[Federal Register Volume 68, Number 109 (Friday, June 6, 2003)]
[Notices]
[Pages 33952-33955]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-14271]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 03030]


Controlling Asthma in American Cities Project Phase II-
Intervention Implementation; Notice of Availability of Funds

    Application Deadline: July 7, 2003.

A. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under section 301 and 317 of the Public 
Health Service Act, (42 U.S.C. 241 and 247b), as amended. The 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 (FY) 2003 funds for a cooperative agreement 
program for the Controlling Asthma in American Cities Project (CAACP). 
This program addresses the ``Healthy People 2010'' focus area of 
Respiratory Diseases.
    The purpose of the program is to build on the planning phase of 
CAACP (including the experience and skills gained from the pilot 
testing of intervention approaches) to improve overall asthma 
management and decrease asthma-related morbidity among children (0-18 
years) in a previously defined urban population with a large and unmet 
asthma control need.
    Measurable outcomes of the program will be in alignment with the 
following performance goal for the National Center for Environmental 
Health: Reduce the burden of asthma.

C. Eligible Applicants

    Assistance will only be provided to currently funded recipients 
from CDC Program Announcement Number 01117, Controlling Asthma in 
American Cities Project, Phase I Planning. Refer to Attachment II for a 
list of currently funded recipients. All attachments referenced in this 
announcement are posted with the announcement on the CDC Web site, 
Internet address: http://www.cdc.gov. Click on ``Funding,'' then 
``Grants and Cooperative Agreements.''
    Program Announcement Number 01117 was for the two-year planning 
phase of this project, while this announcement is competitive among 
planning phase awardees for implementation of intervention activities. 
Program Announcement Number 01117 stated: ``Depending on the 
availability of funds, a new competitive announcement, limited to Phase 
I awardees, may be announced in the future that will implement the 
intervention activities.'' No other applications are solicited.

    Note: Title 2 of the United States Code section 1611 states that 
an organization described in section 501(c)(4) of the Internal 
Revenue Code that engages in lobbying activities is not eligible to 
receive Federal funds constituting an award, grant or loan.

D. Funding

Availability of Funds

    Approximately $4 million is available in FY 2003 to fund 
approximately five to seven awards. It is expected that the average 
award will be $700,000, ranging from $500,000 to $800,000. It is 
expected that the awards will begin on or about September 15, 2003 and 
will be made for a 12-month budget period within a project period of up 
to five years. 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

    Matching funds are not required for this program.

Funding Preferences

    Funding preferences may include: (1) Geographic distribution; (2) 
minority populations with disproportionate asthma burden; and (3) a 
balance of proposed intervention strategies.

E. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1. Recipient 
Activities, and CDC will be responsible for the activities listed under 
2. CDC Activities.
1. Recipient Activities
    a. Describe and implement the community asthma action plan 
developed during the planning period. The plan should be detailed and 
include time-phased intervention objectives that are tied to the asthma 
objectives in Healthy People 2010. The plan should be feasible from a 
programmatic implementation perspective and from a cost perspective. 
The plan should address sustainability issues (i.e., the 
institutionalization of intervention activities), as well as encourage 
community capacity building and empowerment.
    b. Conduct a comprehensive evaluation of the entire project using 
CDC's framework for program evaluation as a guide. As part of this, 
recipients will monitor and evaluate progress in implementing the 
community-based asthma action plan and measure the long-term 
population-based impact of the project on the health of the communities 
of focus.
    c. Continue collaboration with broad community representation and 
support in implementing, modifying, evaluating, and ultimately 
sustaining the project.
    d. Serve as a resource for other asthma control projects.
    e. Document and disseminate experiences in working as a 
collaborative/coalition and in implementing the project interventions.
    f. Formally summarize project activities, progress in reaching 
project objectives, and general insights/lessons every six months to 
local partners and to CDC.
    g. Work with CDC or its contractors to package and disseminate 
effective

