[Federal Register Volume 68, Number 60 (Friday, March 28, 2003)]
[Notices]
[Pages 15191-15196]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-7452]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 03037]


Communication and Negotiation About Barrier Contraceptive Use 
Among Young Adults at Risk; Notice of Availability of Funds

    Application Deadline: May 27, 2003.

A. Authority

    This program is authorized under sections 301(a) and 317(k)(2) of 
the Public Health Service Act, [42 U.S.C. sections 247b(k)(2)], as 
amended. The

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Catalog of Federal Domestic Assistance number is 93.283.

B. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year 2003 funds for a cooperative agreement for 
Communication and Negotiation About Barrier Contraceptive Use Among 
Young Adults At Risk. This program addresses the ``Healthy People 
2010'' focus areas family planning, HIV, and sexually transmitted 
diseases.
    The purpose of this program is to investigate the context within 
which sexually active young adult African American and Latino women and 
men (ages 18-25) communicate sexual values and negotiate about barrier 
contraceptive use (use of male condoms, female condoms, or the 
diaphragm). The program will develop, implement and evaluate case study 
intervention models to encourage choices and effective negotiation 
skills for prevention of HIV/STDs and unplanned pregnancies.
    In Phase I, support will be provided for multi-method formative 
approaches toward understanding communication between heterosexual 
partners about sexual abstinence, monogamy, and barrier contraceptive 
use and factors influencing implicit expectations (about gender roles, 
reproductive ambivalence, competing contraceptive alternatives, power, 
cultural values, social norms, etc.) and explicit negotiation 
processes. This phase will culminate with the development of a plan for 
an intervention model.
    Phase II will support implementation of case studies of community-
based intervention models to facilitate communication about 
reproductive decision making and barrier contraceptive use among young 
adult women and men with their partners, using information gathered in 
Phase I.
    Measurable outcomes of the program will be in alignment with the 
following performance goal for the National Center for Chronic Disease 
Prevention and Health Promotion (NCCDPHP): Support prevention research 
to develop sustainable and transferable community-based behavioral 
interventions.

C. Eligible Applicants

    Applications may be submitted by public and private nonprofit 
organizations and by governments and their agencies; that is, 
universities, colleges, technical schools, research institutions, 
hospitals, other public and private nonprofit organizations, community-
based organizations, faith-based organizations, state and local 
governments or their bona fide agents, including the District of 
Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, the 
Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the 
Federated States of Micronesia, the Republic of the Marshall Islands, 
and the Republic of Palau, federally recognized Indian tribal 
governments, Indian tribes, or Indian tribal organizations. Title 2 of 
the United States Code section 1611 states that an organization 
described in section 501(c)(4) of the Internal Revenue Code that 
engages in lobbying activities is not eligible to receive Federal funds 
constituting an award, grant, or loan.

D. Funding

Availability of Funds

    Approximately $800,000 is available in FY 2003 to fund 
approximately two awards. It is expected that the average award will be 
$400,000, ranging from $300,000 to $450,000. It is expected that the 
awards will begin on or about September 1, 2003 and will be made for a 
12-month budget period within a total project period of five years; the 
first phase will be for two-three years and the second phase will occur 
during the subsequent two-three years. Awards for Phase II will be 
subject to documented collaboration with community partner(s) and 
availability of funds. Funding estimates may change.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.

Recipient Financial Participation

    No matching funds are required for this program.

Funding Priority

    Priority will be given to projects that demonstrate access to and 
propose to target young adult women and men at high risk for STDs, 
including HIV, and unintended pregnancies. Communities in which 
research is to be conducted, and interventions fielded, should be 
predominately African American or Latino and disproportionately 
affected by HIV and other STDs. Priority will be given to communities 
with rates of chlamydia, gonorrhea, and teen pregnancy that are above 
national average rates.
    Funds may be awarded in such a way as to achieve geographic 
distribution of funded projects.

E. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for activities listed under Recipient 
Activities, and CDC will be responsible for activities listed under CDC 
Activities.

Recipient Activities

    The recipient will be responsible for conducting the research 
outlined in Phase I, and using the formative research collected during 
this Phase to develop an intervention plan and case study evaluation 
for Phase II. Funding for Phase II will be contingent upon satisfactory 
progress as evidenced by required reports, the intervention plan, the 
documented establishment of a formal collaboration with a community-
based organization equipped to implement the intervention model, and 
availability of funds. A complete description of the activities 
required within Phase I and Phase II follows.

