Federal Register, Volume 59 Issue 57 (Thursday, March 24, 1994)

[Federal Register Volume 59, Number 57 (Thursday, March 24, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6863]

[[Page Unknown]]

[Federal Register: March 24, 1994]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES
RIN 0905-ZA22

Substance Abuse Prevention Demonstration Grants for High Risk
Youth Populations

AGENCY: Center for Substance Abuse Prevention, Substance Abuse and
Mental Health Services Administration (SAMHSA), HHS.

ACTION: Availability of funds and request for applications.

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SUMMARY: The Center for Substance Abuse Prevention (CSAP) announces the
availability of support for projects that demonstrate and evaluate
comprehensive strategies to prevent and/or reduce the use of alcohol,
tobacco, and other drugs (ATOD), including inhalants and steroids,
among youth at high risk for such behaviors.
Since its inception, an important component of CSAP's mission has
been to direct its efforts toward youth at high risk for using ATOD. To
this end, CSAP has funded a number of projects to demonstrate the
effectiveness of various preventive interventions to reduce the use of
ATOD, and to change the behavior and attitudes of high risk youth about
ATOD. In this Announcement, four related but distinct efforts (program
priority areas) are proposed:
High Risk Youth (Module A)
Female Adolescents (Module B)
Alcohol and Other Drug-Related Violence Among High Risk
Youth (Module C)
Replications of Model Programs for the Prevention of
Alcohol, Tobacco, and Other Drug (ATOD) use Among High Risk Youth
(Cooperative Agreements) (Module D)
It should be noted that support for three of these program priority
areas (High Risk Youth, Female Adolescents, and AOD-Related Violence
Among High Risk Youth) will be in the form of prevention demonstration
grants, while the fourth (Replications) will provide support for
cooperative agreements. Compared with demonstration grant programs,
cooperative agreements involve substantially greater involvement on the
part of the Federal funding agency in the conduct of the project.
Any single project for which support is requested under this
announcement may be addressed to only one of the above program priority
areas. Applicants seeking support for more than one project, whether in
the same priority area or in different priority areas, must submit a
separate and different application for each project.
Eligibility: Applications may be submitted by public organizations,
such as units of State or local governments or eligible agencies of the
Federal government, and by private nonprofit organizations such as
community-based organizations, universities, colleges, and hospitals.
In accordance with section 517(b)(3) of the Public Health Service
Act, applications from community-based organizations will be given
special consideration by CSAP in its award decision-making process.
Target Population: High Risk Youth: Youth who experience multiple
risk factors are considered to be at high risk for alcohol and other
drug use. Section 517(g) of the Public Health Service (PHS) Act
identifies the following groups of youth who are likely to be at high
risk.
Youth under the age of 21 who: (a) Are children of substance
abusers;
(b) Are victims of physical, sexual, or psychological abuse;
(c) Have experienced chronic failure in school;
(d) Have dropped out of school;
(e) Have become pregnant;
(f) Are economically disadvantaged;
(g) Have committed a violent or delinquent act;
(h) Are experiencing mental health problems;
(i) Have attempted suicide;
(j) Have experienced long-term physical pain due to injury.
The PHS Act (in section 517(b)(1)) specifies that priority be given
to substance abuse prevention projects directed at children of
substance abusers, latchkey children, children at risk of abuse or
neglect, preschool children eligible for services under the Head Start
Act, children at risk of dropping out of school, children at risk of
becoming adolescent parents, and children who do not attend school and
who are at risk of being unemployed. CSAP will therefore give special
consideration in its award decision-making process to projects
addressing these populations and their prevention needs.
Conceptual Framework: Based on research and knowledge gleaned from
CSAP's previous demonstration projects, CSAP expects applicants to
propose a comprehensive prevention approach that is conceptualized,
implemented, and evaluated in a logical manner. To ensure
comprehensiveness, CSAP strongly recommends that applicants use a risk/
protective factor approach, an approach that delineates factors that
appear to be correlated with the use of ATOD among children and youth
(risk factors) and that appear to protect youth from ATOD use
(protective factors). These risk and protective factors can be
organized according to six major life areas or ``domains''--the
individual, family, school, peer group, neighborhood/community, and
society. Each domain represents an important sphere of influence in the
lives of children and youth.
To ensure that the demonstration is based in a logically sound
framework, CSAP strongly recommends that applicants use the logic
model, a model that articulates the links between the specific risk and
protective factors that have been identified and are to be addressed,
the specific project objectives, the proposed intervention strategies,
and the anticipated outcomes.
CSAP strongly encourages applicants to use the risk/protective
factor approach and the logic model. However, applicants may propose
alternative frameworks and will be given fair and due consideration, so
long as the applicant provides a clear description of any alternative
frameworks, the alternative frameworks are comprehensive and logical,
and the applicant offers a rationale for their selection over the risk/
protective factor approach and/or the logic model.
Guidelines for using the risk/protective factor approach and the
logic model for ATOD prevention programs targeting high risk youth
populations are included as part of the complete application kit.
This notice consists of four parts:
Part I covers information on the legislative authority and
applicable regulations and policies of the Substance Abuse Prevention
Demonstration Grants for High Risk Youth Populations Program.
Part II is a summary of the application receipt date, estimate of
funds available, anticipated number of awards, period of support, and
project start dates.
Part III describes the four programmatic priority areas (Modules A-
D) under which CSAP is inviting applications.
Part IV provides additional guidance related to the application
process and requirements, review criteria, award decision criteria, and
contacts for additional information.

Part I--Legislative Authority and Other Applicable Regulations and
Policies

Grants awarded under this Program Announcement are authorized under
section 517 of the Public Health Service Act, (42 U.S.C. 290bb-23) as
amended.
The Catalog of Federal Domestic Assistance (CFDA) number for this
program is 93.144.
Federal regulations at title 45 CFR parts 74 and 92, generic
requirements concerning the administration of grants, are applicable to
these awards.
Grants must be administered in accordance with the PHS Grants
Policy Statement (Rev. April 1, 1994).
Interim progress reports, a final report, and Financial Status
Reports (FSRs) will be required and specified to awardees in accord
with PHS Grants Policy Requirements.
Healthy People 2000: The Public Health Service (PHS) is committed
to achieving the health promotion and disease prevention objectives of
Healthy People 2000, a PHS-led national activity for setting priority
areas. This Announcement, ``Substance Abuse Prevention Demonstration
Grants for High Risk Youth Populations,'' is related to the priority
areas of Alcohol, Tobacco, and Other Drugs (ATOD), HIV Infection, and
Violent and Abusive Behaviors. Potential applicants may obtain a copy
of Healthy People 2000 (Full Report: Stock No. 017-001-00474-0) or
Summary Report: Stock No. 017-001-00473-1) through the Superintendent
of Documents, Government Printing Office, Washington, DC 20402-9325
(Telephone 202-783-3238).
Non-Use of Tobacco: The medical dangers and high risk of addiction
associated with first-hand use of tobacco products have been thoroughly
documented (for example, see Boyle, 1993). Moreover, data presented in
leading medical journals (for example, New England Journal of Medicine,
June 10, 1993) and reported widely in the press, associate
environmental exposure to tobacco smoke (passive smoking) with
increased rates of cancer and other pulmonary diseases among people of
all ages and with increased rates of asthma among children. Further,
scientific evidence supports the connection between the use of
smokeless tobacco products, such as chewing tobacco and snuff, and
cancer of the mouth, jaw and throat.
Critical questions now facing public health experts concern the
most effective methods for preventing youth from using tobacco products
in the first place and for preventing and/or reducing infants' and
children's exposure to smoke in both public and private environments. A
combined approach involving public policy, media awareness, and
prevention education strategies appears to be a promising way to
address this serious problem; however, careful development,
implementation, and evaluation of specific tobacco use prevention
strategies is required to establish their efficacy.
The Center for Substance Abuse Prevention recognizes that its
target populations are vulnerable to a variety of preventable health
and social problems, including substance abuse. Therefore, CSAP
believes that preventative education concerning use of tobacco products
must be a priority for grantees. Further, CSAP encourages all grantees
to provide smoke-free programs and work environments.
Health Care Reform: The Public Health Service is committed to
furthering the aims of Health Care Reform. By preventing and/or
reducing the use of alcohol, tobacco, and other drugs among youth,
prevention programs can enhance the overall health status of
participants. As a consequence, ATOD prevention programs can contribute
to a reduction in health care costs related to the medical illnesses,
disorders, and conditions associated with ATOD.
Secretarial Themes for the Fiscal Year 1995 Legislative Program: In
a Special Message For All Health and Human Service (HHS) Employees, the
HHS Secretary articulated three key priorities to support a Department-
wide continuous improvement process. These priorities are: fostering
independence through empowering the people served, preventing future
problems, and improving services to customers through modern management
approaches. Each of the four demonstration programs proposed in this
Announcement supports the Secretary's priorities. By addressing
alcohol, tobacco, and other drug use and related health and social
problems among high risk youth, these programs hold substantial promise
for reducing future public health problems among the target population.
In addition, the programs seek to empower communities, including youth,
to identify particular ATOD problems facing their communities and to
design interventions to address them. Further, these proposed programs
encourage applicants to consider enhancements to service delivery
systems, such as increasing access and coordination of programs,
thereby supporting the Secretary's emphasis on improving service to
customers.

