[Federal Register Volume 63, Number 109 (Monday, June 8, 1998)]
[Notices]
[Pages 31221-31224]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-15122]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Program Announcement 98079]


State Grants to Support the Evaluation of 5 A Day Nutrition 
Programs

Introduction

    The Centers for Disease Control and Prevention (CDC), in 
partnership with the National Cancer Institute (NCI), announces the 
availability of fiscal year (FY) 1998 funds for grants to support the 
evaluation of State and community 5 A Day nutrition intervention 
programs. This announcement addresses one required component, which is 
the ``5 A Day Evaluation'' for supporting the evaluation of 5 A Day for 
Better Health nutrition intervention programs. 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 improve the quality of life. This announcement is related 
specifically to the priority area of Nutrition. (For ordering a copy of 
Healthy People 2000 see the Section, ``Where to Obtain Additional 
Information.'')

Authority

    This program is authorized under section 317(k)(2)(42 U.S.C. 
247b(k)(2)) of the Public Health Service Act, as amended.

Smoke-Free Workplace

    CDC encourages all grant recipients to provide a smoke-free 
workplace and promote the nonuse of all tobacco products, and Pub. L. 
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

    Eligible applicants are the official public health agencies of 
States or their bona fide agents. This includes the District of 
Columbia, American Samoa, the Commonwealth of Puerto Rico, the Virgin 
Islands, the Federated States of Micronesia, Guam, the Northern Mariana 
Islands, the Republic of the Marshall Islands, the Republic of Palau, 
and federally recognized Indian tribal governments, that have 
established, clearly-defined, measurable, long-range 5 A Day for Better 
Health projects in a specific community channel.

Availability of Funds

    Approximately $450,000 is available in FY 1998 to fund 
approximately 6 awards. It is expected that the average award will be 
$75,000 ranging from $55,000 to $90,000 for a 5 A Day for Better Health 
project in a specific community channel, preferably focusing on 
interventions in minority-based population subgroups (i.e. American 
Indian, Asian, Pacific Islander, African American, Hispanic, elderly, 
low socioeconomic status, or the very young). It is expected that the 
awards will begin on or about September 30, 1998, and will be made for 
a 12-month budget period within a project period of one year. Funding 
estimates may vary and are subject to change. Awards under this 
announcement will not be sufficient to fully support an applicant's 
proposed activities, but are meant to be used in conjunction with other 
resources--whether direct funding or in-kind contributions--that the 
applicant may have available.

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 sub-tier contractors) are prohibited from using appropriated 
Federal funds (other than profits from Federal contract) for lobbying 
Congress or any Federal agency in connection with the award of a 
particular contract, grants 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 1998 Department of 
Labor, Health and Human Services, and Education, and Related Agencies 
Appropriations Act (Pub. L. 105-78) states in Section 503(a) and (b) no 
part of any appropriation contained in this Act shall be used, other 
than for normal and recognized executive-legislative relations, 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 or any State legislature, except in presentation to 
the Congress or any State legislative body itself. 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

    The Surgeon General's Report on Nutrition and Health in 1988 noted 
that two-thirds of all deaths are due to diseases associated with diet. 
The report also says that the three most important personal habits that 
influence health are smoking, alcohol consumption, and diet. For the 
two out of three adults who do not drink alcohol excessively or smoke, 
the single most important personal choice influencing long-term health 
is what they eat. Improving dietary intake and physical activity levels 
of minority populations (American Indian, Asian, Pacific Islander, 
African American, Hispanic, elderly, low socioeconomic status, or the 
very young) could substantially extend productive lives and reduce the 
human and financial costs of chronic disease, disability, and premature 
death within population subgroups that suffer a disproportionate cancer 
burden.
    Using effective nutrition education strategies to reach under 
served minority populations in order to initiate successful behavior 
change are critical since healthy eating practices are more likely to 
be obtained with well-developed, culturally-sensitive, linguistically 
appropriate intervention methods that are effective in reaching the 
targeted audience and assist in transforming the local environment. 
Modifications in the environment help promote, support, and 
institutionalize healthy eating practices, and as this transformation 
occurs in various channels, community norms will be transformed also. 
Culturally sensitive and linguistically appropriate interventions 
combined with environmental support can promote lifelong healthy eating 
practices. The Healthy People 2000 national objectives include an 
objective intended to reduce the current high burden of chronic disease 
and premature death: increase fruit and vegetable intake (from 2.5 to 5 
servings per day). To date, progress is slow achieving this objective 
through culturally specific, linguistically appropriate interventions 
and environmental community approaches, especially among minorities and 
economically disadvantaged Americans who are at increased risk for many 
chronic diseases. The 5 A Day for Better Health Program is a nationwide 
effort, lead by the National Cancer Institute (NCI), to achieve the 
Healthy People

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2000 objective for five or more servings per day of fruits and 
vegetables. The CDC is collaborating with NCI to support the activities 
of State health departments in the implementation and evaluation of the 
State 5 A Day activities.