[[Page 33953]]

interventions developed and/or tested as part of CAACP.
    h. Participate annually in a CDC-organized meeting of CAACP 
grantees and key stakeholders.
2. CDC Activities
    a. Provide technical assistance in the development of intervention 
strategies, communication and policy issues, and the interpretation of 
the scientific literature related to asthma management and control.
    b. Provide liaison among grantees and identify potential sources of 
information and assistance.
    c. Coordinate activities among sites, when appropriate.
    d. Provide leadership in development of a comprehensive evaluation 
plan of CAACP as a whole and provide technical assistance to all 
grantee sites regarding appropriate evaluation strategies and specific 
evaluation tools.
    e. Convene meetings among grantees, collaborators, and key 
stakeholders to discuss findings and improve outcomes.
    f. Assist with the interpretation and dissemination of interim and 
final project findings and lessons. This may include coordinating one 
or more publishable reports related to project activities/findings.
    g. If applicable, assist in the development of a research protocol 
for Institutional Review Board (IRB) review by all cooperating 
institutions participating in the research project. If applicable, the 
CDC IRB will review and approve the protocol initially and on at least 
an annual basis until the research project is completed.

F. Content

Applications

    The Program Announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, Evaluation Criteria, and this Content section to develop 
the application content. Additional guidance/clarification is provided 
in Attachment III. The application will be evaluated on the criteria 
listed, so it is important to follow them in laying out the program 
plan. The narrative should be no more than 25 pages, double-spaced, 
printed on one side, with one-inch margins, and unreduced 12-point 
font. In addition to the application forms, the application must 
contain the following in this order:
    1. Table of Contents: A table of contents that provides page 
numbers for each of the following sections should be included.
    2. Project Narrative: The narrative must contain the following 
sections:
    a. Overview of the assets, attributes, and deficiencies of the 
communities of focus (i.e., describing the public health and community 
environment in which CAACP is working, including a description of any 
community assessments or asset mapping done in the past three years).
    b. Summary of asthma-related activities and issues unique to your 
communities of focus that directly or indirectly impact CAACP planning 
and implementation activities (i.e., a description of asthma-specific 
activities not directly funded by CAACP that have occurred or are 
ongoing in the communities of focus).
    c. Description of project organization, staffing, active 
collaboration, and community support.
    d. Summary of the activities of the two-year planning period.
    e. Description and justification of the community-based, 
intervention-phase asthma action plan to be implemented over the next 
five years.
    f. Description of the comprehensive evaluation plan including a 
summary of the baseline data already collected during the planning 
phase.

G. Submission and Deadline

Application Forms

    Submit the signed original and two copies of PHS 5161-1 (OMB Number 
0920-0428). Forms are available at the following Internet address: 
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, July 7, 
2003.
    Submit the application to: Technical Information Management-
PA03030, Procurement and Grants Office, Centers for Disease 
Control and Prevention, 2920 Brandywine Rd., Atlanta, GA 30341-4146.
    Applications may not be submitted electronically.

CDC Acknowledgement of Application Receipt

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

Deadline

    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 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 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 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

    Applicants are required to provide measures of effectiveness that 
will demonstrate the accomplishment of the various identified 
objectives of the cooperative agreement. Measures of effectiveness must 
relate to the performance goals as stated in the purpose section 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.
    A peer review group appointed by CDC may conduct site visits or 
reverse site visits, as a part of their review of the applications and, 
if conducted, will use the results of these visits as well as 
application content addressing the following criteria:
    1. The Community-focused, Intervention-phase Asthma Action Plan (40 
percent).
    The aim of this plan should be to reduce the burden of asthma among 
children ranging from newborn to 18 years of age, throughout the pre-
selected communities of focus. The plan will be evaluated on the 
following criteria.
    a. The detail to which the plan is described.
    b. The likely effectiveness of the individual intervention 
strategies as well as the plan as a whole. This includes the estimated 
efficacy of each intervention (how much it will reduce asthma morbidity 
and/or improve quality of life), the likely reach of each intervention 
(percentage of the community under 18 years of age likely to be 
engaged/impacted by the intervention), and the potential synergy 
created by the intertwining of interventions. While all are essential, 
the project is especially interested in determining the combined 
effectiveness