Phase I (Years One to Two or One to Three)

    This program announcement seeks a multi-method approach toward 
understanding the complexity of communication between partners: To what 
extent does negotiation about sexual choices, including monogamy, 
abstinence, and explicit barrier contraceptive use take place and by 
whom; the nature of the actual communication processes; and the context 
within which they lead to different outcomes. In this initial formative 
phase of the project, applicants are encouraged to propose creative, 
innovative data collection methods that will yield information about 
individual, social, and cultural factors that affect contraceptive 
decision making and behavior that may be used in the Phase II 
intervention design.
    Activities to be conducted are:
    1. Clearly identify key research questions to be addressed 
including, but not limited to:
    a. How do young adult men and women make decisions about 
abstinence, sexual initiation, and monogamy?
    b. How do sexually active young adult men and women decide to use 
barrier contraception and how are these choices negotiated? Or if not 
directly negotiated, how do social roles, norms, and expectations 
influence these decisions?
    c. How are intimacy and commitment to mutual monogamy assumed, 
expected, and communicated between partners, and how do couples that 
perceive themselves as mutually monogamous communicate about barrier 
methods?
    d. Are power differentials between young adult men and women 
perceived, and if so, how are they communicated (verbally or 
nonverbally)?

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    e. What are the tacit assumptions made or the explicit negotiation 
strategies commonly used by young women and men and how do partners 
respond to each approach (what contextual factors are important)?
    f. Do young adult women and men use hierarchical strategies, if 
they have multiple contraceptive methods available?
    g. What social and cultural factors predict young adult men's 
receptiveness to safe sex negotiation strategies offered by a female 
partner? What social and cultural factors predict young adult men's 
ability or willingness to negotiate?
    h. How does marital and childbearing motivation, including cultural 
expectations, ambivalence about pregnancy and perceptions of each 
other's desires affect communication?
    i. How do young adult men communicate their reproductive values to 
their partners and what is the context in which this occurs?
    j. How does communication about hormonal contraceptive use (e.g., 
oral contraceptives, implants, injectables, ring, patch) occur and what 
is the context in which it occurs or what prompts it to occur?
    2. Conduct comprehensive literature review related to identified 
research questions.
    3. Identify and recruit sexually active women and men, ages 18-25 
from predominantly African American or Latino communities with 
documented HIV/STD risk characteristics (rates of chlamydia, gonorrhea, 
and teen pregnancy above national average rates).
    4. Conduct formative research activities such as the following, but 
not limited to:
    a. Development of vignettes or scenarios depicting communication of 
values and barrier negotiation strategies. Presentation of these 
vignettes to young adult men and women (individually or in groups), and 
assessment of their qualitative responses, similar experiences, and 
further development of the situations (for intervention planning).
    b. Mixed or same sex focus groups to explore cultural/environmental 
influences and the role of peers in shaping attitudes toward 
communication about sexual values and choices, including barrier 
contraception. If focus groups are conducted, ensure that the 
appropriate privacy concerns are addressed, as information provided 
will be sensitive and confidential.
    c. In-depth qualitative interviews with young adult men and women 
who are sexually active. May consider their specific experiences with 
barrier contraceptive use, including successful communication, 
avoidance of use or dissuasion of a partner, partner responses, and 
perceptions of partner attitudes, roles, and monogamy. May explore 
implicit or explicit reproductive issues along with the context of 
negotiating hormonal contraceptive use (including newer methods, such 
as the contraceptive patch, ring, and emergency contraception).
    d. Observational study of cohort of sexually active young adult men 
and women provided with barrier contraceptives (male condom, female 
condom, or diaphragm), trained in use of coital diaries (possibly a 
software log), and interviewed at follow-up intervals to assess act-by-
act experiences with negotiation and partner communication (including 
contextual factors).
    5. Conduct analyses of data collected using, but not limited to, 
these methods:
    a. Identify the characteristics of different negotiation/
communication styles among young adult women and men.
    b. Identify key influences on these negotiation and communication 
styles.
    c. Develop or identify existing quantitative measures of key 
variables that could be used in Phase II and be hypothesized to predict 
the behavior of women and men with different communication styles.
    d. Collaborate with other recipients in the development and 
measurement of a common core set of variables to permit comparative 
analyses.
    6. Develop a plan for using this formative research in the design 
of a theory and evidence-based intervention model feasible for 
implementation in a community-based case study.
    a. Present relevant conceptual foundation for the model.
    b. Integrate the results of the research with literature on 
communication interventions and strategies. As part of this synthesis, 
thoroughly document the intervention models and strategies that already 
exist.
    c. Based on formative research, theory and the review of the 
intervention research, develop state-of-the-art recommendations on 
intervention strategies to promote successful negotiation and 
communication for young adult women and men at risk. These 
interventions must consider the characteristics of the community and 
cultural contexts of the participants' lives.
    d. Collaborate with other recipients during development of design 
and protocol.
    7. Establish and document formal collaboration with a community-
based organization(s) or partner qualified to carry out the work 
proposed in Phase II.

