[Federal Register Volume 62, Number 130 (Tuesday, July 8, 1997)]
[Notices]
[Pages 36522-36528]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-17698]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Program Announcement 761]


Replication and Dissemination of Effective Breast and Cervical 
Cancer Health Education Interventions

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of funds in fiscal year (FY) 1997 for cooperative 
agreements to replicate and disseminate effective interventions for the 
early detection of breast and cervical cancer. These efforts should 
address health education for priority populations or professional 
education for health service providers. Activities under this Program 
Announcement are to be conducted in conjunction with the National 
Breast and Cervical Cancer Early Detection Program (NBCCEDP).
    CDC is committed to achieving the health promotion and disease 
prevention objectives of Healthy People 2000, a national activity to 
reduce morbidity and mortality and to improve the quality of life. This 
announcement is related to the priority area of Cancer. (To order a 
copy of Healthy People 2000, see the section WHERE TO OBTAIN ADDITIONAL 
INFORMATION.)

Authority

    This program is authorized by Sections 317(k)(2) and 1507 [42 
U.S.C. 247b(k)(2) and 42 U.S.C. 300n-3] of the Public Health Service 
Act, as amended.

Smoke-Free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the nonuse of all tobacco products, and 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities that receive Federal funds in which education, 
library, day care, health care, and early childhood development 
services are provided to children.

Eligible Applicants

    Assistance will be provided to nonprofit public or private 
organizations. Applicants must have affiliate/local offices or 
organizations in more than, or with access to, two or more States, U.S. 
territories, or Indian tribes or Indian tribal organizations. In 
addition, applicants must have a primary relationship to one or more of 
the priority populations or the health care providers who serve them. A 
primary relationship is one in which the organization's service to the 
priority population or to the health care providers who serve them is 
viewed as the most important component of its mission.
    National organizations; professional associations of health care 
providers and their regional, State, and local constituents and 
affiliates; are eligible to apply. These organizations provide a unique 
opportunity to replicate and disseminate interventions that address 
barriers to screening, enhance the quality of care, and improve the 
priority population's access to and utilization of early detection 
programs.
    * * Applicants must complete the enclosed Eligibility Assurance 
included in the application package and must attach documentation to 
support compliance with these eligibility criteria.

    Note: Effective January 1, 1996, Public Law 104-65 states that 
an organization described in section 501(c)(4) of the Internal 
Revenue Code of 1986 which engages in lobbying activities shall not 
be eligible for the receipt of Federal funds constituting an award, 
grant (cooperative agreement), contract, loan, or any other form.

Glossary

    Priority populations include uninsured or underinsured women, women 
who are aged 50 years and older; women who are racial, ethnic, and 
cultural minorities, such as American Indians, Alaskan Natives, 
African-Americans, Hispanics, Asian/Pacific Islanders, Lesbians, women 
with disabilities, and women who live in hard-to-reach communities in 
urban and rural areas. Priority populations, as defined above, will be 
used throughout this document.
    Replication can include applying a proven, researched, and 
theoretically-based intervention proven to be effective:
    (a) With one disease and one priority population and then adapted 
to breast and/or cervical cancer for another population or in a new 
geographic area;
    (b) For increased screening for breast and cervical cancer and 
adapted for

[[Page 36523]]

another population or geographic area; or
    (c) In increasing breast and cervical cancer screening in a limited 
population and then expanded to reach more members of the same 
population.
    Intended partners are agencies working with priority populations 
and health care providers for whom an intervention is appropriate. 
These agencies will work with the cooperative agreement recipient to 
implement the replication package.
    Additional program definitions and information are included in the 
application kit.

Availability of Funds

    Approximately $3.5 million will be available in FY 1997 to fund 
approximately 10 awards. It is expected that the average award will be 
approximately $350,000, ranging from $250,000 to $400,000. It is the 
intent of CDC to fund a balanced distribution of organizations that 
propose a health education intervention for priority populations and 
those that propose a professional education intervention, e.g. award 
approximately five programs in each category.
    It is expected that these awards will begin on September 29, 1997, 
and will be made for 12-month budget periods within a project period of 
up to 4 years. Funding estimates may vary and are subject to change.
    Continuation awards within the project period will be made on the 
basis of satisfactory progress and the availability of funds. Funds may 
not be expended for the purchase or lease of land or buildings, 
construction of facilities, renovation of existing space, or the 
delivery of clinical and therapeutic services. The purchase of 
equipment is discouraged but will be considered for approval if 
justified on the basis of being essential to the program and documented 
that equipment is not available from any other source.

