97-17123. Young Women at Risk: Prevention of Unplanned Pregnancies, HIV, and Other Sexually Transmitted Diseases  

  • [Federal Register Volume 62, Number 126 (Tuesday, July 1, 1997)]
    [Notices]
    [Pages 35506-35513]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 97-17123]
    
    
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    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    
    Centers for Disease Control and Prevention
    [Program Announcement 774]
    
    
    Young Women at Risk: Prevention of Unplanned Pregnancies, HIV, 
    and Other Sexually Transmitted Diseases
    
    Introduction
    
        The Centers for Disease Control and Prevention (CDC) announces the 
    availability of fiscal year (FY) 1997 funds for cooperative agreements 
    for the prevention of unplanned pregnancies, human immunodeficiency 
    virus (HIV), and other sexually transmitted diseases (STDs) among young 
    women aged 15-25 years, in the United States (U.S.). Applied research 
    programs that design, implement, and evaluate interventions to reduce 
    unprotected sexual intercourse among young women and their male 
    partners will be supported under this cooperative agreement. 
    Applications are sought that focus on the dynamics of heterosexual 
    relationships and the factors that may contribute to successful risk 
    reduction. Research should assess factors that affect sexual decision-
    making, disease and pregnancy prevention behavior, such as the nature 
    and the effect of implicit or explicit communication between 
    heterosexual partners about sex and protective behavior; the importance 
    of gender roles, relationship stage, concordance of couples' 
    reproductive desires, the balance of power in the relationship; and the 
    influence of other network, family, and sociocultural factors.
        The 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 to priority areas of Family Planning, HIV 
    Infection, and Sexually Transmitted Diseases. (To order a copy of 
    Healthy People 2000, see the section ``Where To Obtain Additional 
    Information.'')
    
    Authority
    
        This program is authorized under the Public Health Services Act, 
    Section
    
    [[Page 35507]]
    
    301(a) [42 U.S.C. 241(a)], Section 317(k)(2) [42 U.S.C. 247b(k)(2)], 
    and Section 318(b)(3) [42 U.S.C. 247c(b)(3)], 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
    
        Eligible applicants are the official public health, family 
    planning, and substance abuse agencies of the States, the District of 
    Columbia and Puerto Rico, as well as local governments, nonprofit 
    organizations, academic institutions, and other nonprofit health, 
    family planning, substance abuse, or social service providers. All 
    applicants must provide evidence that demonstrates a successful history 
    of working in partnership with interdisciplinary groups of health 
    researchers and local racial and ethnic minority communities on applied 
    social and behavioral science projects.
    
        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 will not 
    be eligible for the receipt of Federal funds constituting an award, 
    grant, cooperative agreement, contract, loan, or any other form.
    
    Availability of Funds
    
        Approximately $1.2 million is available in FY 1997 to fund 
    approximately three awards. It is expected that the average award will 
    be $450,000, ranging from $300,000 to $650,000. It is expected that 
    awards will begin on or about September 30, 1997, and will be made for 
    a 12-month budget period within a project period of up to 5 years. 
    Funding estimates may vary and are subject to change.
        Continuation awards within the project period will be made on the 
    basis of satisfactory performance and the availability of funds.
    
    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. 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), Public 
    Law No. 104-208 (September 30, 1996), provides as follows:
    
        Section 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.
        Section 503(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
    