Part II.--Summary Table
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Estimated
Module Applic. receipt date Est. funds number of Period of support Estimated award date
available awards
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A............................................ May 24, 1994............. $4.7 m 17 Up to 5 years............ Sept. 1994.
B............................................ May 24, 1994............. 4.0 m 15 Up to 5 years............ Sept. 1994.
C............................................ May 24, 1994............. 2.0 m 5 Up to 5 years............ Sept. 1994.
D:
(Pt A)..................................... May 24, 1994............. 2.0 m 8 Up to 5 years............ Sept. 1994.
(Pt B)..................................... ......................... 1.0 m 4
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Subject to the availability of funds in future fiscal years, CSAP
may reissue this announcement and publish future receipt dates and a
notice of availability of funds in the Federal Register. Because the
President's 1995 budget request proposes to consolidate SAMHSA's
categorical substance abuse prevention demonstrations, certain aspects
of this program could change. Therefore, applicants are strongly
encouraged to verify the availability and terms of funding for new
awards for this program.
Consequences of Late Submission: Applications must be received by
the above receipt date to be accepted for review. An application
received after the deadline may be acceptable if it carries a legible
proof-of-mailing date (assigned by the carrier) and that date is not
later than one week prior to the deadline date. However, private
metered postmarks are not acceptable as proof of timely mailing.

Part III--Program Priority Areas

Module A: High Risk Youth

Introduction: CSAP will provide support in the high risk youth
priority area for projects that will demonstrate and assess the
effectiveness of comprehensive strategies to prevent and/or reduce the
use of alcohol, tobacco and other drugs (ATOD), including inhalants and
steroids, among youth at high risk for such behaviors.
This program priority area takes several major steps forward from
CSAP's earlier High Risk Youth Demonstration Grants Program.
Specifically: All programs in this priority area are to include
strategies for the prevention and reduction of tobacco and alcohol use
among high risk youth in addition to strategies for the prevention of
use of any other drugs that may be included or emphasized in the
program.
It strongly recommends a multiple risk factor approach for
designing prevention programs. With the understanding that substance
use is a function of multiple factors in multiple risk factor domains
(viz., the individual, the family, the school, the peer group, the
neighborhood/community, and society), a multiple risk factor approach
is considered necessary to respond comprehensively and effectively to
the problem of substance use among youth.
The program further differs from its predecessor in that applicants
are asked to involve youth and others in the community both in
identifying the relevant risk factors for ATOD use that are to be
addressed and in selecting appropriate interventions to address these
risk factors.
It also requires all programs that serve youth 12 years of age and
over to ascertain the effectiveness of their intervention strategies in
reducing the incidence and prevalence of alcohol, tobacco, and/or other
drug use. Programs serving youth 12 years and over are required to
obtain incidence measures in addition to assessing the effectiveness of
the intervention strategies in reducing the risk factors or enhancing
the protective factors on which the project is focused. This will be
the first time CSAP will be receiving data on common outcome variables,
specifically on the incidence and reduction of use for alcohol and
tobacco and other drugs. These common outcomes will be generated by
programs using culturally tailored strategies and addressing different
combinations of risk factors.
It also tests the hypothesis that factors that place youth at risk
for ATOD use may also place them at risk for engaging in violent acts.
The high risk youth priority area also has a special interest in
effective strategies that are designed to positively influence youth by
the time they reach 8th grade. Recent studies lead us to believe that
it is important to intervene with prevention programs prior to 8th
grade because the inception of substance use frequently occurs at about
this age. CSAP also has a special interest in youth residing in public
housing.
Program Goals and Objectives: One of CSAP's most fundamental
program goals is the prevention of ATOD use among high risk youth. This
implies the elimination of the problems associated with such use, such
as engaging in acts that interfere with the achievement, maintenance,
and restoration of optimal health at the individual, family, and
community levels. As part of its mission to decrease the incidence and
prevalence of ATOD use and resulting problems, CSAP is dedicated to
identifying and disseminating strategies that prevent or delay the use
of alcoholic beverages, tobacco products, and other drugs among
children and youth.
To fulfill this goal, CSAP has established the following outcome
objectives to demonstrate the effectiveness of the projects supported
under this Announcement:
1. To decrease the incidence of ATOD use among high risk youth by
(a) Identifying and reducing factors in the individual, the family
and significant others, the school, the peer group, the neighborhood/
community, and society that place youth at high risk for ATOD use;
(b) Enhancing factors in the individual, the family and significant
others, the school, the peer group, the neighborhood/community, and
society that may strengthen youth resiliency and protect youth from
using alcohol, tobacco, and other drugs.
2. To delay and reduce the consumption of alcoholic beverages, and
the use of tobacco products and other drugs among high risk youth.
Recommended Approach: CSAP invites applications that address, at a
minimum, the following questions:
1. What combination of strategies is most effective in improving
family management practices and/or establishing a healthy family
environment for various racial/ethnic/gender populations? Which risk
factors and risk factor domains must be addressed?
2. What combination of strategies is most effective in increasing
bonding/commitment to school for populations differing with respect to
age, gender and race/ethnicity? Which risk factors and risk factor
domains must be addressed?
3. Which combination of strategies is most effective (and hence,
which risk factors and risk factor domains must be addressed) in
decreasing the influence and association of drug-using peer groups on
members of the target population and/or to increase the association and
influence of non-drug-using peer groups on the target population? For
whom are they effective?
4. What combination of strategies is most effective in increasing a
negative attitude toward alcohol, tobacco, and other drug use by: (a)
The target population; or (b) the peer group; or (c) the family; or (d)
the school; or (e) the community? Which risk factors and risk factor
domains must be addressed?
These questions are in addition to the ATOD-specific questions
listed in the Outcome Evaluation section of part IV.
All applications are to address the prevention and reduction in use
of alcoholic beverages and tobacco products and other drugs. Also
applicants are strongly encouraged to develop policies that promote
nonuse of tobacco products by staff, clients, and visitors at project
sites.
Contact for Additional Information: F. Tommie Johnson, Division of
Demonstrations for High Risk Youth Populations, Center for Substance
Abuse Prevention, Rockwall II, Room 9B-03, 5600 Fishers Lane,
Rockville, Md. 20857, (301) 443-0353.