Phase II (Years Three to Five or Four to Five)

Case Study: Community-Based Intervention Models
    Project(s) in this phase would implement and conduct a feasibility 
assessment of an intervention for facilitating reproductive decision-
making and effective barrier contraceptive negotiation by young adult 
women and men based on the selected intervention plan. Proposed 
interventions should address the subtle strategies and interpersonal 
pathways to successful communication, the contextual (social normative, 
etc.) factors that facilitate or constrain negotiation and 
communication, and be designed to influence large numbers of young 
adult men and women in a community. Applicant activities to be 
conducted are:
    1. Collaborate with community partners and members of the target 
group to plan all phases of the project.
    2. Identify a community site for implementation of the case study. 
A comparison community may be used as part of a case study approach to 
evaluation that includes extensive process evaluation, documenting all 
aspects of program design and implementation.
    3. Clearly state the objectives of the proposed intervention model.
    4. Propose an intervention model that could be replicated in 
community-based settings (a concept and preliminary approaches proposed 
in this application must be fully developed based on Phase I: six a-d).
    5. Develop and implement community-based intervention strategies 
that have the potential for broad reach and high impact.
    6. The cost effectiveness of the model as a public health 
intervention must be addressed. Interventions that are costly and 
logistically difficult for implementation in public health settings, 
such as couples-based counseling interventions for young adults, will 
not be supported by this announcement.
    7. Collaborate with other recipients during the development and 
implementation of the project evaluation.

CDC Activities

    1. Host meetings each year to facilitate planning of the research 
program and to promote progress toward meeting national health 
objectives.
    2. Provide technical assistance in the design and development of 
the

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formative research, scientific review and evaluation of measurement 
strategies and instruments, and development of operational plans for 
the protocols. Coordinate review of intervention plans and process 
evaluation strategies.
    3. Coordinate plans for data management and analysis of data from 
Phase I and Phase II; assist with development of plan for, and 
participation in analysis, preparation, and reporting of results.
    4. Assist with development of a research protocol for Institutional 
Review Board (IRB) review by all cooperating institutions participating 
in the research project. Perform site visits to assess program progress 
and to provide technical assistance.

F. Content

Letter of Intent (LOI)

    A LOI is required for this program. The Program Announcement title 
and number must appear in the LOI. The LOI narrative should be no more 
than three pages, double-spaced, printed on one side, with one-inch 
margins, and unreduced 12-point font. The LOI will be used to enable 
CDC to determine the level of interest in the announcement and should 
include the following information: Target group and site 
characteristics, experience collaborating with relevant community 
partner(s) and specific objectives to be addressed in the proposed 
project.

Applications

    Program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. The application narrative should be no more than 25 pages single-
spaced, printed on one side, with one-inch margins, and unreduced 12-
point font.
    The narrative should consist of a Background and Significance 
section, a Plan, Objectives, Methods, a Research and Intervention 
Capacity section, a Collaboration section, Evaluation, and Budget.

G. Submission and Deadline

Letter of Intent (LOI) Submission

    On or before April 28, 2003. Submit the LOI to the Grants 
Management Specialist identified in the ``Where to Obtain Additional 
Information'' section of this announcement.

Application Forms

    Submit the signed original and two copies of application form PHS 
398. Forms are available at the following Internet address: http://www.cdc.gov/od/pgo/forminfo.htm If you do not have access to the 
Internet, or if you have difficulty accessing the forms on-line, you 
may contact the CDC Procurement and Grants Office Technical Information 
Management Section (PGO-TIM) at: 770-488-2700. Application forms can be 
mailed to you.

Submission Date, Time, and Address

    The application must be received by 4 p.m. Eastern Time May 27, 
2003. Submit the application to: Technical Information Management-
PA 03037, Procurement and Grants Office, Centers for Disease 
Control and Prevention, 2920 Brandywine Rd, Atlanta, GA 30341-4146.

CDC Acknowledgement of Application Receipt

    A postcard will be mailed by PGO-TIM, notifying you that CDC has 
received your LOI and application.