Use of Funds

Restrictions on Lobbying

    Applicants should be aware of restrictions on the use of Department 
of Health and Human Services (HHS) funds for lobbying of Federal or 
State legislative bodies. Under the provisions of 31 U.S.C. Section 
1352 (which has been in effect since December 23, 1989), recipients 
(and their subtier contractors) are prohibited from using appropriated 
Federal funds (other than profits from a Federal contract) for lobbying 
Congress or any Federal agency in connection with the award of a 
particular contract, grant, cooperative agreement, or loan. This 
includes grants/cooperative agreements that, in whole or in part, 
involve conferences for which Federal funds cannot be used directly or 
indirectly to encourage participants to lobby or to instruct 
participants on how to lobby.
    In addition, the FY 1997 Departments of Labor, HHS, and Education, 
and Related Agencies Appropriations Act, which became effective October 
1, 1996, expressly prohibits the use of 1997 appropriated funds for 
indirect or ``grass roots'' lobbying efforts that are designed to 
support or defeat legislation pending before State legislatures. 
Section 503 of this new law, as enacted by the Omnibus Consolidated 
Appropriations Act, 1997, Division A, Title I, Section 101(e), Pub. L. 
No. 104-208 (September 30, 1996), provides as follows:
    Sec. 503: (a) No part of any appropriation contained in this Act 
shall be used, other than for normal and recognized executive-
legislative relationships, for publicity or propaganda purposes, for 
the preparation, distribution, or use of any kit, pamphlet, booklet, 
publication, radio, television, or video presentation designed to 
support or defeat legislation pending before the Congress, * * * except 
in presentation to the Congress or any State legislative body itself.
    (b) No part of any appropriation contained in this Act shall be 
used to pay the salary or expenses of any grant or contract recipient, 
or agent acting for such recipient, related to any activity designed to 
influence legislation or appropriations pending before the Congress or 
any State legislature.

Background

Breast Cancer

    In the United States, approximately 500,000 women will die of 
breast cancer this decade. Among women, breast cancer accounts for 29 
percent of all new cancer cases and is the second leading cause of 
cancer-related deaths. In 1996, the American Cancer Society estimated 
that 184,300 women were diagnosed with invasive breast cancer and that 
44,300 women died of this disease. Death rates from the disease are 
highest among women aged 40 years or more, and among black women 
compared with white women for those aged less than 70 years.
    It is not currently known how to prevent breast cancer. Thus, 
detecting carcinoma of the breast in its early stages is the key to 
more treatment options, improved survival, and decreased mortality. 
Research has shown that the use of mammography can reduce the mortality 
attributable to breast cancer among women aged 50 years and older by 30 
percent.
    The percent of women who are regularly screened for breast cancer 
decreases with age. The baseline data on mammography use from the 1992 
National Health Interview Survey show that only 49 percent of women 
aged 50 years and older reported having had a mammogram within the past 
three years. This proportion was lower for racial and ethnic minority 
women, for women who had less than a high school education, for women 
who were over age 75 years, and for women who were living below the 
poverty level. In Healthy People 2000, the CDC established that by the 
year 2000, sixty (60) percent of women aged 50 years and older should 
receive a mammogram annually.