Module B: Female Adolescents

Introduction: Through its High Risk Youth initiative, CSAP has
sought to develop model projects that demonstrate successful techniques
to alter the behaviors and attitudes toward, and prevent and/or reduce
the use of alcohol, tobacco and other drugs (ATOD), including inhalants
and steroids, among youth at high risk for such behavior.
CSAP recognizes that female adolescents are at great risk for ATOD
use and other related negative outcomes, and present a unique challenge
to individuals and organizations that seek to provide outreach and
prevention services to them. Female adolescents (ages 10 to 21) may use
ATOD for different reasons than males, have different needs and
problems associated with their use of ATOD, and require different
intervention strategies to successfully prevent and decrease their ATOD
use.
While we know that gender differences in ATOD use exist, we know
very little about what exactly these differences are.
We know that interventions designed for males--such as using
confrontational strategies--may not be effective for females. We do not
know nearly enough, however, about how to design effective
interventions for females.
What factors place female adolescents at risk for ATOD abuse,
sexually-transmitted diseases (STDs) including HIV/AIDS, early
pregnancy/childbirth and single parenting, school dropout and
delinquency, and poverty and un/under-employment? What strategies can
be devised that will address these factors, and that will successfully
reach out to young women not often targeted by traditional school,
social service or medical programs? What prevention strategies will
result in changes in attitudes and behaviors of young women with
respect to their ATOD use and related problems, and how can we measure
such outcomes?
This Announcement will support demonstration programs that seek to
answer questions such as those above, and to develop, implement,
document, evaluate, and disseminate information about comprehensive
strategies to address and respond to the unique needs of female
adolescents.
Program Goals and Objectives: The overriding goal of this program
priority area is to demonstrate strategies that decrease ATOD use among
female adolescents and promote optimal health at the individual,
family, and community levels. More specifically, the goals are:
1. Primary Prevention: To decrease (and delay) the incidence of
ATOD use among female adolescents by:
(a) Identifying and specifying methods to reduce factors in the
individual, family and/or significant others, school, peer group,
neighborhood/community, and society/media that increase young women's
vulnerability to initiating ATOD use; and
(b) Enhancing factors in the individual, family and/or significant
others, school, peer group, neighborhood/community and society/media
that strengthen young women's resiliency and protect them against using
alcohol, tobacco, and other drugs.
2. Secondary Prevention: To decrease the prevalence of ATOD use
among female adolescents by providing appropriate early intervention
strategies to female adolescents who have already initiated ATOD use or
who have engaged in other problem behaviors which are associated with
ATOD use, such as early sexual activity, truancy, or running away from
home.
3. To decrease the incidence and prevalence of negative outcomes
associated with ATOD use among female adolescents by addressing risk
factors that significantly contribute to these outcomes, especially
childhood sexual and physical abuse. Related negative outcomes include
early pregnancy and parenthood; HIV transmission and AIDS, and other
sexually-transmitted diseases; adolescent mental disorders, including
eating disorders, depression, and suicidal behaviors; school dropout;
involvement in prostitution, delinquency, or violent behaviors that may
lead to criminal justice involvement; and homelessness.
Target Population: Where appropriate, applicants are encouraged to
target the following populations who, traditionally, have been
underserved: (a) Female adolescents, ages 10-21, not normally targeted
by traditional school, social service or medical programs, such as
young women who have dropped out of school or female adolescents in the
work force.
(b) Female adolescents who have been involved with the criminal/
juvenile justice system;
(c) Female adolescents with HIV/AIDS or other STDs, or those at
especially high risk for these diseases;
(d) Female adolescents with disabilities;
(e) Female adolescents who are lesbian or bisexual;
(f) Female adolescents who have a current or past history of
physical/sexual abuse or incest.
The applicant must clearly document that the target group chosen is
at high risk for ATOD use by specifying the relevant risk factors.
Although applicants may target female adolescents aged 10-21,
provisions must be made in the data collection plan to disaggregate
data for participants aged 12-21. Collecting data on females aged 12-21
will allow for comparisons with other SAMHSA programs targeting
females.
In identifying female adolescents who are ``at risk'' for ATOD use,
CSAP proposes this framework for considering risk (See Resnick, 1993):
Risk factors are: (1) Those environmental forces that have a
negative impact on the individual by producing an increased
vulnerability to ATOD use. These include family dysfunction, including
childhood physical/sexual abuse and incest; high risk neighborhoods/
environments; and poverty.
(2) Those visible indicators of problems in individuals, which
represent the onset of potentially negative behaviors related to ATOD
use and other negative outcomes. These may often be found in public
records, and include poor school performance and involvement with child
protective services, such as out-of-home placement in the foster care
system.
Risk factors for the use of alcohol, tobacco, and other drugs may
be found in six domains: The individual, the family, the school, peer
groups, the neighborhood/community, and society.
Primary prevention efforts for ATOD use should identify female
adolescents who are affected by multiple risk factors (environmental
forces and visible indicators). Secondary prevention efforts should
target female adolescents who may have already initiated ATOD use or
have engaged in other problem behaviors such as early sexual activity,
truancy, or running away from home.
Recommended Approach: CSAP encourages applicants to develop
comprehensive programs that will address one or more of the following
questions:
1. What combination of strategies is most effective in improving
the self-image, including body image, and the generalized self-esteem
and self-efficacy of female adolescents?
2. What combination of strategies is most effective in developing
the competencies or life skills of female adolescents in such areas as
intra/interpersonal communications and problem-solving?
3. Which combination of strategies is most effective in improving
the family functioning and strengthening the families of female
adolescents, and increasing adolescents' levels of parenting skills so
that they will be prepared to parent effectively and appropriately when
they have children?
4. What combination of strategies is most effective in combatting
the long-lasting effects of sexual abuse/assault?
5. What combination of strategies is most effective in promoting
healthy life styles and life skills (e.g., negotiation, conflict-
handling, self-assertion) among female adolescents?
These questions are in addition to the ATOD-specific questions
listed in the Outcome Evaluation section of Part IV.
Applicants are asked to involve representatives of youth and others
in the community to: (1) Identify the risk factors for ATOD use that
are to be addressed in the project and (2) select the appropriate
interventions.
Successful interventions should also impact not only on ATOD use,
but on other negative outcomes associated with ATOD use. Related
negative outcomes include adolescent pregnancy and parenting;
HIV/AIDS and other sexually-transmitted diseases; adolescent mental
disorders, including eating disorders and depression; suicide; violent
acts and criminal justice involvement; and homelessness. CSAP is
especially interested in programs which will address physical/sexual
abuse, teen pregnancy, and HIV/AIDS and STDs, in addition to ATOD use.
Contact for Additional Information: Ulonda B. Shamwell, M.S.W.,
Division of Demonstrations for High Risk Populations, Center for
Substance Abuse Prevention, Rockwall II, room 9B-03, 5600 Fishers Lane,
Rockville, MD 20857, (301) 443-4564.