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of interventions that together have a high degree of community reach 
and participation.
    c. The feasibility of the plan from a program implementation 
perspective, and from a cost/economic perspective. Included in this 
should be an estimate of how long it will take to fully implement the 
plan, with the idea that the quicker the intervention can be 
implemented effectively and efficiently, the better.
    d. The degree to which pilot testing, previous community 
experience, and/or the science of effective asthma interventions were 
used/are being used to create the plan and its details.
    e. The degree to which the plan reflects and builds on a mature and 
comprehensive understanding of the assets, attributes, and deficiencies 
of the communities of focus including non-CAACP asthma activities 
completed or ongoing in these communities.
    f. The degree of community participation in the plan. The following 
questions should be addressed: Is there documentation of community 
participation in the development of the plan? Does the plan encourage 
community capacity building and empowerment? Do community partners play 
a large role in the implementation period and does this empower or 
build capacity within the community?
    g. Approach to sustainability issues. This includes a discussion of 
what needs to happen to make the intervention strategies sustainable 
after project funding is finished, how likely it is that this will 
occur, and what project staff and partners are doing or planning to do 
to make this happen.
    h. The value of the community asthma action plan and the individual 
intervention strategies from a broader scientific and community public 
health perspective. In other words, are the strategies innovative and 
ambitious enough to stretch our understanding of asthma control and 
community health?
    i. Ability to replicate the community asthma action plan in other 
cities or expand into new neighborhoods within the same city. This 
includes the degree to which the individual intervention strategies 
will likely be attractive to other communities (i.e., cost-feasible, 
resource-feasible, and reproducible).
    2. Project organization, staffing, active collaboration and 
community support (30 percent). Projects will be judged on the 
following:
    a. The diversity of individuals and organizations involved in the 
project.
    b. The competence and community leadership potential of those 
actively engaged and participating in the project.
    c. The depth of expertise (both formal expertise and significant 
past hands-on experience) in all areas critical to the project's 
success.
    d. The overall competence, leadership, and vision of the principal 
investigator(s) and project coordinator(s). This is based, in part, on 
their individual skills/experience with a community-based team approach 
to decision-making and problem solving.
    e. The ability of project staff and collaborators to communicate 
openly and easily, to understand each other's roles, and to make 
optimal project-related decisions. This will be based, in part, on the 
project's organizational structure and decision-making procedures 
developed and practiced over the two-year planning period.
    f. The commitment of the collaborating individuals and especially, 
organizations. This includes the degree to which project collaborators 
have taken ownership or plan to take ownership of the project.
    g. The effort made by project staff and collaborators to involve 
grassroots community members and/or representatives in a meaningful 
way.
    h. The project's effectiveness in creating community awareness and 
interest in asthma and the project, in particular.
    i. The prospect of sustaining the collaborative partnership beyond 
the project period and even beyond childhood asthma as the public 
health focus. This includes an assessment of how the project interacts 
with other existing community projects and coalitions in the region.
    3. Evaluation Plan (20 percent).
    Projects will be judged on the following:
    a. Outcome-based Evaluation Strategies. The overall evaluation plan 
should be designed to measure the impact of the project's activities 
and interventions as a whole on the targeted communities' population of 
children and/or teens with asthma. Evaluation strategies aimed at 
measuring the impact of a single, specific intervention are important 
but remain secondary to measuring the project's overall population-
based impact. Evaluation strategies that incorporate some or all of the 
following outcome measures (but not necessarily limited to the 
following) are suggested:
    (1) Hospitalization data (ideally starting a minimum of three years 
prior to the onset of intervention activities to allow for trend 
analyses, and with comparable data from outside the communities of 
focus for comparison).
    (2) Emergency care data (as above if possible).
    (3) School absenteeism (all causes in those identified as having 
asthma or asthma-specific absenteeism).
    (4) Quality of life and/or asthma symptom surveys (if a non-biased 
sample can be identified and obtained).
    (5) Asthma medications (i.e., the ratio of rescue to controller 
medication prescriptions filled).
    (6) Asthma care visits (i.e., ratio of scheduled to unscheduled 
visits, or number of asthma maintenance visits per year).
    (7) Changes in community empowerment and/or active participation in 
community health (as measured by a validated instrument in a non-biased 
sample of the community).
    b. Comprehensive Evaluation Plan: Applicants will be judged on how 
well they have articulated an evaluation plan that complements the 
outcome-based measures described above (section H2a) and is likely to 
be useful in understanding and/or measuring the following: (1) The 
dynamics of the collaborative process, including decision making; (2) 
the general effectiveness of the collaborative in helping to create, 
implement, and sustain community interventions; (3) the relationship 
between the project/collaborative and the community it seeks to serve; 
(4) the reach of project activities in the communities of focus; (5) 
the effectiveness of specific intervention components; (6) the cost and 
resource feasibility of specific intervention components; and (7) the 
impacts of the project and/or collaborative on the community outside of 
its specific impacts on asthma.
    The evaluation plan will be additionally judged on the degree to 
which: (1) The project's stakeholders have been identified; (2) their 
perspectives and evaluation needs are reflected in the plan; and (3) 
the evaluation plan is cost and resource feasible.
    c. Baseline comprehensive evaluation data collected, organized, 
and/or analyzed during the two-year planning phase with an emphasis on 
the following: (1) The proportion of baseline data needed for the 
proposed comprehensive evaluation already collected and analyzed; (2) 
the likelihood that the baseline data not yet collected will be 
collected and analyzed in the near future; (3) the quality of the data 
and the data analysis reports already collected and/or analyzed; and 
(4) the adequacy of the collected or soon-to-be collected data as a 
baseline for the proposed comprehensive evaluation.
    d. Does the application adequately address the CDC Policy 
requirements