Cervical Cancer

    The overall incidence of invasive cervical cancer has decreased 
steadily over the last several decades, but in recent years, this rate 
has increased among women who are less than 50 years old. In 1996, 
invasive cervical cancer was diagnosed among approximately 15,700 
women, and carcinoma in situ was diagnosed among about 65,000 women, 
and about 4,900 women died of cervical cancer.
    The primary goal for cervical cancer screening is to increase 
detection and treatment of precancerous cervical lesions and thus 
prevent the occurrence of cervical cancer. Although no clinical trials 
have studied the efficacy of Papanicolaou (Pap) test in reducing 
cervical cancer mortality, experts agree that it is an effective 
technology. Since the introduction of the Pap test in the 1940s, 
cervical cancer mortality rates have decreased by 75 percent in the 
United States.
    In 1991, the PHS established that by the year 2000, 75 percent of 
women should be receiving a Pap test within the preceding one to three 
years. Baseline data on the use of the Pap test from the 1992 National 
Health Interview Survey (NHIS) show that only 65 percent of women aged 
18 years and older reported having had a Pap test within the past three 
years. As with mammography screening, this proportion was lower for 
racial and ethnic minority women, for women who had less than a high 
school education, for women who were over 75 years of age, and for 
women who had low incomes.

[[Page 36524]]

National Breast And Cervical Cancer Early Detection Program

    In 1990, the U.S. Congress passed The Breast and Cervical Cancer 
Mortality Prevention Act, Pub. L. 101-354 to reduce the morbidity and 
mortality from breast and cervical cancer. This legislation enables 
CDC, in partnership with State health departments, U.S. Territories, 
and Indian tribes or Indian tribal organizations to make breast and 
cervical cancer screening, referral, tracking, and follow-up services 
available and accessible to women, with priority for services given to 
low-income, and uninsured and underinsured women. Many women do not 
have access to a well-coordinated and integrated approach to screening, 
follow-up, and treatment services because of social, financial, and 
geographic barriers.
    In accordance with Pub. L. 101-354, a comprehensive program 
includes the following program components: (1) breast and cervical 
cancer screening, (2) referral and follow-up, (3) public health 
education, (4) professional education, (5) quality assurance, and (6) 
surveillance and program evaluation. Additionally, the success in 
carrying out these programs requires appropriate partnership 
development and community involvement. The importance of these program 
components and a systematic, coordinated approach is necessary to 
ensure maintenance of quality and comprehensive services. In FY 1997, 
with a Congressional appropriation of $140 million, CDC funded 50 
States, five U.S. territories, the District of Columbia, and 13 Indian 
tribes or Indian tribal organizations.
    Program success is enhanced when State, territorial, and tribal 
resources and efforts are combined with those of other State, 
territorial, and tribal programs, voluntary organizations, private 
sector organizations, and community-based organizations through 
partnership development. Statewide, territorial and tribal 
comprehensive breast and cervical cancer control programs can make a 
vital contribution to the nationwide effort to reduce morbidity and 
mortality and to improve quality of life.

Purpose

    The purpose of this program is to improve and change the knowledge, 
attitudes, and behaviors of priority populations and/or the health care 
providers that serve them related to breast and cervical cancer early 
detection.
    Ultimately the goal is to increase the number of women from the 
priority populations served by the NBCCEDP through the development of 
effective interventions and health care provider education. Examples of 
interventions can include:
    Public Health Education--
     Interventions that reach priority populations and address 
cultural differences between individual providers and their clients.
     Interventions that have been effective with select 
priority populations for other health concerns or chronic diseases that 
have the potential to increase breast and cervical cancer screening for 
priority populations.
    Professional Education--
     Training for health care providers that focus on breast 
and cervical cancer skills building and application in a culturally 
sensitive manner.
     Interventions that incorporate culturally sensitive breast 
and cervical cancers prevention education in medical, nursing, and 
other health service provider curricula.
     Interventions that change institutional polices and health 
provider practices to improve access to screening services for priority 
populations.

Program Requirements

    CDC's intent is to support programs that will result in increased 
screening and rescreening at CDC supported National Breast and Cervical 
Cancer Early Detection Program (NBCCEDP) sites for priority 
populations. Applicants:
    A. Should focus on affecting the priority population with whom they 
have the greatest likelihood of impacting or a professional 
organization that can influence health provider behavior.
    B. Are encouraged to collaborate with other agencies in the 
replication and dissemination of an intervention that would target both 
the women to be screened and the health care providers that serve them.
    C. Must have a currently existing or develop a collaborative 
relationship with recipients of the NBCCEDP in conducting these 
projects.
    In conducting activities to achieve the purpose of this program, 
the recipient shall be responsible for conducting the activities under 
A. Recipient Activities, and CDC shall be responsible for conducting 
activities under B. CDC Activities.