        Adolescent and young women in racial and ethnic communities are at 
    increased risk for a range of preventable health threats such as 
    unplanned pregnancy, human immunodeficiency virus (HIV) infection, and 
    other sexually transmitted diseases (STDs). Although CDC promotes 
    abstinence as the most effective strategy for prevention of these 
    public health problems, many women will choose to become sexually 
    active during adolescence and young adulthood. An estimated one million 
    adolescents become pregnant every year, and teenagers undergo one-third 
    of the 1.5 million abortions performed in the U.S. each year. There are 
    adverse consequences of having a baby during early adolescence for both 
    the mother and the infant. These include increased risk of low birth 
    weight and developmental problems for the child, as well as detrimental 
    effects on the lifelong physical, educational, and financial well-being 
    of the young mother. These problems are compounded for young women who 
    are living in communities characterized by high rates of violence, 
    illegal drug use, and poverty.
        HIV infection and STDs are a significant threat to young people--
    one out of every eight adolescents contracts an STD, and 20 percent of 
    the acquired immunodeficiency syndrome (AIDS) cases reported are among 
    persons younger than 29 years of age. Because the median time between 
    infection with HIV and the onset of AIDS symptoms is 8 to 10 years, 
    most of these young people were probably infected during their teenage 
    years. Further, the pattern of HIV infection in the U.S. has made a 
    significant shift toward women. The overall slowing in the growth rate 
    of the AIDS epidemic in the U.S. has not been seen among women--the 
    proportion of AIDS cases among women has risen from 11 percent of cases 
    reported in 1989, to 20 percent of cases reported in 1996. AIDS is now 
    the third leading cause of death among U.S. women aged 25-44 years. 
    Heterosexual transmission accounts for at least 40 percent of current 
    AIDS cases among women, and in 1992, surpassed injecting drug use as 
    the most common mode of HIV transmission to U.S. women. The increase in 
    rates of AIDS has especially affected racial and ethnic minority 
    women--78 percent of all women and 85 percent of children diagnosed 
    with AIDS are Black or Hispanic.
        Eighty percent of women with AIDS are of childbearing age and 90 
    percent of AIDS cases reported among children are believed to have been 
    transmitted from the mother. With the recent finding that zidovudine 
    (AZT) given to HIV-positive pregnant women can significantly reduce the 
    risk of perinatal transmission, there is hope of significantly reducing 
    this mode of HIV transmission to children. Still, as of the end of 
    1996, 7,629 pediatric AIDS cases had been reported. Preventing primary 
    HIV infection among women and helping women who are already infected 
    with HIV to avoid unintended pregnancies will help reduce HIV infection 
    among infants.
        In 1991, in response to the growing threat of HIV to women and 
    infants, and in recognition of the need to integrate pregnancy and 
    disease prevention strategies for women at risk, CDC funded cooperative 
    agreements for the prevention of HIV among women and infants 
    (Announcement Number 124).
    
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    This project, known as Project CARES (Comprehensive AIDS and 
    Reproductive Health Education Study), provided reproductive health 
    services in nontraditional settings and enhanced counseling services 
    offered by peer para-professionals to women aged 15-44 years. Women at 
    risk for unplanned pregnancy, HIV, and other STDs, as well as women 
    living with HIV infection, participated in a counseling intervention 
    tailored to each woman's readiness to change her sexual risk behavior.
        Findings from Project CARES suggest that the male sex partner's 
    influence on condom and other contraceptive use among young women at 
    risk is an important area for further research and intervention. The 
    partner's reproductive desires, length of the relationship, the 
    partner's support for using contraceptives, and communication with 
    one's partner about condom use, are associated with condom and other 
    contraceptive use. Very little research has been done that focuses on 
    the influence of sex partners on each other and the effect of other 
    social and normative factors on the sexual dyad.
        Thus, this announcement seeks research that expands the conceptual 
    framework for understanding the sexual behavior of young women at high 
    risk for unplanned pregnancy, HIV, and other STDs, by taking into 
    consideration individual-level, relationship-level, and social-level 
    factors, and to using this foundation to design interventions to reduce 
    sexual risk behavior.
    
    Purpose
    
        These awards will support advancing efforts to prevent unplanned 
    pregnancy, HIV, and other STDs among young women in the U.S. by 
    focusing on sexual behavior as a social or dyadic phenomenon best 
    understood by considering the joint influence of sex partners on 
    behavior. To reach this goal, the program will support applied research 
    that meets the following criteria:
    
        1. Extends or enhances existing social and psychological models 
    of sexual behavior change, and develops and tests new hypotheses and 
    measures to examine the dynamics of heterosexual relationships, 
    taking into consideration the influence of sex partners on each 
    other. Individual-level variables (e.g., perception of partners' 
    attitude toward condom use, etc.), relationship-level variables 
    (e.g., length of relationship, concordance of partners' attitudes 
    toward risk reduction, etc.), and social and cultural-level 
    variables (e.g., culturally prescribed sexual behavior norms for 
    young men and women, etc.) should be assessed.
        2. Designs, conducts, and evaluates new intervention strategies, 
    or extensions of existing strategies, to promote safer sexual 
    behavior, including condom and other contraceptive use, among young 
    women (who have chosen not to abstain) and their male sex partners.
    