Module C: Alcohol and Other Drug-Related Violence Among High Risk Youth

Introduction and Background: CSAP announces the availability of
funds to support projects that demonstrate and evaluate comprehensive
strategies to prevent alcohol and other drug-related (AOD-related)
violence among or affecting youth aged 6 to 14. Under this program
priority area, applicants should propose prevention demonstrations
directed to youth who are at high risk for becoming witnesses, victims,
or perpetrators of violent acts associated with the use of alcohol and
other drugs (AOD).
For the purpose of this Announcement, CSAP defines violence as a
public health, social, and economic issue that affects people of all
races, ethnicities, and socioeconomic classes with enormous
consequences to all Americans. CSAP recognizes that substance abuse is
both correlated with and causes violence and that, in turn, violence
give rise to substance abuse. Thus, substance abuse and violence are
inextricably intertwined. Violence may be understood as any act that
causes psychological, emotional, or physical harm to individuals and/or
communities, or that causes damage to property. In this context,
violence arises from substance use and abuse, the trade in illicit
substances, racism, misogyny, homophobia, among other factors, and
results in homicide; assaults, including rape and sexual assault;
spouse abuse and battering; child physical and sexual abuse; child
neglect; suicide; and vandalism and other forms of property
destruction. This broad CSAP definition of violence illustrates the
fact that violence affects its victims, witnesses, and perpetrators.
CSAP recognizes that violence is linked to a host of social and
health problems that plague many communities; however, the Center is
particularly concerned with the relationship of violence to the use and
abuse of alcohol and other drugs.
The Center seeks to identify those strategies that will be
effective in preventing and/or reducing AOD-related violence among or
affecting youth, ages 6 to 11 and 12 to 14. CSAP wishes to fund
prevention programs that include strategies targeting risk/protective
factors in the individual, family, school, peer group, neighborhood/
community, and society.
Because AOD-related violence is a highly complex problem, effective
prevention of it requires a comprehensive, community-based approach.
Community-based initiatives offer advantages over more individually-
focused strategies by encouraging the various segments of the community
to accept an active role in AOD prevention. Further, the community-
based approach emphasizes that a wide range of environmental factors
influence youth who become involved with AOD-related violence.
Therefore, efforts predicated on this approach avoid the error of
developing programs based on a conceptual framework that blames the
victim.
This demonstration grant program differs from its predecessor, the
High Risk Youth Demonstration Grant Program, in two significant ways:
(1) It encourages applicants to examine risk factors that are common to
both AOD use/abuse and AOD-related violence, and (2) it asks applicants
to involve all appropriate segments of the community in the prevention
effort targeted to high risk youth. Applicants are expected already to
have established a community coalition capable of addressing risk
factors in multiple domains. Members of the community, including youth,
should be involved in identifying relevant risk/protective factors and
in designing interventions to address them.
Program Goals and Objectives: The overall goal of this program
priority area is to demonstrate strategies that will: (1) prevent or
reduce those factors that place youth aged 6-14 at risk for AOD-related
violence, and (2) reduce the incidence and prevalence of AOD-related
violent acts and of AOD use among the target population.
To achieve these goals, CSAP encourages applicants to design
projects that will positively influence the target population by:
1. Increasing children's and youth's communication and other social
and life skills, including conflict-handling skills.
2. Promoting youth bonding/commitment to school, church, and/or
community.
3. Improving communication and other necessary skills among
participants' parents to reduce the level of family conflict and
domestic violence.
4. Increasing school policies, procedures, and staff attitudes that
promote school bonding/commitment.
5. Linking children and youth with positive community role models.
6. Organizing media awareness and media advocacy initiatives to
address inappropriate portrayal of AOD and violence.
Target Population: In keeping with CSAP's emphasis on primary
prevention and early intervention, the target population for this
program is youth. Children experience developmental challenges
requiring them to master age-specific tasks; their particular needs and
the approaches appropriate to meet those needs vary significantly from
age to age. This program, therefore, divides the target population into
two sub-populations: children and youth aged 6 to 11, and youth aged 12
to 14.
Within both sub-populations, youth may experience factors or
conditions that increase their vulnerability to AOD use and to being
witnesses, victims, or perpetrators of AOD-related violence. These risk
factors can be organized according to six domains: The individual,
family/significant others, school, peer group, neighborhood/community,
and society. Youth who experience risk factors in multiple domains are
considered to be at ``high risk.''
Recommended Approach: CSAP invites applications that will permit
CSAP to answer questions such as, but not limited to, those identified
here:
1. What combination of strategies is effective in developing
communication, social, and life skills among youth at risk for becoming
witnesses, victims, and/or perpetrators of AOD-related violence?
2. Which combination of strategies is effective in improving family
functioning to reduce levels of family violence and AOD use?
3. What combination of strategies is effective in promoting and
sustaining the involvement of youth at risk for AOD-related violence in
positive, pro-social activities?
4. What strategies are effective in promoting a community-based
approach to identifying and addressing the AOD-related problems in the
target population?
5. Which strategies are suitable and effective in AOD-related
violence prevention with sub-sets of youth (for example, by age,
gender, race/ethnicity/culture) as well as with their families,
schools, peers, and communities?
6. What strategies are effective in changing the behavioral norms
that support violence in communities experiencing high rates of AOD
use?
These questions are in addition to the ATOD-specific questions
listed in the Outcome Evaluation section of part IV.
CSAP strongly recommends that applicants propose to implement
comprehensive, community-based prevention strategies that address
multiple risk and/or protective factors in three or more domains.
Applicants may choose to target one or both of the designated sub-
populations of high risk youth; that is, applicants may propose
programs for 6 to 11 year olds and/or 12 to 14 year olds.
Applicants should design interventions to influence not only
alcohol and other drug use and AOD-related violence, but also such
associated conditions and outcomes as lack of neighborhood structure,
lack of positive role-models, school drop-out, and vandalism.
Programs are asked to address risk factors outside the individual
that can precipitate, precede, or co-exist with AOD use and AOD-related
violence. Applicants are particularly encouraged to design prevention
projects that involve significant persons in the youthful participant's
family and social network, especially siblings.
At the same time that programs should be comprehensive, they should
also take into account the particular needs of individual program
participants. Strategies should be developmentally appropriate.
Strategies must also be tailored to meet the cultural, linguistic,
gender, and ethnic characteristics of program participants.
In order to ensure a community-based approach, applicants are
requested to demonstrate that they have in existence a coalition
consisting of community members who are willing and able to address
relevant risk/protective factors. Representatives of the community,
including youth, should be involved in identifying the relevant risk/
protective factors and in developing the strategies to address them.
Applicants are encouraged to consider implementing improvements in
the way services are delivered in their community to ensure that the
local service delivery system can support the multifaceted, community-
based prevention approach recommended for AOD and AOD-related violence
prevention. For example, applicants should consider the need and
appropriateness of linking and coordinating services through formal or
informal agency and organizational agreements.
CSAP recommends that vigorous recruitment and innovative strategies
for retaining participants be an integral part of the proposed project.
Applicants are requested to discuss how they will accomplish this in
their applications.
Youth at high risk for AOD use may also be at risk for HIV/AIDS. As
appropriate and feasible, applicants are urged to consider this
ancillary problem of substance use in designing their interventions.
Award Criterion: Consistent with HHS policy, in addition to the
award criteria listed in part IV of this Federal Register Notice, CSAP
will give consideration to applications from Historically Black
Colleges and Universities in making funding decisions under this
priority area.
Contact for Additional Information: Rose C. Kittrell, M.S.W.,
Division of Demonstrations for High Risk Populations, Center for
Substance Abuse Prevention, Rockwall II, room 9B-03, 5600 Fishers Lane,
Rockville, MD 20857, (301) 443-0353.