A. Recipient Activities

    Activities under this Cooperative Agreement are divided into five 
phases. It is anticipated that recipients will complete and move from 
one phase to the next at different times, depending on the expertise 
and capabilities possessed by each. However, funding for each 
successive phase will depend on the availability of funds and 
documentation to CDC by the recipient that the previous phase has been 
successfully completed.
    1. Phase 1: Recipients will develop the replication package.
    2. Phase 2: Recipients will develop plans to implement and evaluate 
the replication package.
    3. Phase 3: The replication package will be piloted.
    4. Phase 4: The package will be refined based on the pilot 
experience and then implemented to others.
    5. Phase 5: Recipients will analyze the replication package and 
prepare summary reports that address the effectiveness of the 
replication. Good replication of interventions should include proper 
process and outcome evaluation conducted throughout the span of the 
cooperative agreement.
    The program requirements for the first phase of activity are:
    Develop the replication package in collaboration with grantees of 
the NBCCEDP. The package will be written in language understandable to 
nonresearchers and contain:
    1. A full description of the intervention on which the replication 
is based.
    2. A list of the priority populations or the health care providers 
for whom the replication would target.
    3. A time line of specific steps and costs for setting up the 
replication.
    4. A list of the types of agencies needed for collaboration on the 
replication and approaches to establishing linkages with them.
    5. A list of all necessary materials, other resources, staff 
commitment (numbers and time) and skills, and cost breakdowns for 
conducting the replication.
    6. Protocols for implementing the replication and ensuring its 
quality and consistency.
    7. If appropriate, plans for formative research with new or 
expanded target audiences, with an explanation of how the original 
intervention will be adapted or changed.
    8. Specific strategies for overcoming barriers to implementation.
    9. The replication package should include practical examples, 
strategies, and suggestions from the original intervention and should 
contain copies of all relevant materials.
    The program requirements for the second phase of activity are:

[[Page 36525]]

    Create a strategy to implement and evaluate the replication 
package. The recipient will:
    1. Compile a list of intended partners.
    2. Select ways to inform intended partners about the availability 
of the package. This strategy will be used to identify intended 
partners who are interested in carrying out the intervention package 
with the technical assistance of the recipient.
    3. Create a timeline of specific steps and costs for marketing the 
intervention.
    4. Develop methods and procedures for evaluating process, outcome, 
and cost-implications of the replication.
    The program requirements for the third phase of activity are:
    Pilot the replication package. The recipient will pilot test the 
replication package with at least two selected sites. This should 
include:
    1. Develop procedures for collecting process data, e.g., on 
unforeseen barriers to implementation, solutions to barriers, and cost 
containment.
    2. Implement the replication package with the partners at the pilot 
sites.
    3. Provide on-going technical assistance and consultation.
    4. Provide a timeline of specific steps and costs for implementing 
the intervention.
    The program requirements for the fourth phase of activity are:
    Implement the replication package. Based on the results of the 
pilot test, the recipient will:
    1. Refine the package and select at least four intended partners to 
participate in the implementation of the replication package.
    2. Provide the intended partners with the replication package and 
with specific instructions for implementation.
    3. Provide ongoing technical assistance and consultation.
    4. Provide a timeline of specific steps and costs for conducting 
the intervention.
    The program requirements for the fifth phase of activity are:
    Analyze and Evaluate the replication package. Such evaluation 
should:
    1. Use appropriate qualitative or quantitative methods.
    2. Include an assessment of the fidelity of the implementation of 
the intervention to the methods and protocols presented in the 
replication package.
    3. Provide a timeline of specific steps and costs for evaluating 
the replication package.
    4. Describe results of the replication package on priority 
populations' or health care providers' behaviors.
    Any materials developed in whole or in part with CDC funds shall be 
subject to a nonexclusive, irrevocable, royalty-free license to the 
Federal government to reproduce, translate, publish, or otherwise use 
and authorize others to use for government purposes.

