foundation
for Accountability.

<http://www.markle.org/resources/facct/doclibFiles/documentFile_287.pdf>

Partnership for Prevention:

List of resources aimed at improving health among populations of people.

<http://www.prevent.org/content/view/21/21>

Promoting Physical Activity: A Guide for Community Action:

Text guides you step-by-step in addressing your target population\'s
understanding and skills, the social networks, the physical environments
in which they live and work, and the policies that most influence their
actions.

<http://www.cdc.gov/nccdphp/dnpa/pahand.htm>

CDC's Healthy People 2010: Healthy People 2010 provides a framework for
prevention, including a statement of national health objectives designed
to identify the most significant preventable threats to health and
establish national goals to reduce these threats. 

<http://www.healthypeople.gov/>

CDC\'s Brochure, Trails for Health: Promoting Healthy Lifestyles &
Environments:

Initiative to help Americans of all ages achieve the health benefits of
physical activity by increasing opportunities for physical activity and
helping to make it an integral part of community life.

<http://www.cdc.gov/nccdphp/dnpa/pdf/Trails_Increasing_Opportunities.pdf>

CDC's Evaluation Working Group: Provides an overview of the group,
highlights of a framework for program evaluation, and additional
resources that may help when applying the framework, as well as further
information about evaluation or assistance in conducting an evaluation
project. <http://www.cdc.gov/eval/index.htm> (Note: for framework
document see, CDC. (1999). Framework for Program Evaluation in Public
Health, MMWR, 48(RR-11), 1-40.)

W.K. Kellogg Foundation: Nonprofit organization focused on building the
capacity of individuals, communities, and institutions to solve their
own problems. Offers several toolkits outlining the essential elements
for building an effective communication (e.g., developing clear
objectives), evaluation (e.g., developing a logic model), and public
policy programs (e.g., achieving long term change).
<http://www.wkkf.org/>

DHHS Office of Minority Health: Seeks to improve and protect the health
of racial and ethnic minority populations through the development of
health policies and programs that will eliminate health disparities.
<http://www.omhrc.gov/>

DHHS Health Resources and Services Administration: Charged with
providing access to essential health care services for underserved
populations, including people who are low-income, uninsured or who live
in rural areas or urban neighborhoods where health care is scarce;
collects data and statistics in the areas of HIV/AIDS, primary health
care, maternal and child health, rural health services, and health
workforce. <http://www.hrsa.gov/default.htm>

The Robert Wood Johnson Foundation: Seeks to improve the health and
health care of all Americans by focusing on four areas: access to
quality care; improving the quality of care and support for people with
chronic health conditions; promoting healthy communities and lifestyles;
and reducing the personal, social and economic harm caused by substance
abuse. RWJF supports training, education, research, and projects that
demonstrate the effective delivery of health care services.
<http://www.rwjf.org/index.jsp>

The Commonwealth Fund: Promotes a high performing health care system
that achieves better access, improved quality, and greater efficiency,
particularly for society\'s most vulnerable, including low-income
people, the uninsured, minority Americans, young children, and elderly
adults by supporting independent research on health care issues and
making grants to improve health care practice and policy.
[http://www.cmwf.org](http://www.cmwf.org/)

The Kaiser Family Foundation: Provides students, faculty and others
interested in learning about health policy easy access to the latest
data, research, analysis, and developments in health policy; includes
narrated slide [tutorials](http://kaiseredu.org/tutorials_index.asp),
background [reference
libraries](http://kaiseredu.org/reference_index.asp), and [issue
modules](http://kaiseredu.org/issue_index.asp) on current topics and
policy debates. The main KFF website and others can also be accessed
through this website. <http://www.kaiseredu.org/>

The Agency for Healthcare Research and Quality\'s: Seeks to improve the
quality, safety, efficiency, and effectiveness of health care for all
Americans; sponsors and conducts research that provides evidence-based
information on health care outcomes; quality; and cost, use, and access.
Information helps health care decision makers---patients and clinicians,
health system leaders, purchasers, and policymakers---make more informed
decisions and improve the quality of health care services. Publishes two
major reports, National Healthcare Disparities Report (tracks
disparities in both quality of and access to health care in the United
States for both the general population and for congressionally
designated priority populations; includes 13 core measures of access to
care) and National Healthcare Quality Report (179 performance measures
that can be used to monitor the Nation\'s progress toward improved
health care quality for all Americans). Issued an evidence-based report
on Community-based Participatory Research: Assessing the Evidence (AHRQ
Pub. No. 04-EO22-2). <http://www.ahrq.gov/>