Module D: Replications of Model Programs for the Prevention of Alcohol,
Tobacco, and Other Drug Use Among High Risk Youth (Cooperative
Agreements)

Introduction: CSAP announces the availability of Cooperative
Agreement Awards to support projects that demonstrate and evaluate
strategies to replicate one of twelve identified models of High Risk
Youth Substance Abuse Prevention. Utilizing Cooperative Agreement
Awards to support replication projects will ensure coordination of a
national effort to increase knowledge about the mechanics of
demonstration project replication. Through extensive technical
assistance and consultation, this mechanism will facilitate efforts to
standardize and integrate information forwarded to, and derived from
ongoing program efforts.
Definition of Replication: All projects identified in this
Announcement as ready for replication (referred to as ``replicant''
projects) are CSAP funded High Risk Youth projects that have
demonstrated promising strategies in altering the behaviors and
attitudes toward and preventing and/or reducing the use of alcohol and
other drugs (AOD) among youth at high risk for such behaviors. The
identified replicant projects are a representative sample of the most
promising projects that were chosen based on specific criteria.
Criteria for choosing these projects is described in this module under
``Recommended Approach.''
This replication effort is a pilot project to determine whether,
and to what extent, the identified promising models may be:

Part A. Replicated by entities other than the original
developers of the demonstration; or
Part B. Replicated by the original developers of the
demonstration.

Although CSAP has stressed the importance of demonstrating project
replicability, until now it has not provided funding specifically for a
replication initiative. This replication is a pilot project and, as
such, is limited by the scope and range of identified projects. Subject
to the results of this effort, CSAP expects that future replication
initiatives may be more inclusive with respect to expanding the
identified replicant population as well as with other aspects, such as
introducing a wider range of variables that may be incorporated into
the replication.
CSAP recognizes the difficulty inherent in reproducing an existing
project regardless of who developed it and would prefer to define
replication in a broad enough sense to give applicants some flexibility
in their approach to this effort. For purposes of this announcement,
replicability may be defined as reproducing original projects as
closely as possible in all aspects, or as reproducing an identified
project and adapting it in some respects to meet particular needs of an
applicant. For example, the applicant might wish to determine if an
urban-developed project could, with appropriate alterations in
interventions, be successfully reproduced in a suburban or rural area.
In making the choice to alter a project for replication purposes, the
applicant should carefully examine the circumstances, resources,
evaluation, etc., of the chosen project, and be able to present a
logical case for linking the final choice of the project being
replicated to expected outcomes.
Therefore, at this time, CSAP is not inviting applications that
propose to change the cultural group or age group of the target
population, although such an adaptation might provide some interesting
outcomes. Because of its nature as a pilot project and because of the
limited number of applications to be funded, introducing too many
variables into this current effort would be counter-productive. The
instruction regarding cultural groups is not relevant to all the
identified replicant projects, as some of them are multicultural.
CSAP will accept applications which propose to reproduce the
identified projects in their entirety, unless advised by the replicant
project that replicating all components would not be practicable within
the context of the replication.
CSAP legislation did not require the original replicant projects to
address tobacco use prevention. However, replications will be expected
to address tobacco use prevention if the replicant project addressed
this issue.
This initiative should increase CSAP's knowledge of the mechanics
of demonstration project replication--its costs, pitfalls and
probability of success--as well as increase knowledge in the general
area of preventing ATOD use and abuse by high risk youth. CSAP invites
applications that will provide information regarding:
1. Whether interventions and techniques that have been promising in
modifying ATOD use under a given set of circumstances can be as or more
promising with a change in circumstances, e.g., a different
administering agency, a different geographical/demographic area,
different personnel, etc.
2. How minor alterations in program objectives or implementation
will affect replicability and outcomes.
3. How the general replication process may be effected and
evaluated both from CSAP's standpoint and the standpoint of the
organizations implementing the replications. This Announcement
requires, in addition to the outcome evaluation, a process evaluation
that includes an evaluation of the overall replication process as well
as other areas generally addressed in a process evaluation.
Program Goals and Objectives: CSAP's overriding program goal is the
elimination of ATOD use among high risk youth and of the problems
associated with such use that interfere with the achievement,
maintenance, and restoration of optimal health at the individual,
family, and community levels. As part of its mission to decrease the
incidence and prevalence of ATOD use and the resulting problems, CSAP
is dedicated to identifying and disseminating strategies that prevent
or delay the use of alcoholic beverages, tobacco products, and other
drugs among youth. The identification of effective replication models
will add to this knowledge. If CSAP can demonstrate that promising
interventions and strategies can be replicated in diverse areas and,
ultimately, among diverse populations, and if CSAP can determine the
effectiveness of these promising approaches, the field of ATOD
prevention will have been advanced and youth will be better served.
Recommended Approach: CSAP subjected all of its High Risk Youth
grantees' projects to a multi-level screening process, the criteria for
which included comprehensiveness, theoretical foundation, empowerment
of served populations, cultural appropriateness, strength of evaluation
design, accessibility to the target population, coordination, and
overall readiness for replication. The selected projects represent a
spectrum of completion that includes projects now in their fourth year,
as well as projects which are completed and no longer receive CSAP
funding. Through this process, CSAP has identified the replicable
projects listed in the matrix that follows. Abstracts for each of the
identified projects have been included in the complete application kit.
All of the identified grantees have been contacted and have agreed
to be included in the replication effort. They have developed manuals
describing their projects and containing information regarding their
specific aims, target population(s), approach/methods, project
management and implementation plans, project staffing and organization,
staff skill levels (including job descriptions), financial resources
required, participant protection plans, and an overview of their
perceptions of what the necessary ingredients are to effectively
replicate the project. High Risk Youth Replicant manuals are available
to potential applicants through the National Clearinghouse on Alcohol
and Drug Information (NCADI), 1-800-729-6686. CSAP suggests that
organizations who anticipate applying to replicate any of the 12
following projects look first at the abstract(s), and then obtain and
examine carefully the applicable manual(s) from NCADI. If, after
scrutinizing the information prepared by potential replicants,
applicants desire additional information, they may call the project
they wish to replicate. Replicant organizations will participate in
Technical Assistance Workshops sponsored by CSAP. These workshops are
planned to take place within a 60-day period following publication of
this announcement.
Upon award of a Cooperative Agreement to replicate a project, a
grantee may obtain further technical assistance and training from the
replicant agency. Upon request of the applicant (in the application
budget), provision will be made in the individual awards for projects
funded to reimburse the replicant agency for such assistance.
Negotiations will be conducted directly between the grantee and the
replicant agency. It is strongly recommended that the applicant discuss
such technical assistance with the replicant agency prior to writing
the application in order to provide an accurate estimate of the
required cost.