B. CDC Activities

    1. Provide consultation and technical assistance regarding the 
adaptation, implementation, and evaluation of the replication package.
    2. Collaborate with recipients in developing, implementing, 
evaluating and disseminating the replication packages designed to 
improve and change the knowledge, attitude, and screening behaviors of 
priority populations and/or the health care providers who serve them.
    3. Monitor the recipient's performance of project activities and 
attainment of project objectives through the provisions of technical 
assistance and progress reporting.
    4. Provide periodic updates about public knowledge, attitudes, and 
practices regarding the early detection and control of breast and 
cervical cancer and up-to-date scientific information.
    5. Assist with the evaluation of project activities including the 
analysis of ongoing process measures and the redirection of activities 
as necessary.
    6. CDC will cooperate with the preparation and publication of study 
findings.

Technical Reporting Requirements

Progress Reports

    An original and two copies of a progress report must be submitted 
on a semiannual basis, no later than 30 days after the end of each 6-
month period. The semiannual progress reports should include:
    A. A brief program description.
    B. A comparison of the actual accomplishments to the goals and 
objectives established for the period.
    C. If established goals and objectives were not accomplished or 
were delayed, describe both the reason for the deviation and 
anticipated corrective action or deletion of the activity from the 
project.
    D. Other pertinent information including, when appropriate, 
analysis and explanation of unexpectedly high costs for performance.

Financial Status Reports

    An original and two copies of the financial status reports (FSR) 
must be submitted no later than 90 days after the end of each budget 
period. Final financial status and performance reports are required no 
later than 90 days after the end of the project period. All reports are 
submitted to the Grants Management Branch, Procurement and Grants 
Office, CDC.

Application Content

    Applicants may elect to submit proposals that address one of the 
following types of activities: (1) health education interventions 
designed to increase the participation of priority populations in 
screening services; or (2) health care provider interventions designed 
to build skills of health service providers to better encourage client 
participation in screening services.
    Applicants must develop their applications in accordance with PHS 
Form 5161-1 (Rev. 7-92), information contained in the program 
announcement, and the instructions below. The application, excluding 
appendixes, should not exceed 50 pages.

A. Health Education and Professional Education Intervention(s)

    1. Description and justification.
    (a) Supply permission from the original developers of the proposed 
intervention to replicate the intervention, including use of 
appropriate materials, etc.
    (b) Describe the intervention(s) to include:
    (1) priority population for whom the replication package was 
designed (including behavioral risks), (2) theoretical basis, (3) 
intervention design and components, (4) programmatic objectives, (5) 
behavior change goal, (6) methods of delivery, and (7) outcome 
evaluation method. Identify the agency(ies) that originally developed, 
conducted, and evaluated the intervention that will be the object of 
the replication and dissemination.
    (c) Substantiate the need for replication in terms of (1) size of 
priority population, (2) appropriateness to selected population groups 
(on the basis of analysis of the current data), (3) program objectives 
of the intended partners, (4) and address the inclusion of women and 
members of minority groups and their sub-populations.
    2. Demonstrated effectiveness.
    (a) Provide appropriate documentation of the original 
intervention's effectiveness. This includes professional publications, 
technical reports, or other appropriate documents. These documents 
should address a description of the original intervention including the 
population served, intervention components, and the time period in 
which the intervention was conducted.

[[Page 36526]]

    (b) Describe the research methods used that include what variables 
were measured.
    (c) Describe results of the evaluation.

B. Replication Package Plans for Implementation and Evaluation

    1. Discuss the (1) purpose, (2) intended users, (3) programmatic 
objectives, (4) format, and (5) message concepts of each component of 
the package, and (6) how these features are appropriate for the 
intended partners' needs and capabilities.
    2. Explain how recipients of CDC's National Breast and Cervical 
Cancer Early Detection Programs will be involved in the development of 
the package.
    3. Describe the proposed package (materials, protocols, and 
guidelines). Examples: (1) priority populations for whom the 
replication would be appropriate; (2) specific steps for setting up the 
replication; (3) necessary collaborators; (4) necessary materials, 
other resources, and staff commitment (numbers and time) and skills for 
conducting the intervention; (5) protocols for carrying out the 
replication and ensuring quality and consistency; (6) barriers to 
implementation and how they were overcome; and (7) evaluation methods.
    4. Outline the planned procedures for reviewing and piloting 
materials developed as part of the package.
    5. Present a timeline for developing the replication package.