Deadline

    Letters of intent and applications shall be considered as meeting 
the deadline if they are received before 4 p.m. Eastern Time on the 
deadline date. Any applicant who sends their LOI or application by the 
United States Postal Service or commercial delivery services must 
ensure that the carrier will be able to guarantee delivery of the 
application by the closing date and time. If an LOI or application is 
received after closing due to (1) carrier error, when the carrier 
accepted the package with a guarantee for delivery by the closing date 
and time, or (2) significant weather delays or natural disasters, CDC 
will upon receipt of proper documentation, consider the application as 
having been received by the deadline.
    Any LOI or application that does not meet the above criteria will 
not be eligible for competition, and will be discarded. The applicant 
will be notified of their failure to meet the submission requirements.

H. Evaluation Criteria

Application

    Applicants are required to provide measures of effectiveness that 
will demonstrate the accomplishment of the various identified 
objectives of the grant or cooperative agreement. Measures of 
effectiveness must relate to the performance goal stated in section 
``B. Purpose'' of this announcement. Measures must be objective and 
quantitative and must measure the intended outcome. These measures of 
effectiveness shall be submitted with the application and shall be an 
element of evaluation.
    An independent review group appointed by CDC will evaluate each 
application against the following criteria (in order of weight):
1. Methods (30 points)
    The extent to which the design, methods, plans for instrument 
development, data collection, and analysis for Phase I are 
scientifically sound and capable of producing the intended results. The 
extent to which the research is innovative and represents a new 
approach by integrating new literature sources and using sophisticated 
methodology to identify subtle or complex communication variables. The 
extent to which the data synthesis process can be clearly used in a 
timely manner for development of the Phase II intervention plan. The 
extent to which the proposed intervention approaches for Phase II 
represent a consideration of appropriate theoretically, empirically, 
and programmatically justified intervention approaches which could 
realistically be adapted using Phase I data. The proposed intervention 
model should be feasible in community-based settings in which many 
women and men might be influenced. The extent to which the applicant 
describes a plan for process evaluation to be conducted during Phase 
II.
2. Background and Significance (15 points)
    The extent to which the applicant: Describes the background leading 
to the application, including the theoretical or conceptual framework; 
critically evaluates existing knowledge; specifically identifies gaps 
that the Phase I project is intended to fill; and describes the target 
population and the potential health impact of the research and 
intervention.
3. Plan (15 points)
    The quality of the justification for the theoretical, empirical and 
programmatic focus of Phase I research and the approach proposed for 
the Phase II intervention model (approaches and concepts considered for 
design of Phase II are expected in the application; the proposed 
intervention plan may be revised and will be fully developed at the end 
of Phase I).
    The extent to which the applicant describes the proposed research 
plan for Phase I and the plan for establishing collaboration with a 
community-based

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organization/partner qualified to carry out the work proposed in Phase 
II. In Phase I, linkage between the research questions and the 
formative research activities should be clearly presented. The extent 
to which the applicant proposes a feasible case study plan for Phase 
II.
    The applicant must address the CDC Policy requirements regarding 
the inclusion of women, ethnic, and racial groups in the proposed 
research plan. This includes:
    1. The proposed plan for the inclusion of both sexes and racial and 
ethnic minority populations for appropriate representation.
    2. The proposed justification when representation is limited or 
absent.
    3. A statement as to whether the design of the study is adequate to 
measure differences when warranted.
    4. A statement as to whether the plans for recruitment and outreach 
for study participants include the process of establishing partnerships 
with community(ies) and recognition of mutual benefits.
4. Objectives (10 points)
    The extent to which the applicant describes the broad objectives 
and the specific research questions this project is intended to address 
in Phase I and II. The research questions must address multiple levels: 
individual, partner, social, cultural, and other contextual variables. 
The objectives must be quantifiable in terms of output and timeline.
5. Research and Intervention Capacity (10 points)
    The extent to which the applicant provides an account of the 
research team members' studies pertinent to the application that will 
help establish the experience and competence of the team members to 
pursue both phases of the proposed project. The extent to which the 
applicant documents access to researchers with experience and training 
in analysis of qualitative data, demonstrates the capacity to obtain 
the participation of adequate numbers of male and female participants 
from the proposed sites, and describes the adequacy of the staff (in 
each phase) and facilities to feasibly carry out the project. Extent of 
experience with formative research on this topic, experience conducting 
community-based interventions addressing sexual risk behavior or 
reproductive health, and experience implementing process evaluations.
6. Collaboration (10 points)
    The extent to which the applicant describes how community partners 
and members of the target group will be involved in Phase I and 
potentially Phase II, defines the responsibilities of organizations in 
the community on this project and highlights past involvement with 
community-based organizations or partners (provides letters of 
support).
7. Evaluation (10 points)
    The methods by which the applicant proposes to measure progress in 
meeting goals and objectives, and presents a reasonable plan for 
collecting data, analyzing data, and reporting the results. Quality 
assurance plan must be addressed.
8. Budget (reviewed but not scored)
    The extent to which the budget and justification are consistent 
with program objectives and purpose.
9. Human Subjects Involvement (reviewed but not scored)
    The extent to which the applicant addresses the requirements of 45 
CFR part 46 for the protection of human subjects. Not scored; however, 
an application can be disapproved if the research risks are 
sufficiently serious and protection against risks is so inadequate as 
to make the entire application unacceptable.
10. Performance Goals (reviewed but not scored)
    The extent to which the applicant addresses the relevant 
Performance goals. The relevant goals include (timeline may vary):
    Year 1: Design the formative research component, including 
literature review, methods, sampling frame, data collection 
instruments, and IRB package.
    Year 2: Conduct data collection and prepare a detailed analysis and 
publication plan.
    Year 3: Analyze the data, synthesize data with review of literature 
on communication interventions and strategies, prepare a report and 
develop an intervention and evaluation plan.
    Year 4: Pending approval and funds, implement the intervention and 
prepare an interim process evaluation report.
    Year 5: Evaluate the intervention and prepare a final report 
summarizing results of the case study and recommendations for 
technology transfer.

I. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. An interim progress report. The interim progress report will be 
due on the 15th of March each year through 2008. This interim progress 
report will serve as your non-competing continuation application. A 
second report is due 90 days after the end of each budget period. These 
reports must include the following elements:
    a. A succinct description of the program accomplishments and 
progress made in meeting each Current Budget Period Activities 
Objectives during the previous six months of the budget period.
    b. A succinct description of the program accomplishments/narrative 
and progress made in meeting each Current Budget Period Activities 
Objectives during the previous six months of the budget period.
    c. The reason(s) for not meeting established program objectives and 
strategies to be implemented to achieve unmet objectives.
    d. Current Budget Period Financial Progress.
    e. New Budget Period Proposed Activities and Objectives.
    f. Detailed Line-Item Budget and Justification.
    g. For all proposed contracts, provide the name of contractor, 
method of selection, period of performance, scope of work, and itemized 
budget and budget justification. If the information is not available, 
please indicate ``To Be Determined'' until the information becomes 
available; it should be submitted to CDC Procurement and Grants 
Management Office contact identified in this program announcement.
    2. Financial status report, no more than 90 days after the end of 
the budget period. The financial status report should include an 
attachment that identifies unspent balances for each program component.
    3. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    Send all reports to the Grants Management Specialist identified in 
the ``Where to Obtain Additional Information'' section of this 
announcement.

Additional Requirements

    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment I of the 
program announcement as posted on the CDC Web site.

AR-1 Human Subjects Requirements
AR-2 Requirements for Inclusion of Women and Racial and Ethnic 
Minorities in Research

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AR-5 HIV Program Review Panel Requirements
AR-7 Executive Order 12372 Review
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2010
AR-12 Lobbying Restrictions

J. Where To Obtain Additional Information

    This and other CDC announcements, the necessary applications, and 
associated forms can be found on the CDC Web site, Internet address: 
http://www.cdc.gov.
    Click on ``Funding'' then ``Grants and Cooperative Agreements''.
    For general questions about this announcement, contact: Technical 
Information Management, CDC Procurement and Grants Office, 2920 
Brandywine Rd, Room 3000, Atlanta, GA 30341-4146, Telephone: 770-488-
2700.
    For business management and budget assistance, in the states, 
contact: LaKassa Wyatt, Procurement and Grants Office, Centers for 
Disease Control and Prevention, 2920 Brandywine Road, Room 3000, 
Atlanta, GA 30341-4146, Telephone: 770-488-2728, E-mail address: 
[email protected].
    For business management and budget assistance in the territories, 
contact: Charlotte Flitcraft, Centers for Disease Control and 
Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341-4146, 
Telephone: 770-488-2632, E-mail address: [email protected].
    For program technical assistance, contact: Rebecca Cabral, Ph.D., 
Division of Reproductive Health, Centers for Disease Control and 
Prevention, 4770 Buford Hwy, NE., Atlanta, GA 30341, Telephone: 770-
488-6399, E-mail address: [email protected].

    Dated: March 24, 2003.
Sandra R. Manning,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention.
[FR Doc. 03-7452 Filed 3-27-03; 8:45 am]
BILLING CODE 4163-18-P