RAND: Conducts research on a broad range of social, economic, and
political issues, including the U.S. health care system; public
databases include information on education, population and demographics,
and health and socioeconomic issues; conducts research that advances
understanding of health and health behaviors, and examining how the
organization and financing of care affect costs, quality, and access.
<http://www.rand.org/health/>

National Research Council: Provides science, technology and health
policy advice under a congressional charter. Functioning in accordance
with general policies determined by the National Academy of Sciences,
the National Research Council has become the principal operating agency
of both the National Academy of Sciences and the National Academy of
Engineering in providing services to the government, the public and the
scientific and engineering communities.
<http://www.nationalacademies.org/nrc/>

Community-Campus Partnerships for Health: Promote health through
service-learning, community-based participatory research (CBPR),
broad-based coalitions and other partnership strategies. Foster
partnerships between communities and educational institutions that build
on each other\'s strengths and develop their roles as change agents for
improving health professions education, civic responsibility and the
overall health of communities. Provide listing of tools, publications,
and service networks related to CBPR efforts.

<http://depts.washington.edu/ccph/commbas.html>

Attachment G

Glossary of Terms

Attachment G

Glossary of Terms

Adult/elderly Immunization, Hepatitis B, and/or tuberculosis:
Immunization rates among persons aged 65 years and older remain
significantly lower than the general population. Seventy percent of
older Whites received influenza vaccinations, compared with 48 % of
older African Americans and older Hispanics. Disparities for
pneumococcal vaccination coverage were greater, with rates of 59 % for
Whites, 35 % for African Americans and 26 % for Hispanics. Despite the
decline in tuberculosis (TB) nationwide, rates among racial and ethnic
minorities and foreign-born individuals have increased, accounting for
over 80% of all TB cases. The rate of TB per 100,000 was 21 times
greater in Asians, 15 times greater in Native Hawaiians or other Pacific
Islanders, over 8 times greater in non-Hispanic Blacks, almost 8 times
greater in Hispanics, and nearly 6 times greater in American
Indians/Alaskan Natives than compared to non-Hispanic Whites.

Asthma: Although asthma affects people at all socioeconomic levels,
ages, races and ethnic groups, children, low-income and minority
populations continue to experience substantially higher rates of deaths,
hospitalizations, and emergency room visits due to asthma. American
Indian/Alaska Natives were most likely to have ever had asthma, as well
as still have asthma, compared to all other racial and ethnic groups,
while non-Hispanic Blacks and non-Hispanic Whites had similar rates.
Black children were significantly more likely to report ever having been
told they have asthma, as well as having an asthma attack in the past
year, compared to all other racial and ethnic groups.

Budget Period: The interval of time (usually 12 months) into which the
project period is divided for budgetary and funding purposes.

Capacity Building: Refers to the [coalition formation and planning
stages of]{.mark} activities that improve a community or organization's
ability to achieve its mission more effectively. Capacity building may
relate to almost any aspect of work: improved governance, leadership,
mission and strategy, administration (e.g., human resources, financial
management, and legal matters), program development and implementation,
fundraising and income generation, diversity, partnerships and
collaboration, evaluation, advocacy and policy change, marketing,
positioning, or planning.

Cardiovascular Diseases (CVD): Heart disease and stroke are the most
common cardiovascular diseases. Heart disease is the leading cause of
death for all racial and ethnic groups in the United States. In the
United States; growing numbers of people are dying from these conditions
or surviving with disability, dependency, and high risk for recurrence.
Generally, the heart disease death rate has been consistently higher in
the African American population than in the white population. In 1998,
rates of death from cardiovascular disease were about 30% higher among
African American adults than among white adults.

Central Coordinating Organization: The lead organization for a community
coalition that has direct fiduciary responsibility over the
administration and management of the project.