C. Piloting the Replication Package

    1. Discuss a plan to identify intended partners and indicate any 
that have already shown interest in or may be interested in 
implementing the replication package.
    2. Describe how the participation of partners will be solicited.
    3. Elaborate on the criteria and mechanism for selecting the 
partners who will pilot the replication package.

D. Implementing the Replication Package

    1. Describe the strategy to facilitate implementation of the 
package, including direct technical assistance from the recipient to 
the partners selected.
    2. Discuss procedures to involve selected partners in implementing 
the package to include use of the selected partner's existing staff and 
resources, and barriers to implementation and how to overcome them. 
Feasibility and ability to sustain the replication with existing 
resources are important for the successful adoption of the package.

E. Evaluation Activities

    Describe the plan for evaluating the replication package. Address: 
(1) methods, (2) research protocols that should include ongoing process 
and outcome measures, (3) supervision, (4) quality assurance, (5) 
consistency, (6) confidentiality of participant information, (7) 
employee recruitment and retention, (8) participant recruitment and 
follow-up, (9) accuracy and completeness of record keeping, (10) 
documentation of intervention episodes, (11) monitoring of intervention 
delivery, and (12) forming and maintaining collaborative relationships.

F. Capacity

    1. Demonstrate capacity to conduct the proposed activities.
    2. Explain the proposed staffing, show percentages of each staff 
member's commitment to this and other projects, division of duties and 
responsibilities for this project; include brief position descriptions 
for existing and proposed personnel.
    3. Demonstrate that the staff have the expertise to complete this 
project.
    4. Discuss any partnership between the applicant and recipients of 
CDC's National Breast and Cervical Cancer Early Detection Programs and 
also general activities, such as project oversight that will contribute 
to the completion of activities.
    5. Name the staff members that are key to the completion of the 
project. Include: (a) their curriculum vitae; (b) a description of 
their experience with interventions, particularly those involving 
breast and cervical cancer control, or the development, implementation, 
and evaluation of other health interventions, (c) a description of 
their work in developing partnerships with others, (d) and their 
experience in providing technical assistance.
    6. Describe equipment and facilities that will be used for the 
proposed activities.

G. Budget

    Provide a detailed budget and justification of all operating 
expenses consistent with the stated objectives and planned activities 
of the project. Be precise about the program purpose of each budget 
item and itemize calculations when appropriate.

Typing and Mailing

    Applicants are required to submit an original and two copies of the 
application. Appendixes should be of a reasonable length; only include 
documents necessary to support the application. Pages should be clearly 
numbered and a complete index to the application and any appendixes 
included. The original and each copy of the application must be 
submitted unstapled and unbound. All materials must be typewritten, 
single-spaced, with unreduced type on 8 1/2'' by 11'' paper, with at 
least 1'' margins, headers and footers, and printed on one side only.

Evaluation Criteria (100 Points)

    Applications will be reviewed and evaluated according to the 
following criteria:

A. Health Education and Professional Education Intervention (17 Points 
Total)

    1. Description and justification (7 points) Thoroughness of the 
description and quality of the original intervention design, 
components, and methods. Appropriateness of the intervention methods 
for the proposed priority population. Convincing need for the 
intervention's replication. Feasibility of implementation by 
organizations with limited resources. Documented permission from the 
developers of the intervention proposed for replication to publicize 
and market replication materials and protocols. As appropriate, 
information is provided on the extent to which the proposed work 
addresses the inclusion of women, racial and other ethnic minorities.
    2. Documented effectiveness (10 points) Thoroughness of the 
description of the documented effect of the intervention to be 
replicated including evaluation and research findings. Extent of the 
intervention's effectiveness, as defined in the APPLICATION CONTENT 
section. Inclusion of publications.

B. Description of the Replication Package (18 Points)

    Level of detail in the description or outline of the proposed 
package, including materials, protocols, and guidelines. Clarity of 
described intended audiences, objectives, format, and concepts. 
Justification of the appropriateness of the package's objectives, 
format, and concepts to the intended users' (e.g. health care providers 
or community-based organizations) needs and capabilities. Level of 
involvement from recipients of CDC's National Breast and Cervical 
Cancer Early Detection Programs in development of the package. Adequacy 
of method or strategy to review and pretest proposed materials. Time 
scheduled for completing the proposed steps of the package's 
development is realistic.