Replication Candidates
------------------------------------------------------------------------
Grant No. Grantee agency State Ethnicity
------------------------------------------------------------------------
1246............. Youth Health WV Caucasian.
Services Inc.
1295............. Lancaster PA Multiple.
Schools.
1397............. Colorado State CO Multiple.
University.
1756............. Schertz-Cibola TX Multiple.
School District.
2205............. Red Cliff Band.. WI Native American.
1800............. Progressive Life DC African American.
Center, Inc.
3073............. Southwest CA Hispanic.
Regional
Laboratory.
2403............. Lac du Flambeau WI Native American.
Band.
0230............. Asian Youth CA Asian.
Project.
0618............. Student NY Multiple.
Assistance
Services.
0767............. Boys and Girls NY Multiple.
Clubs.
1405............. Metro Atlanta GA African American.
Council of
Alcohol and
Drugs.
------------------------------------------------------------------------

CSAP will accept applications that attempt to replicate an
identified model with as much fidelity as possible, regarding
comprehensiveness, targeted domains, setting, target population,
demographics, level of staff expertise, etc. Applicants wishing to
adapt a project to specific needs in their area may do so, but should
provide sufficient justification for proposed changes.
Applicants are expected to provide a logical rationale for choosing
a particular project for replication, that is, linking this choice to
an identified need for such a project in their area and proposed
outcomes for the target population.
It is important that applicants understand that they are proposing
not only to replicate an existing project, but that this project is, as
well, a high risk youth project. Consequently they must be prepared to
address: a. Outcomes to assess the impact of the interventions to be
delivered on participating youth,
b. The process of implementing and conducting a project targeted to
a high risk youth population, and
c. The process of implementing and conducting the project as a
replication.
Questions that need to be addressed that pertain to High Risk Youth
participant outcomes may be found in Module A, under Recommended
Approach. For this effort, CSAP invites applications that will,
additionally, address the following replication-specific questions:
Does the fidelity with which projects are replicated
affect participant outcomes and the overall success of the project as a
replication? In what respects?
How can lessons learned from the replicants'
implementation process be applied to improve a like project?
What impact did the availability of ancillary services and
resources have on: (a) The success of the replicant project; and (b)
how closely the applicant's available resources must parallel those of
the replicant in order to conduct a successful project?
How can the impact of such intangibles as combinations of
personnel attributes and characteristics on the success of the
replicant project be measured; and how can this information be used in
developing a replication?
Evaluation: All applications must include a plan for documenting
program implementation and performance, particularly with regard to the
replication process (process evaluation), and for measuring results
(outcome evaluation), as outlined in part IV of this notice. It is
important to note that the replication requires an evaluation that
exceeds the usual evaluation requirements. The evaluation design should
provide for evaluating outcomes with respect to the effect of the
intervention on participants, just as it would in any other High Risk
Youth project. The process evaluation, however, requires a two-part
approach. On one level, the process evaluation would parallel the
process evaluation in the replicant project. On an additional level,
data would need to be collected to ascertain how the project worked as
a replication. All applications, in their process evaluation design,
should pay particular attention to documenting implementation as it
relates to the replication process.
It is the purpose of this effort to replicate promising
interventions, and assess their effectiveness. Regardless of the
evaluation design of the original replicant project, the evaluation
plan for this application should be rigorous and should be designed to
answer the specific questions detailed in the High Risk Youth priority
area (Module A, Recommended Approach), and in the Evaluation section of
part IV of this notice.

Special Requirements

Role of Federal Staff in Cooperative Agreements: The Cooperative
Agreement mechanism includes significant post-award Federal
programmatic participation in the conduct of the project. It is
anticipated that CSAP staff participation in this program will be
substantial. Such involvement may include: Provision of extensive
technical assistance; contribution of guidance to enhance the potential
replication of results; provision of support services for training,
evaluation, and data collection both for the benefit of individual
grantee evaluations and with respect to any national evaluation CSAP
may conduct; arrangement of meetings designed to support activities of
the individual cooperative agreement awardees; membership on policy
steering or other working groups established to facilitate
accomplishment of the project goals; authorship or co-authorship of
publications to make results of the project available to other
prevention programs.
Role of Awardee in Cooperative Agreements: The awardee is expected
to participate/cooperate fully with CSAP staff in the implementation
and evaluation of the project. Activities include compliance with all
aspects of the terms and conditions for the cooperative agreement,
cooperation with guidance provided by and requests from CSAP staff, and
response to all requests for client interviews and admissions.
Review Criteria: In addition to the criteria listed in Part IV of
this Federal Register Notice, the criteria listed below for
replications will be included in the technical merit review of
applications for replications.

General

Potential as a demonstration project to make a significant
contribution to knowledge regarding replicability of existing projects
as effective strategies for substance abuse prevention in youth.

Proposed Approach and Activities

Adequacy of overall replication plan, including
understanding of replicant's project's theoretical basis and context
for execution, as well as its application to the area/population being
chosen, plans for execution of interventions, etc.
Evidence indicating that the applicant has thoroughly
researched the chosen replicant project and is cognizant of what
replicating that project will entail, including evaluation costs and
the kind, amount, and cost of technical assistance the applicant may
need to acquire from the replicant project.

Evaluation Plan

Qualifications of evaluator, particularly as they relate
to appropriate educational background and experience with research and
evaluation in the ATOD field.

Personnel, Management Plan, and Resources

Qualifications of the Program Director, chief evaluator,
and other key personnel, particularly as they relate to counterpart
personnel in the project chosen for replication.
Contact for Additional Information: Rose C. Kittrell, M.S.W.,
Division of Demonstrations for High Risk Populations, Center for
Substance Abuse Prevention, Rockwall II, room 9B-03, 5600 Fishers Lane,
Rockville, MD 20857, (301) 443-0353.