Chronic Disease Burden: A general term used in public health and
epidemiological literature to identify the cumulative effect of a broad
range of harmful chronic disease consequences on a community, including
the health, social, and economic costs to the individual and to society.

Community Based Participatory Approaches (CBPA): Community based
participatory approaches are a means to equitably involve all partners
in the research practice in a way that recognizes the unique strengths
that each brings. Characteristics of CBPA include: a co-learning
process, systems development and local community capacity building,
empowerment of participants, and a balance between research and action.

Cooperative Agreement: The legal instrument that reflects an assistance
relationship between the Federal government and the recipient in which
substantial programmatic involvement is anticipated between the Federal
agency and the recipient during the performance of the contemplated
activity.

Cultural Competency: Integration and transformation of knowledge about
individuals and groups of people into specific standards, policies,
practices, and attitudes used in appropriate cultural settings to
increase the quality of services; thereby producing better outcomes.

Breast and Cervical Cancer: The overall death rate from breast cancer in
women has decreased since 1990; however, from1990 to 2002, the
percentage of decline was greatest among White women, least in Black and
Asian/Pacific Islander women, and no change among American Indian/Alaska
Native women. Although the incidence of breast cancer is highest among
White women, Black women experience the highest mortality rate. Data
clearly indicate the lack of adequate screening, as well as delays in
and the inadequacy of treatment received by many among racial and ethnic
women.

Diabetes Mellitus: Diabetes is a group of diseases marked by high levels
of blood glucose resulting from defects in insulin production, insulin
action, or both. It is associated with an increased risk for a number of
serious, sometimes life-threatening complications. Diabetes remains 2.5
times higher among American Indians, more than 2 times higher among
Alaska Natives, and nearly 2 times higher among non-Hispanic Blacks when
compared with Whites. Although formerly rare in children and
adolescents, type 2 diabetes is also being diagnosed in this age group
more often, particularly in American Indian, African American, and
Hispanic American children.

Digital Divide: the gap in healthcare that occurs when underserved
populations have limited access to technology or digital information

Duplication of Funds: Receiving funds from two different sources to pay
for one expenditure (e.g., double billing).

Evidence-based Practices: Interventions that have been proven to be best
practices or effective by scientific study (i.e., randomized controlled
trials, experimental designs, etc.). They also have been subject to
expert/peer review that has determined that a particular approach or
strategy has a significant level of evidence of effectiveness in public
health research literature.

Fiscal Year (FY): A twelve month period set up for accounting purposes:
for example, the Federal government's fiscal year runs from October 1 to
September 30 of the following year.

Funding Opportunity Announcements (FOA): A publicly available document
by which a Federal agency makes known its intentions to award
discretionary grants or cooperative agreements, usually as a result of
competition for funds. Funding opportunity announcements may be known as
requests for application (RFAs), program announcements (PAs), notices of
funding availability, solicitations, or other names depending on the
agency and type of program.

Healthy People 2010: A national activity that sets ten-year targets for
what individuals, families, health care providers, and communities can
do to eliminate health disparities and improve the quality of life by
the year 2010. For additional information on Healthy People 2010, see
Attachment F.

Health Priority Areas: For the purposes of this FOA, the identified
health priority areas include: breast and cervical cancer;
cardiovascular disease; diabetes mellitus; adult/older adult
immunization, hepatitis B, and/or tuberculosis; asthma; and infant
mortality. Additionally, related conditions such as oral health and
behavioral health (i.e., mental health, alcohol use, physical activity,
nutrition, and tobacco use) may be considered as intervening factors
when addressing the above health disparities.

Incidence: The number of new cases of a disease or condition that occurs
within a given period of time. Often incidence is expressed annually
(e.g., the number of new cases occurring during a year).

Infant Mortality: U.S. infant mortality rates show that Blacks suffer
from significantly higher infant deaths when compared to other
racial/ethnic groups. National infant mortality among Black infants
occurred at a rate of 13.6 per 1,000 live births, which is almost double
the national average of 6.9 deaths per 1,000 live births. Even more
disturbing, the infant mortality rate for Blacks is almost three times
the rate for Whites at 5.7 per 1,000 live births. This trend also occurs
among other ethnic groups when compared to their White counterparts. For
example, the infant mortality rate for American Indian/Alaska Natives
(8.9) is almost two times higher than the rate for White infants.