        All proposed projects must be grounded in social and behavioral 
    science theory and past research, and applicants must provide 
    theoretical, scientific, and programmatic justification for the 
    activities proposed.
        The research program is intended to benefit populations of young 
    women (aged 15-25 years) who are currently having sex with men (or who 
    are likely to do so in the future), and who live in communities in 
    which there are elevated rates of social and health problems among the 
    adolescent and young adult population, and who have had, or are at risk 
    for unintended pregnancy, STDs, using crack cocaine or other illegal 
    drugs, trading sex for money, drugs, or other things, sex with partners 
    who have known risks for HIV infection, running away from home, 
    dropping out of school, becoming involved with the juvenile justice 
    system.
        Interventions may target young women as described above, and may 
    also include (1) their male sexual partner(s), (2) other young men in 
    the community who are not necessarily current sex partners, or (3) 
    other important peer, family, or social network members. Research and 
    measurement activities may extend beyond those who directly participate 
    in the intervention. For example, applicants who intervene with young 
    women only may propose to limit research questions and outcome 
    evaluation to the individual-level (e.g., perception of partners' 
    attitude, perceived social norms regarding gender-appropriate behavior, 
    etc.), or they may include assessment of male partners or other peer, 
    family, or social network members not directly targeted by the 
    intervention to examine diffusion effects of the intervention and to 
    further understand contextual factors that affect the sexual risk 
    behavior of young women and their male partners.
    
    Program Requirements
    
        In conducting activities to achieve the purpose of this program, 
    the recipient will be responsible for the activities under A. 
    (Recipient Activities), and CDC will be responsible for conducting 
    activities under B. (CDC Activities).
    
    Recipient Activities
    
        1. Develop a theory-based, and empirically supported, conceptual 
    model of heterosexual risk behavior for young women at risk for 
    unplanned pregnancies, HIV and other STDs that focuses on the dynamics 
    of heterosexual relationships and the factors that may contribute to 
    successful risk reduction including comprehensive measures of key 
    intrapersonal, interpersonal, and sociocultural factors that affect 
    sexual relationships.
        2. Validate the conceptual model through the development and 
    testing of measures of key interpersonal, intrapersonal, and/or 
    sociocultural influences, and through the answering of specific 
    research questions, such as, but not limited to, the following:
        (a) How do women come to understand and interpret partner attitudes 
    toward family planning, contraception, and STD and HIV prevention?
        (b) How are reproductive and disease prevention values communicated 
    between young women and their sex partners, and within their social 
    networks?
        (c) How is a couple's sexual behavior affected by their agreement 
    or disagreement on goals for childbearing, contraception, and HIV and 
    other STD prevention?
        (d) How do changes in a couple's relationship over time affect 
    their sexual behavior, family planning, contraceptive use, and HIV and 
    other STD prevention behavior?
        (e) What are the positive and negative influences of a partner's 
    attitude and behavior on sexual risk behavior? How important are 
    partner influences relative to other personal, family, network, or 
    cultural influences?
        (f) How can male partners and other social and family network 
    members support young women in achieving proximal pregnancy and disease 
    prevention goals, and more long-term reproductive health preservation 
    goals?
        3. Develop and conduct an intervention based on theory and data 
    that will influence specific intrapersonal, interpersonal and 
    sociocultural factors to reduce unprotected sexual intercourse among 
    young women and their male partners. Examples include, but are not 
    limited to, the following:
        (a) Providing theory-based training to help young women negotiate 
    sexual risk reduction.
        (b) Identifying and enlisting family, peer, and social networks to 
    support and reinforce sexual risk reduction.
        (c) Creating and mobilizing new networks of communication, 
    influence, and support concerning sexual risk reduction.
        (d) Providing opportunities for acquisition and practice of
    