Part IV--Additional Guidance for Applicants

Coordination With Other Federal/Non-Federal Programs: Applicants
seeking support under this announcement are encouraged to coordinate
with other Federal, State, and local public and private programs
serving their target population. Program coordination helps to better
serve the multiple needs of the client population, to maximize the
impact of available resources, and to prevent duplication of services.
Applicants should identify, by name and address, all organizations with
which they are coordinating and describe the process to be used for
coordinating efforts. Special consideration will be given in the award
decision-making process to applications that demonstrate a coordinated
approach to providing comprehensive substance abuse prevention and
related services. Copies of letters of commitment from organizations
that have agreed to collaborate with the applicant to implement the
proposed project must be provided in an appendix to the application,
entitled ``Letters of Commitment from Collaborating Organizations/
Agencies/Individuals.'' These letters must specify the kind(s),
level(s), and period of support the organization has agreed to commit.
Single State Agency Coordination: Coordination with the Single
State Agency (SSA) for alcohol and other drug abuse is encouraged to
ensure communication, reduce duplication, and facilitate continuity.
Therefore, a copy of a letter sent by the applicant to the SSA that
briefly describes the application should be included in an appendix to
the application entitled ``Letters to/from SSAs.'' A list of SSAs can
be found in the grant application kit. If the target population falls
within the jurisdiction of more than one State, all representative SSAs
should be involved. Evidence of support for the proposed project from
the SSA will be considered in making funding decisions.
Intergovernmental Review (Executive Order 12372): Applications
submitted in response to this Announcement are subject to the
intergovernmental review requirements of Executive Order 12372, as
implemented through DHHS regulations at 45 CFR part 100. Executive
Order 12372 sets up a system for State and local government review of
applications for Federal financial assistance. Applicants (other than
federally recognized Indian tribal governments) should contact the
State's Single Point of Contact (SPOC) as early as possible to alert
them to the prospective application and to receive any necessary
instructions on the State review process. For proposed projects serving
more than one State, the applicant is advised to contact the SPOC of
each affected State. A current listing of SPOCs is included in the
application kit. The SPOC should send the recommendations from the
State review process to the following office at CSAP (not to the
Division of Research Grants, NIH, which is the central receipt point
for applications): Office of Review, Center for Substance Abuse
Prevention, Rockwall II Building, room 630, 5600 Fishers Lane,
Rockville, MD 20857, ATTN: SPOC.
The due date for the State review process recommendations is no
later than 60 days after the deadline date for the receipt of
applications. CSAP does not guarantee to accommodate or explain SPOC
comments that are received after the 60-day cutoff.
Public Health System Reporting Requirements: The Public Health
System Impact Statement (PHSIS) is intended to keep State and local
health officials apprised of proposed health services grant
applications submitted by community-based, non-governmental
organizations within their jurisdictions.
Community-based, non-governmental service providers who are not
transmitting their applications through the State must submit a PHSIS
to the head(s) of the appropriate State and local health agencies in
the area(s) to be affected no later than the pertinent receipt date for
applications. The PHSIS consists of the following information:
a. A copy of the face page of the application (Standard Form 424).
b. A summary of the project (PHSIS), not to exceed one page, which
provides:
(1) A description of the population to be served.
(2) A summary of the services to be provided.
(3) A description of the coordination planned with the appropriate
State or local health agencies.
State and local governments and Indian Tribal Authority applicants
are not subject to the Public Health System Reporting Requirements.
Application Submission Procedures: All applicants must use
application form PHS 5161-1 (Rev. 7/92), which contains Standard Form
424 (face page).
Grant application kits (including form PHS 5161-1 with Standard
Form 424, complete application procedures, and accompanying guidance
materials for the narrative approved under OMB No. 0937-0189) may be
obtained from: National Clearinghouse on Alcohol and Drug Information
(NCADI), Post Office Box 2345, Rockville, Maryland 20852, 1-800-729-
6686.
An audio-cassette of the Announcement is also available from the
above address.
Applicants must submit: a. An original copy of the application
signed by the authorized official of the applicant organization, with a
complete set of the appropriate appendices; and
b. Two additional, legible copies of the application and all
appendices. Faxes are not permissible.
The above materials should be sent to the following address: Center
for Substance Abuse Prevention Programs, Division of Research Grants,
NIH, Westwood Building, room 240, 5333 Westbard Avenue, Bethesda,
Maryland 20892.*
---------------------------------------------------------------------------

*If an overnight carrier or express mail is used, the correct
ZIP Code is 20816.
---------------------------------------------------------------------------

The Division of Research Grants (DRG) serves as the central receipt
point for applications. When received, applications will be screened
for eligibility, completeness, and compliance with instructions for
submission.
Evaluation: This Announcement requires more rigor in the
conceptualization, design and implementation of projects and in their
evaluation than the previous High Risk Youth Demonstration Grant
Program. The goal is to achieve and document measurable reductions in
ATOD use incidence, prevalence, and related negative consequences among
appropriately aged high risk youth populations, in addition to
assessing the effectiveness of specified intervention strategies in
reducing the risk factors, or enhancing the protective factors on which
the project is focused.
CSAP will support only applicant projects that have a well
developed and comprehensive evaluation plan. The evaluation plan must
be conceptually and procedurally integrated with the overall project,
and must have both an outcome evaluation component and a process
evaluation component (discussed below).
Since the purpose for issuing this Announcement is to reduce the
incidence and prevalence of ATOD use and its related negative
consequences and to assess the effectiveness of specified intervention
strategies with selected high risk youth populations, instruments
should be used which will provide periodic measures of all delineated
indicators. Applicants must specify the means to be used to collect
these data. Applicants are required to collect baseline data, yearly
progress report data, end of project data, and follow-up data on all
indices.
The evaluation plan must present a sound methodology for the
collection, storage, analysis, and interpretation of data. The
evaluation plan must utilize psychometrically sound measures and
instruments for data collection. Applicants must describe the selection
of instruments to be used and must provide information about their
normative properties, including the appropriateness of their use for
the culture(s) under study. The presented evaluation methods, measures
and instruments must be sensitive and relevant to the target groups of
the community with respect to age and gender distribution, reading
level, and culture. The evaluation plan must also present a time-line
for carrying out all evaluation procedures.
The evaluation plan must be designed and carried out by a
professional who is highly experienced in comparative evaluation
methodology, independent of the project, and able to work closely with
the grantee.
A range of from fifteen to twenty-five percent of the funds
available may be used for the evaluation component.

Process Evaluation

Process evaluation is a quantitative and qualitative description of
a project that documents its evolution from inception through
implementation and completion. The purpose of the process evaluation is
to document what happened in the project and what was learned, what
barriers existed to inhibit implementation, what was done to overcome
these barriers, and what should be done differently in future projects.
A process evaluation should also document the context for the project,
that is, how the program fit into the community and interacted with the
existing relevant human service programs and resources that were
available to serve the target population. The use of resources and the
acceptability and appropriateness of the program activities for the
target population to meet the project objectives should also be
addressed. Formal and on-going linkages between project objectives and
program interventions should be developed to ensure feedback and
appropriate project modifications.