Legacy Projects: Members of communities who seek to initiate or expand
efforts to eliminate health disparities may apply to a CEED for legacy
funds to conduct activities that contribute to their efforts. These
activities may consist of, but are not limited to, conducting a
community needs assessment, community asset mapping, health impact
assessment, training or enhancement of skills, initiation of relevant
community-based or systems level activities, local start-up activities
of a community coalition, synthesis of evidence or practice-based
approaches in a specific area, or development or use of culturally
appropriate assessment instruments or methodologies. Each Legacy Project
must be consistent with one or more of the identified programmatic
efforts of REACH US and the program activities and expertise of the
CEED. Funding for each project should be consistent with the proposed
work and total \$25,000 - \$50,000 for a maximum time period of one
year.

Memorandum of Agreement (MOA): A document developed to formalize the
exchange of resources between two or more collaborating agencies. MOAs
are preferred over "letters of support," because the relationship
between collaborating agencies is described clearly and is agreed upon
by both agencies, and has signatures from both agencies.

Non-research: Public health practices that include epidemiological
investigations, surveillance, programmatic evaluations, and clinical
care.

Outcome Evaluation: A method of evaluation which uses techniques that
will provide evidence of whether or not the program or intervention
accomplished the intended efforts.

Policy: Initiatives that prevent initiation in a behavior that can cause
disease, promote behavior change, and eliminate barriers.

Practice-based Evidence: Interventions that have not been proven to be
effective, but are considered promising practices and are based upon
local and/or clinical experience (i.e., non-experimental data,
experience of practitioners, etc.).

Prevalence: The number of persons living with a disease or condition
during a given time period.

Process Evaluation: A method of evaluation most often used to assess the
manner in which the program was conducted and to identify problems
encountered in the planning, organization, implementation, or monitoring
phases of the program and services provided.

Project Period: The total time a discretionary project has been approved
for programmatic support. A project period may consist of one or more
budget periods. The total project period comprises the original project
period and any extensions.

Promising Approaches: Approaches that incorporate the philosophy,
values, characteristics, and indicators of other positive or effective
public health interventions based on guidelines, protocols, standards,
or preferred practice patterns that have been proven to lead to
effective public health outcomes. It is a process of continual quality
improvement that: 1) accumulates and applies knowledge about what is
working and not working in different situations and contexts; 2)
continually incorporates lessons learned, feedback, and analysis to lead
toward improvement/positive outcomes; and, 3) allows for and
incorporates expert review, feedback, and consensus from the public
health field. A promising practice has an evaluation component/plan in
place to move towards demonstration of effectiveness; however, it does
not yet have evaluation data available to demonstrate positive outcomes.

Public Health Practice: Methods used to prevent or control disease or
injury and improve health, or improve a public health program or service
through epidemiological investigations, surveillance, programmatic
evaluations, and clinical care for the population. These activities also
include collection and analysis of identifiable health data by a public
health authority for the purpose of protecting the health of a
particular community.

Racial and Ethnic Minorities: For the purposes of this FOA, the
identified population groups consist of: African American/Black,
American Indian/Alaska Native, Asians, Native Hawaiian/Other Pacific
Islander, and Hispanic/Latino. This definition is based on OMB Directive
15.

Research: Involves human subjects for the purpose of a systematic
investigation, including research development, testing and evaluation,
designed to develop or contribute to generalizable knowledge

Social Ecological Model: A change theory that integrates individual,
family, organizational, and community-level factors as they influence
health outcomes.

Systems Change: Defines how communities and related organizations can be
influenced to promote healthy behaviors, environments, and policies
critical to the elimination of racial and ethnic health disparities.
Additional work is needed to establish this evidence base, including
changing communities (i.e., their structure and organization) and
systems (i.e., education, healthcare, etc.) and understanding how key
individuals (change agents) contribute to this process.

Translation: Transform evidence-based or practice-based findings and
information into practice.