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    communication skills and risk reduction strategies.
        4. Measure the success of interventions with targeted populations 
    in comparison to a control/comparison group (or community) with outcome 
    measures of interpersonal, intrapersonal, and sociocultural changes 
    such as, but not limited to, self-reports, observations, and other 
    measures of:
        (a) Cognitive, emotional, and behavioral change among individuals,
        (b) Interpersonal changes such as changes in distribution of power 
    in sexual relationships, changes in network characteristics or 
    functioning, and
        (c) Cultural and normative changes such as changes in content of 
    media messages on reproductive health, changes in distribution of 
    reproductive health services funds, changes in community attitudes, 
    etc.
        5. Work with other cooperative agreement recipients and CDC to 
    develop and refine research questions and methods, conceptual 
    frameworks, measurement and analysis strategies, and intervention 
    protocols so that findings can be used to facilitate national efforts 
    to prevent unplanned pregnancy, HIV, and other STDs among young women 
    at risk. This may require modifying conceptual frameworks, sampling 
    plans, data collection instruments, intervention activities, and other 
    elements of the applicant's proposal to meet the program goals.
        6. Collaborate and coordinate efforts with appropriate health, 
    substance abuse, youth-service, community-based, and minority 
    organizations who deliver services or interventions to the targeted 
    populations. Include members of the targeted population in planning, 
    developing, and revising the research and intervention activities 
    whenever appropriate and feasible.
        7. Develop a plan for disseminating results of the research to 
    members of the scientific, programmatic, and targeted communities.
    
    CDC Activities
    
        1. Host meetings each year to plan the research program and to 
    promote progress toward national objectives.
        2. Provide scientific and technical assistance in the design and 
    development of the research, intervention, and evaluation protocols, 
    selection of measures and instruments, operational plans and 
    objectives, and data analysis strategies.
        3. Provide scientific and technical coordination of the general 
    operation of the research project, including data management support.
        4. Participate in the analysis of data gathered from program 
    activities and the reporting of results.
        5. Conduct site visits to assess program progress.
    
    Technical Reporting Requirements
    
        Semiannual progress reports are required and must be submitted no 
    later than 30 days after each semiannual reporting period. The 
    semiannual progress reports of activities conducted and accomplishments 
    during the previous period should include:
        1. A brief program description.
        2. A comparison of actual accomplishments to goals and objectives 
    established for the 6-month period.
        3. Explanations for all goals or objectives either delayed or not 
    accomplished and a plan of corrective action.
        4. Documentation of the applicant's ability to conduct the research 
    and intervention activities, including implementation of the 
    intervention and evaluation protocol activities within the required 
    timelines, recruitment and follow-up of required number of 
    participants, recruitment and maintenance of appropriate personnel, and 
    efficient use of funds.
        5. Data on participation in intervention and research activities, 
    including numbers of completed baseline and follow-up (if appropriate) 
    interviews, and recruitment and retention rates, should be presented in 
    tabular form for the 6-month period and cumulatively.
        6. Activities planned for the next six months to accomplish the 
    goals and objectives, including the following (as appropriate to the 
    design):
        a. Procedures and strategies for tracking and contacting the target 
    population for follow-up interviews within the required time period.
        b. Projected numbers of baseline and follow-up interviews to be 
    completed.
        c. Intervention activities, and projected numbers of participant 
    contacts.
        d. Monitoring/quality assurance.
        e. Training (if any).
        f. Process evaluation (data collection and entry).
        g. Outcome evaluation (interview data collection and entry).
        h. Plans for data transfer to data management contractor.
        i. Qualitative and quantitative data analysis plans (both process 
    and outcome), including amount of staff resources designated for site 
    specific and cross-site data analysis and paper/presentation 
    preparation.
        Report for the first 6-month period should detail progress in 
    accomplishing program objectives. The second report should detail 
    progress in the preceding 6 months and summarize the entire year's 
    accomplishments. The final progress report is required no later than 90 
    days after the end of the project period. All manuscripts published as 
    a result of the work supported in part or whole by the cooperative 
    agreement will be submitted with the progress reports.
        An annual financial status report (FSR) must be submitted no later 
    than 90 days after the end of each budget period. The final financial 
    status report is due no later than 90 days after the end of the project 
    period.
        An original and two copies of all reports should be submitted to 
    the Grants Management Officer, Grants Management Branch, CDC.
    
    Application Content
    
        Applications must be developed in accordance with PHS Form 5161-1 
    (OMB Number 0937-0189), information contained in the program 
    announcement, and the instructions and format provided below.
        Applications should describe:
        1. How the applicant will assess predictors of sexual risk 
    behavior, including the specific research questions that will be 
    addressed and conceptual models used.
        2. The design and evaluation of an intervention to reduce 
    unprotected sexual intercourse between young women and their male sex 
    partners.
        3. A feasible and timely strategy for disseminating findings from 
    this research to scientific, public health, and community partners.
        The application should include a general introduction, followed by 
    one narrative subsection per application content element in the order 
    in which the elements appear below. Each narrative subsection should be 
    labeled with the element title and contain all of the information 
    needed to evaluate that element of the application (except for 
    curriculum vita, references, and letters of support, that are 
    appropriate for the appendixes).
    