[[Page 36527]]

C. Description of Plan to Pilot the Package (15 Points)

    Quality of plan identifying proactive methods to identify and 
solicit intended partnerships. Adequacy of criteria and mechanism for 
selecting the partnerships for carrying out the package.

D. Description of Replication Implementation (15 Points)

    Clarity of the strategy to coordinate with selected partners in 
adopting and implementing the replication package. Understanding of 
barriers to implementation and demonstration of how to identify and 
overcome them. Adequacy and feasibility of plan to assist selected 
partners in implementing the replication package using their existing 
resources and staff.

E. Description of Plan to Evaluate Implementation (15 Points)

    Feasibility and appropriateness of the plan to evaluate the 
selected partner's implementation of the replication package. 
Intervention components to be evaluated are thorough and realistic.

F. Demonstrated Capacity (20 Points)

    Overall ability of the applicant to perform the proposed activities 
as reflected in their staff's and consultant's qualifications, 
experience with intervention development, evaluation, dissemination, 
and demonstrated familiarity with breast and cervical cancer screening 
interventions. The ability to publicize the replication. Adequacy of 
existing support staff, equipment, and facilities.

G. Budget (Not Weighted)

    Extent to which the budget is reasonable, itemized, clearly 
justified, and consistent with the intended use of the funds.

Executive Order 12372 Review

    Applications are subject to Intergovernmental Review of Federal 
Programs as governed by Executive Order (E.O.) 12372. E.O. 12372 sets 
up a system for State and local government review of proposed Federal 
assistance applications. Applicants (other than federally recognized 
Indian tribal Governments) should contact their State Single Point of 
Contact (SPOC) as early as possible to alert them to the prospective 
applications and receive any necessary instructions on the State 
process. For proposed projects serving more than one State, the 
applicant is advised to contact the SPOC of each affected State. A 
current list of SPOCs is included in the application kit. If SPOCs have 
any State process recommendations on applications submitted to CDC, 
they should send them to Sharron P. Orum, Grants Management Officer, 
Grants Management Branch, Procurement and Grants Office, Centers for 
Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE., 
Room 314, mail Stop E-18, Atlanta, Georgia 30305, no later than 30 days 
after the application deadline. The Program Announcement Number and 
Program Title should be referenced on the document. The granting agency 
does not guarantee to ``accommodate or explain'' State process 
recommendations it receives after that date.
    Indian tribes are strongly encouraged to request tribal government 
review of the proposed application. If tribal governments have any 
tribal process recommendations on applications submitted to CDC, they 
should forward them to Sharron P. Orum, Grants Management Office, 
Grants Management Branch, Centers for Disease Control and Prevention 
(CDC), 255 East Paces Ferry Road, NE., Room 314, Mailstop E-18, 
Atlanta, Georgia 30305. This should be done no later than 30 days after 
the application deadline. The granting agency does not guarantee to 
``accommodate or explain'' for tribal process recommendations it 
receives after that date.

Public Health System Reporting Requirements

    This program is subject to the Public Health System Reporting 
Requirements. Under these requirements, all community-based 
nongovernmental applicants must prepare and submit the items identified 
below to the head of the appropriate State and/or local health 
agency(s) in the program area(s) that may be impacted by the proposed 
project no later than the receipt date of the Federal application. The 
appropriate State and/or local health agency is determined by the 
applicant. The following information must be provided:
    A. A copy of the face page of the application (SF 424).
    B. A summary of the project that should be titled ``Public Health 
System Impact Statement'' (PHSIS), not to exceed one page, and include 
the following:
    1. A description of the population to be served;
    2. A summary of the services to be provided; and
    3. A description of the coordination plans with the appropriate 
State and/or local health agencies.
If the State and/or local health official should desire a copy of the 
entire application, it may be obtained from the State Single Point of 
Contact (SPOC) or directly from the applicant.