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regarding the inclusion of women, ethnic, and racial groups in the 
proposed research? These include:
    (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 the study participants includes the process of 
establishing partnerships with community(s) and recognition of mutual 
benefits.
    4. Use of the Planning Period (10 percent).
    The project will be judged on how well it made use of the two-year 
planning period (accountability). The following planning period 
activities should be considered in this overall evaluation of the 
activities undertaken to date. (Of note: Planning phase activities 
specifically related to the organization of the collaborative aspects 
of the project will not be included in this section. These activities 
will instead be incorporated into the score for section 2. ``Project 
organization, staffing, active collaboration, and community support'' 
above).
    a. The development of a well-articulated, plausible vision for the 
project that meets the needs of stakeholders and collaborators.
    b. The degree to which planning phase goals and objectives were 
clearly defined, improved upon (as needed), and achieved.
    c. The degree to which piloting of project ideas took place and 
were well focused and well designed.
    d. The degree to which the project staff and partners learned from 
these piloting experiences (i.e., were they evaluated in a way 
meaningful to the project).
    e. The quality and usefulness of project-related materials 
(educational materials, training manuals, resource banks, clinical 
referral lists, etc.) created, identified, and/or organized during the 
planning period.
    f. The degree to which the staff/collaborators acquired clearly 
defined skills (i.e., via training) that helped or will help in the 
creation and/or implementation of intervention strategies.
    g. The degree to which baseline assessments (i.e., community health 
assessments, asset mapping, focus groups, key informant interviews, 
survey data, utilization data, etc.) and/or process evaluation (of the 
planning period) were effectively utilized by project staff, partners, 
and other community stakeholders.
    h. The degree to which the planning period was useful in developing 
a more accurate and richer understanding of the assets, attributes, and 
deficiencies of the communities of focus as well as the asthma-related 
activities/issues in these communities (outside of CAACP).
    5. Budget (not scored)
    The extent to which the budget is clearly detailed, justified, and 
appropriate for the activities proposed.
    The applicant should include costs for one person to travel to 
Atlanta, GA to attend the sixth National Environmental Health 
Conference, December 3-5, 2003. Review the CDC/NCEH Web site for 
additional information concerning this conference: http://www.cdc.gov/nceh/default.htm.
    6. Human Subjects (not scored)
    Does the application adequately address the requirements of Title 
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.)

I. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. Interim progress report, no less than 90 days before the end of 
the budget period. The progress report will serve as the non-competing 
continuation application, and must contain the following elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Detailed Line-Item Budget and Justification.
    e. Additional Requested Information.
    2. Financial status report, no more than 90 days after the end of 
the budget period.
    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
AR-7 Executive Order 12372 Review
AR-8 Public Health System Reporting Requirements
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2010
AR-12 Lobbying Restrictions

Office of Management and Budget Clearance

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

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., Atlanta, GA 30341-4146, Telephone: (770) 488-2700.
    For business management and budget assistance, contact: Mildred 
Garner, Grants Management Officer, Procurement and Grants Office, 
Centers for Disease Control and Prevention, 2920 Brandywine Road, 
Atlanta, GA 30341-4146, Telephone: (770) 488-2745, e-mail address: 
[email protected].
    For program technical assistance, contact: Michael Friedman, M.D., 
Air Pollution and Respiratory Health Branch, National Center for 
Environmental Health, Centers for Disease Control and Prevention, 1600 
Clifton Road, NE., MS E-17, Atlanta, GA 30333, Telephone Number: (404) 
498-1028, e-mail address: [email protected].

    Dated: June 2, 2003.
Edward Schultz,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 03-14271 Filed 6-5-03; 8:45 am]
BILLING CODE 4163-18-P