Purpose

    These awards will support State efforts to evaluate 5 A Day 
nutrition intervention programs. Emphasis will be placed on:
    (1) Evaluation of a community intervention's impact on knowledge, 
attitude, awareness and behavioral change in minority-based population 
groups (such as elderly, young children or low-income groups, and 
ethnic groups such as, but not exclusive to, American Indians, Asians, 
Pacific Islanders, African Americans or Hispanics) which have low fruit 
and vegetable intakes or have a disproportionately greater risk for 
cancer;
    (2) Testing the effects of culturally sensitive and linguistically 
appropriate strategies within a community intervention designed to 
increase the consumption of fruits and vegetables in minority 
population subgroups and promote other related lifestyle behaviors 
which are recognized covariates that influence fruit and vegetable 
consumption; or
    (3) Evaluation of communication channels (radio, tv, print media) 
which target the specific minority population subgroups identified as 
part of 5 A Day-based community intervention campaigns.

Program Requirements

    Applicants should propose an evaluation plan for a clearly defined, 
established, long-range effort in one or more specific community 
channels in accordance with the following definitions:

A. Clearly Defined

    Intervention objectives are clearly stated; activities necessary to 
accomplish objectives are described, to include who is responsible for 
each activity and when they will be accomplished; and work is done 
within a specific channel with a defined targeted audience.

B. Established

    The applicant is licensed with NCI and has developed an ongoing 5 A 
Day Program. Evaluating pretested or piloted interventions is 
desirable.

C. Evaluation Plan

    Clear, measurable evaluation objectives and expected outcomes are 
defined with appropriate statistical power. Use of current theoretical 
frameworks to guide the evaluation study is desirable. A combination of 
process and impact objectives is also desirable, with outcome 
objectives where feasible. In designing the study, consideration should 
be given to the number of individuals or groups needed to detect 
realistic changes in post-intervention outcome measures when compared 
with pre-intervention measures. Sample sizes should give adequate power 
(80 percent) to detect these changes. If the appropriate design 
expertise does not exist within the State health department, inclusion 
of an organization with the necessary design expertise on the project 
team, such as a university affiliate, is recommended.

D. Long Range

    The program is not just a single activity at one point in time, but 
a sustained effort involving appropriate behavior change strategies. 
Programs including environmental approaches, such as administrative 
changes, are encouraged.

Technical Reporting Requirements

    An original and two copies of a final progress report and financial 
status report are required no later than 90 days after the end of the 
budget/project period. Final financial and performance reports are 
required no later than 90 days after the end of the budget/project 
period. All reports are submitted to the Grants Management Branch, 
Procurement and Grants Office, CDC.
    The progress reports must include the following for each program, 
function, or activity involved: (1) A comparison of the actual 
accomplishments to the goals established for the period; (2) the 
reasons for slippage if established goals were not met; and (3) other 
pertinent information including, when appropriate, analysis and 
explanation of unexpectedly high costs for performance.

Application Content

    Applications must be developed in accordance with Form PHS-5161-1 
(Revised May 1996, OMB Number 0937-0189), information contained in this 
program announcement, and instructions provided in this section.
    A 10-page narrative, excluding the budget and attachments, is 
required and must contain the following information:

A. Background

    Provide a brief but clear description of a current long-range 
project in one or more specific community channels including project 
goals and objectives, target group, methodology of intervention, and 
length of time of the current project.

B. Program Plan

    Provide a realistic, time phased, and specific work plan including 
evaluation goals, objectives, methods, and outcomes to be achieved 
during the 12-month period; and a clear plan to evaluate the current 
long-range effort in a particular channel or channels and assess the 
impact of those activities with measures of process and outcomes 
related to the targeted audience. Examples of potential evaluation 
projects might include but are not limited to the following:
    a. Evaluation of the process and impact of instituting a community 
neighborhood 5 A Day project targeting for example minority, elderly, 
youth, or low-income groups and its effect on perceived barriers, 
attitudes, beliefs, dietary behaviors and fruit and vegetable 
consumption.
    b. Evaluation of innovative measurement techniques appropriate for 
targeted minority audiences and their perceptions/response to the 
current 5 A Day Program recommendations of 5 to 9 servings of fruits 
and vegetables daily.
    c. Evaluate the impact of a 5 A Day media and/or education campaign 
on knowledge, attitudes, and behaviors of targeted minority community 
members, with a focus on issues of awareness translating to action/
behavioral stages of change and changes in fruit and vegetable 
consumption. (e.g. food assistance program like Women Infant Children 
(WIC) or other community-based program combined with a media 
intervention).
    d. Evaluate an intervention that promotes healthy dietary choices 
(5 A Day) and physical activity in a defined community setting with a 
focus on the effect of affiliated environmental change(s) on behavior.

C. Capacity

    Document the expertise of the evaluation team by including the 
curriculum vitae (limited to 1 page attachment per person) for key 
members of the team. If sufficient evaluation expertise is not 
available in the State health department, States are strongly 
encouraged to work with an academic institution in the design, data 
collection, and analysis activities for this evaluation. For 
interventions involving

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administrative changes, describe the infrastructure that is or will be 
in place to support the administrative change once made in the defined 
setting.