    A. Significance, Impact, and Theoretical Basis of the Proposed Research
    
        The applicant should clearly describe how the proposed research 
    will advance efforts to prevent unplanned pregnancy, HIV, and other 
    STDs among young women in the U.S. Specifically, the application should 
    describe how existing social and psychological models of sexual 
    behavior change will be expanded or extended to take into consideration 
    the influence of both members of a couple on each other, and
    
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    should include explicit models (with schematic drawings) that 
    illustrate factors to be modified through intervention and to explain 
    the mechanisms by which outcome effects are believed to arise.
        Applicants should discuss how the research and intervention is 
    innovative and represents a new approach to the integration and 
    extension of known theoretical models and intervention strategies to 
    reduce unprotected sexual intercourse among young women and their male 
    sex partners.
        Applicants should describe what results are expected from the 
    research; the potential limitations of the results given the complexity 
    of the research focus, the target population, and the applied nature of 
    the evaluation; to whom the findings will be generalizable; and how 
    they can be used to develop national recommendations for reducing 
    unprotected sexual intercourse among young women at risk for unplanned 
    pregnancy, HIV, and other STDs.
    
    B. Research and Intervention Plan
    
        The applicant should describe in detail the proposed research and 
    intervention plan, including:
        1. A review of the relevant literature to provide a theoretical, 
    empirical, and programmatic justification for the proposed research.
        2. A set of clear and testable research questions and hypotheses 
    that are responsive to the intended purposes of the research sought 
    under this cooperative agreement.
        3. A description of all aspects of the study design and methods, 
    including a detailed description of the targeted population and 
    comparison group and how they will be accessed; the sampling strategy, 
    and if applicable, the randomization strategy; the evaluation design 
    (both process and outcome) and how threats to validity will be handled; 
    the plans for instrument development, pilot-testing, interviewer 
    training, data collection, analysis, interpretation, and quality 
    assurance.
        4. A description of the intervention including how theory and past 
    research will be operationalized; and a justification for how and why 
    the intervention can be expected to produce the intended effect. 
    Discuss feasibility of the intervention in the selected setting and 
    acceptability and potential sustainability of the intervention for the 
    targeted population.
        5. A description of how the intervention implementation process 
    will be measured and how the findings will be used to monitor 
    implementation and provide feedback to staff, and to explicate other 
    findings. Discuss how findings could be used to sustain the 
    intervention or replicate it in other settings.
        6. Describe the quality assurance monitoring plan for all research 
    and intervention activities.
        7. Describe the plans for data management, analysis, and 
    interpretation; highlight how they are innovative (for example, 
    integrate qualitative and quantitative data); and present a realistic 
    and detailed timeline for the generation of papers, reports, and other 
    products that can be used by program planners and policy makers.
    
    C. Research and Intervention Capacity
    
        1. Demonstrate the feasibility of the proposed research and 
    intervention plan by providing a detailed timeline, with specific 
    products, specifying which staff person will be responsible for which 
    task.
        2. Demonstrate the capacity to obtain the participation of, and 
    retain for follow-up if appropriate, adequate numbers of the targeted 
    population for assessment by providing detailed information about the 
    targeted population (characteristics, risk factors, numbers available 
    for intervention in specific settings, etc.), and describe how they 
    will be accessed and previous service or research conducted involving 
    this population (include letters from organizations, journal articles, 
    etc.).
        3. Describe the research team and show that the proposed research 
    staff for the project represent an interdisciplinary team of behavioral 
    and social scientists with the scientific training and the previous 
    scientific and practical experience needed to conduct and complete high 
    quality research within the specified timeline, as evidenced by the 
    successful completion of past research in the areas proposed in this 
    application.
        4. Demonstrate the adequacy of the proposed staff to carry out all 
    proposed activities (i.e., sufficient in number, percentage of time 
    commitments, behavioral or social scientists in key project positions, 
    and qualifications), and the adequacy of the staff time allocated for 
    specific responsibilities, with at least a 50 percent time Ph.D.-level 
    research director and a 100 percent time project director, through 
    curriculum vita and position descriptions that detail responsibilities. 
    Include a list of all grants and other sources of support (include 
    percent of time on project) for all investigators.
        5. Describe the facilities, data processing and analysis capacity, 
    and systems for management of data security and participant 
    confidentiality.
        6. Provide assurances that the applicant and all members of the 
    applicant's research and intervention team are willing to work closely 
    with other funded sites and CDC, and are willing to modify research 
    questions, sampling plans, instruments, and protocols. The applicant 
    must assure that no organizational or institutional barriers will 
    impede this process or the successful completion of the research and 
    intervention project. Applicant must also state a commitment to 
    participate with other sites and CDC on data analysis, presentation, 
    and publication of research findings.
    