Catalog of Federal Domestic Assistance Number

    The Catalog of Federal Domestic Assistance number is 93.283.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from 10 
individuals or more and funded by the cooperative agreement will be 
subject to review by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act.

Human Subjects

    If the proposed project involves research on human subjects, the 
applicant must comply with the Department of Health and Human Services 
Regulations (45 CFR Part 46) regarding the protection of human 
subjects. Assurance must be provided to demonstrate that the project 
will be subject to initial and continuing review by an appropriate 
institutional review committee. The applicant will be responsible for 
providing assurance in accordance with the appropriate guidelines and 
form provided in the application kit, including those surrounding the 
issues of human subjects.

Women, Racial, and Ethnic Minorities

    It is the policy of the Centers for Disease Control and Prevention 
(CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) 
to ensure that individuals of both sexes and the various racial and 
ethnic groups will be included in CDC/ATSDR-supported research projects 
involving human subjects, whenever feasible and appropriate. Racial and 
ethnic groups are those defined in OMB Directive No. 15 and include 
American Indians, Alaskan Natives, Asian/Pacific Islanders, Blacks and 
Hispanics. Applicants shall ensure that racial and ethnic minority 
populations are appropriately represented in applications for research 
involving human subjects. Where clear and compelling rationale exist 
that inclusion is inappropriate or not feasible, this situation must be 
explained as part of the application. This policy does not apply to 
research studies when the investigator cannot control the race, 
ethnicity, or sex of participants. Further guidance to this policy is 
contained in the Federal Register, Vol. 60, No. 179, pages 47947-47951, 
and dated Friday, September 15, 1995.

[[Page 36528]]

Application Submission and Deadline

    The original and two copies of the application PHS Form 5161-1 
(Revised 7-92, OMB #0937-0189) must be submitted to Sharron P. Orum, 
Grants Management Officer, Procurement and Grants Office, Centers for 
Disease Control and Prevention, 255 East Paces Ferry Road, NE., Room 
314, MS E-18, Atlanta, GA 30305, on or before August 15, 1997.
    1. Deadline: Applications shall be considered as meeting the 
deadline if they are either:
    a. Received on or before the deadline date; or
    b. Sent on or before the deadline date and received in time for 
submission to the objective review group. (Applicants must request a 
legibly dated U.S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks will not be accepted as proof of timely mailing.)
    2. Late Applications: Applications that do not meet the criteria in 
1.a. or 1.b. above are considered late applications. Late applications 
will not be considered in the current competition and will be returned 
to the applicant.

Where to Obtain Additional Information

    To receive additional written information, call (404) 332-4561. You 
will be asked to leave your name, address, and telephone number. Please 
refer to Program Announcement 761. You will receive a complete program 
description, information on application procedures, and application 
forms. If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from Albertha Carey, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 314, Mail Stop 
E-18, Atlanta, Georgia 30305, telephone (404) 842-6591; electronic mail 
at [email protected].
    Programmatic technical assistance may be obtained from Corinne 
Graffunder or Patti Poindexter, Program Services Branch, Division of 
Cancer Prevention and Control, National Center for Chronic Disease 
Prevention and Health Promotion, Centers for Disease Control and 
Prevention (CDC), 4770 Buford Highway NE., Mailstop K-57, Atlanta, GA 
30341-3724; telephone (770) 488-4880; electronic mail at [email protected] 
and [email protected], respectively.
    You may obtain this announcement from one of two Internet sites on 
the actual publication date: CDC's homepage at http://www.cdc.gov or 
the Government Printing Office homepage (including free on-line access 
to the Federal Register at http://www.access.gpo.gov).
    Please refer to Announcement Number 761 when requesting information 
and submitting an application.
    Potential applicants may obtain a copy of Healthy People 2000 (Full 
Report; Stock No. 017-001-00474-0) or Healthy People 2000 (Summary 
Report; Stock No. 017-001-00473-1) referenced in the Introduction 
through the Superintendent of Documents, Government Printing Office, 
Washington, DC 20402-9325; telephone (202) 512-1800.

    Dated: July 1, 1997.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 97-17698 Filed 7-7-97; 8:45 am]
BILLING CODE 4163-18-P