D. Human Subjects

    Documentation that human subject assurances are met, either through 
copies of approved protocols or notation of the institutional review 
committee that will review the project, particularly if the 
intervention targets children or pregnant women. Should human subjects 
review be required, the proposed work plan should incorporate time 
lines for such development and review activities.

E. Budget

    Provide a detailed budget and line-item justification that is 
consistent with the stated objectives, purpose, and planned activities 
of the project. (Not to be counted as part of the 10 page narrative.)
    An original and two copies of the application are required. Pages 
should be numbered, and an index to the application and appendix must 
be 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. 
Materials that should be part of the basic plan will not be accepted if 
placed in the appendix. Appendix material should not exceed 25 pages. 
Please do not include reports (or portions thereof), journal articles, 
mass media articles, or presentations of national statistical data.

Evaluation Criteria (100 Points)

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

A. Background: (25 Points)

    The degree to which the applicant clearly describes a long-range, 
clearly defined, measurable project, including a description of the 
intervention targeted population, method, and community channel(s).

B. Program Plan: (45 Points)

    The adequacy of the applicant's plan to carry out the evaluation 
within the 12-month time period, including the specific objectives, 
methods, and measures to be used in the evaluation.

C. Capacity: (30 Points)

    The capabilities of the personnel (including consultants where 
appropriate) to carry out the evaluation.

D. Human Subjects: (Not Weighted)

    Whether or not exempt from the Department of Health and Human 
Services (HHS) regulations, are procedures adequate for the protection 
of human subjects? Recommendations on the adequacy of protections 
include: (1) Protections appear adequate and there are no comments to 
make or concerns to raise, (2) protections appear adequate, but there 
are comments regarding the protocol, (3) protections appear inadequate 
and there are concerns related to human subjects, or (4) disapproval of 
the application is recommended because the research risks are 
sufficiently serious and protection against the risks are inadequate as 
to make the entire application unacceptable.

E. Budget: (Not Weighted)

    The extent to which the applicant provides a detailed budget and 
line-item justification that is consistent with the evaluation plan.

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, Mailstop 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 not subject to the Public Health System Reporting 
Requirements.

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 or more 
individuals 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. In addition to other applicable 
committees, Indian Health Service (IHS) institutional review committees 
also must review the project if any component of IHS will be involved 
or will support the research. If any American Indian community is 
involved, its tribal government must also approve that portion of the 
project applicable to it. The applicant will be responsible for 
providing assurance in accordance with the appropriate guidelines and 
form provided in the application kit. Should human subjects review be 
required, the proposed work plan should incorporate time lines for such 
development and review activities.

Women, Racial and Ethnic Minorities

    It is the policy of the CDC to ensure that women and racial and 
ethnic groups will be included in CDC-supported research projects 
involving

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human subjects, whenever feasible and appropriate. Racial and ethnic 
groups are those defined in OMB Directive No. 15 and include American 
Indian or Alaskan Native, Asian, Black or African American, Native 
Hawaiian or Other Pacific Islander, and Hispanic or Latino. Applicants 
shall ensure that women and racial and ethnic minority populations are 
appropriately represented in applications for research involving human 
subjects. Where clear and compelling rationale exist that inclusion is 
not feasible, this situation must be explained as part of the 
application. In conducting the review of applications for scientific 
merit, review groups will evaluate proposed plans for inclusion of 
minorities and both sexes as part of the scientific assessment and 
assigned score. This policy does not apply to research studies when the 
investigator cannot control the race, ethnicity and/or sex of subjects. 
Further guidance to this policy is contained in the Federal Register, 
Vol. 60, No. 179, Friday, September 15, 1995, pages 47947-47951.

Application Submission and Deadline

    The original and two copies of the application PHS Form 5161-1 
(Revised 5/96, OMB Number 0937-0189) must be submitted 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, Mailstop E-18, Atlanta, GA 
30305, on or before July 1, 1998.
    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 shall 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 and will be returned to the 
applicant.

Where To Obtain Additional Information

    To receive additional written information, call (888) 472-6874. You 
will be asked to leave your name, address, and telephone number. Please 
refer to Announcement 98079. 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 Sheryl L. Heard, 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, GA 30305, telephone (404) 842-6802; electronic mail at 
[email protected].
    Programmatic technical assistance may be obtained from Sarah 
Kuester, MS, RD, Division of Nutrition and Physical Activity, National 
Center for Chronic Disease Prevention and Health Promotion, Centers for 
Disease Control and Prevention (CDC), 4770 Buford Highway, NE., Mail 
Stop K-26, Atlanta, GA 30341-3724, telephone (770) 488-6019, fax (770) 
488-6000, or Internet or CDC WONDER electronic mail at [email protected].
    You may obtain this announcement from CDC's homepage at http://
www.cdc.gov.
    Please refer to Program Announcement 98079 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: June 1, 1998.
John L. Williams,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention (CDC).
[FR Doc. 98-15122 Filed 6-5-98; 8:45 am]
BILLING CODE 4163-18-P