Outcome Evaluation

The purpose of the outcome evaluation is to determine the
effectiveness of the intervention, and applicants must propose an
evaluation design which will allow this determination to be made.
Outcome evaluation assesses whether the project was effective in
achieving its goals, objectives and activities. The plan to generate,
process and analyze data should be detailed and clearly articulated.
For the purposes of this grant program, the outcome evaluation must:
(a) Identify the specific factors to be addressed according to the
terms of the model selected to conceptualize the program;
(b) Specify the proposed interventions to be implemented detailing
frequency and intensity of exposure of each intervention proposed, per
member of target population;
(c) Specify the desired outcomes in relation to both the identified
factors (generally these are intermediate outcome measures), and the
selected interventions;
(d) Identify the instruments for measuring the factors to be
addressed and for monitoring changes related to desired outcomes and
submit copies of any non-standard instruments;
(e) Specify the indicators of ATOD use to be monitored;
(f) Identify the instruments to be used for gathering those
measurements related to ATOD indicators;
(g) Describe the plan for data collection, data processing and data
analysis.
The outcome evaluation design should be as rigorous as possible.
Whenever feasible, the outcome evaluation design should employ a time
series design that allows for comparisons within and between control or
matched comparison groups. For capturing changes at the community
level, a pre-post with repeated measures design, for community
indicators, is acceptable. For measuring changes at the individual/
group level, control or comparison groups, utilizing either random
assignment or matched comparison, should be used. However, if an
applicant chooses another design without the use of a randomized
control or matched comparison group, the applicant must describe the
alternate design in detail and explain the method for determining the
effectiveness of the intervention. If the target group(s) is to be
randomly selected, indicate the method for randomization of target and
control group. If a matched comparison group is to be used, detail the
method for matching the groups. In all cases, applicants must include a
discussion of plans to deal with attrition, accretion, and other
threats to internal and external validity. All applicants must also
collect baseline data, yearly progress report data, and end of project
data on all indices. In accordance with the age guidelines provided in
the Modules, these data should be designed to answer questions that
include, but are not limited to, the following: (Additional questions
specific to each priority area are included in the Recommended Approach
section of each module).
1. What measurable changes have occurred as a result of the
combination of intervention strategies regarding the number of new
users in the target population, compared to the control/comparison
group, for each of the following substances:
Alcoholic beverages;
All types of tobacco products; and
Other drugs such as marijuana, cocaine, crack/cocaine,
inhalants, steroids, heroin, etc.?
2. What measurable changes have occurred as a result of the
combination of intervention strategies regarding the number of users in
the target population, compared to the control/comparison group, who
have used each of the following substances in the past month:
Alcoholic beverages;
All types of tobacco products; and
Other drugs such as marijuana, cocaine, crack/cocaine,
steroids, inhalants, heroin, etc.?
3. What measurable changes have occurred as a result of the
combination of intervention strategies regarding the amount of regular
use of alcoholic beverages, all types of tobacco products, and other
drugs such as marijuana, cocaine, crack/cocaine, steroids, inhalants,
heroin, etc., by the users in the target population, as compared to the
control/comparison group?
4. What measurable changes have occurred as a result of the
combination of intervention strategies regarding the numbers of the
target population compared to the control/comparison group, who
disapprove of the use of alcoholic beverages, tobacco products, and
other drug use?
5. What measurable changes have occurred as a result of the
combination of intervention strategies regarding participants' and
control/comparison groups' perceptions of harm associated with ATOD
use?
6. What measurable changes have occurred as a result of the
combination of intervention strategies regarding the target
population's, compared to the control/comparison group's, self-reported
involvement in physical fighting, victimization, assault injuries,
aggressive behavior, carrying and usage of weapons, and activities that
bring youth in contact with the juvenile/criminal justice system?
Grantees will be required to collect uniform baseline and yearly
data on some indicators using standardized instruments common to all
grantees. Details regarding the specific instruments, data collection
and analysis, aggregation to group, and procedures for transmitting the
results to CSAP will be provided at the first grantee meeting following
award. OMB clearance will be obtained for these instruments.
Substance abuse and related problems have frequently been measured
through surveys and archival indicator data. CSAP encourages applicants
to make use of such available data in their communities, such as crime
statistics and Drug Abuse Warning Network (DAWN) data.
CSAP Cross-Site Evaluation: In addition to the requirement for
individual project evaluation, CSAP is planning to conduct a cross-site
evaluation of the High Risk Youth Demonstration Grant Program. All
applicants must provide written assurance that they will cooperate
fully in the conduct of the cross-site evaluation.
Review Process: Applications accepted for review will be assigned,
at the central receipt point (Division of Research Grants, NIH), to an
Initial Review Group (IRG) composed primarily of non-Federal experts.
Applications will be reviewed by the IRG for technical merit in
accordance with established PHS/SAMHSA peer review procedures for
grants. Notification of the IRG's recommendation will be sent to the
applicant upon completion of the initial review. In addition, the IRG
recommendations on the technical merit of applications will undergo a
second level of review by the appropriate advisory council, whose
review may be based on policy considerations as well as technical
merit. Applications may be considered for funding only if the advisory
council concurs with the IRG's recommendation for approval.
Review Criteria: The following criteria will be included in the
technical merit review of all applications and apply to priority areas
A, B, C and D. Additional criteria specific to replications are
identified in Module D.

General

Potential as a demonstration project to make a significant
contribution to knowledge of effective substance abuse prevention
strategies for youth of different ages, of different cultures, and/or
from different environments, e.g., urban, suburban, or rural areas.

Proposed Approach and Activities

Adherence to the risk/protective factor framework and the
logic model in conceptualizing the proposal or adequate explanation of
and rationale for alternative framework(s) selected.
Comprehensiveness and clarity of the applicant's approach,
and appropriateness of the identified intermediate and long-term
objectives. (For Modules A, B, and C, a comprehensive approach is
defined as one with interventions targeting three or more risk factor
domains. For Module D, applicants are expected to address the same
domains as in the replicant project. For Modules A, B, C, and D,
applicants not using the risk/protective factor model are expected to
demonstrate the comprehensiveness of the selected alternative
approach.)
Adequacy and appropriateness of the proposed strategies
and interventions to fulfill the applicant's stated objectives for the
specified population, taking age, culture, and gender into
consideration.
Accessibility and acceptability of program to the target
population and community; adequacy of procedures to identify, recruit,
and retain the target population; and adequacy of procedures to empower
program participants such that they actively participate in the
planning and implementation of the prevention process, including the
inclusion of youth and other community members in the identification of
risk and protective factors and interventions (or, in the case of
projects proposing an alternative conceptual framework, inclusion of
youth and other community members in identifying problems and
approaches in terms consistent with the conceptual framework selected).
Commitment and ability to implement a gender-appropriate
and culturally competent project, as evidenced in such areas as
staffing, intervention strategies, instrumentation, and evaluation.

Evaluation Plan

Clarity, feasibility, appropriateness, completeness, and
adequacy, including adequacy of resources of the evaluation plan to
meet the requirements for process and outcome evaluation as outlined in
this Announcement. For the outcome evaluation, particularly, the
adequacy of the design and methodology to demonstrate the effectiveness
of the intervention must be shown.

Personnel, Management Plan, and Resources

Evidence of (1) capability and experience of the applicant
organization; (2) appropriate qualifications of the Program Director,
Chief Evaluator, and other key personnel.
Feasibility of the proposed project in terms of (1) time
frames, (2) adequacy, availability and accessibility of facilities and
resources, and (3) reasonable and effective project management plan.
Documentation of specific commitments from proposed
collaborators for resources committed to the project (e.g., shared
staff, work space, training or other services) as well as support for
the project from relevant sources (e.g., Government agencies, community
agencies, other local groups).

Budget

Appropriateness of the budget for each year of the
proposed activities.

Participant Protection

Adequacy of procedures for the protection of participants.
Award Decision Criteria: Applications recommended for approval by
the Initial Review Group and by the appropriate advisory council will
be considered for funding primarily on the basis of their overall
technical merit as determined through the review process.
Other award considerations will include:

Availability of funds.
Geographic (within the U.S.) and urban/rural balance.
Balance among types of prevention strategies in CSAP's
grant portfolio.
Balance among multi-cultural populations in CSAP's grant
portfolio.
Evidence of support for the proposed project from the
Single State Agency for Alcohol and/or Drug Abuse.
Applications from community-based organizations.
Applications that address the needs of children of
substance abusers, latchkey children, children at risk of abuse or
neglect, preschool children eligible for services under the Head Start
Act, children at risk of dropping out of school, children at risk of
becoming adolescent parents, and children who do not attend school and
who are at risk of being unemployed.
Evidence that project will demonstrate a coordinated
approach to providing comprehensive substance abuse and prevention and
related services to the target population.

Contacts for Additional Information

Questions concerning program issues may be directed to: Michele M.
Basen, M.P.A. or Catherine D. Nugent, M.S., Division of Demonstrations
for High Risk Populations, Center for Substance Abuse Prevention,
Rockwall II, room 9B-03, 5600 Fishers Lane, Rockville, MD 20857, (301)
443-9110.
Questions regarding grants management issues may be directed to:
Margaret E. Heydrick, Grants Management Officer, Center for Substance
Abuse Prevention, Rockwall II Building, room 640, 5600 Fishers Lane,
Rockville, Maryland 20857, (301) 443-3958.

Note: For the hearing impaired, a TDD machine is available.
However, prior notification, including date and time of TDD call,
must be given by voice to (301) 443-9110 to ensure staff coverage of
the TDD. The TDD number is (301) 443-2261.

Dated: March 18, 1994.
Richard Kopanda,
Acting Executive Officer, SAMHSA.
[FR Doc. 94-6863 Filed 3-23-94; 8:45 am]
BILLING CODE 4162-20-P