    D. Collaboration
    
        Describe how academic, program, and community partners will 
    participate in developing, conducting, and evaluating the proposed 
    research. Specifically:
        1. Describe the involvement of appropriate key organizations, and 
    members of the targeted population (as evidenced by letters of support 
    describing their role in the proposed scope of work, etc.).
        2. Define the responsibilities of these other organizations and 
    individuals.
        3. Discuss previous work of the proposed collaborators and request 
    evidence of past successful collaboration and commitment to 
    participation in the proposed project.
    
    E. Dissemination and Sustainability
    
        Provide a clear dissemination plan that includes a plan for the 
    timely sharing of findings with local partners; describes efforts that 
    will be made to secure separate funding to continue prevention 
    activities that are proven to be effective in reducing sexual risk 
    behavior; and includes a plan to work with CDC and other sites to 
    ensure that analysis and production of papers, presentations, and 
    reports give priority to findings that can be used to develop national 
    prevention recommendations for young women at risk for unplanned 
    pregnancy, HIV, and other STDs.
    
    F. Budget with Justification
    
        Provide a detailed budget request and complete line-item 
    justification that is consistent with the proposed activities.
    
    G. Human Subjects
    
        Describe any risks to human subjects and the procedures that will 
    be used to protect human subjects. The applicant will be responsible 
    for providing assurance in accordance with the appropriate guidelines 
    and form provided in the application kit.
    
    [[Page 35511]]
    
    H. Women, Racial, and Ethnic Minorities
    
        Applicants shall ensure that women, 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.
    
    Typing and Mailing
    
        Applicants are required to submit an original and two copies of the 
    application. The application may not exceed 30 single-spaced pages in 
    length, excluding appendixes. Provide a one-page abstract of the 
    proposal. Number all pages clearly and sequentially and include a 
    complete index to the application and its appendixes. The original and 
    each copy of the application must be submitted unstapled and unbound. 
    Print all material, single-spaced, in a 12-point or larger font on 8 
    \1/2\'' by 11'' paper, with at least 1'' margins and printed on one 
    side only.
    
    Evaluation Criteria
    
        Applications will be reviewed and evaluated according to the 
    following criteria:
    
    A. Significance and Impact of the Proposed Research (20 Points)
    
        The extent to which the research proposed will advance efforts to 
    prevent unplanned pregnancy, HIV, and other STDs among young women in 
    the U.S. Specifically, the extent to which:
        1. The research proposed will extend or enhance existing social and 
    psychological models of sexual behavior change that take into 
    consideration the influence of both members of a couple on each other.
        2. The research and intervention is innovative and represents a new 
    approach to the integration and extension of known theoretical models 
    and intervention strategies to reduce unprotected sexual intercourse 
    among young women and their male sex partners.
        3. The research and intervention evaluation will provide results 
    that are scientifically sound, generalizable, and useful for developing 
    national recommendations for reducing unprotected sexual intercourse 
    among young women at risk for unplanned pregnancy, HIV, and other STDs.
    
    B. Research and Intervention Plan (30 Points)
    
        The quality of the proposed research and intervention plan, 
    including:
        1. The theoretical, empirical, and programmatic justification for 
    the proposed research.
        2. The clarity and testability of the research questions and 
    hypotheses, and the extent to which the questions are responsive to the 
    intended purposes of the research sought under this cooperative 
    agreement.
        3. The extent to which the study design and methods, the plans for 
    instrument development, data collection, and analysis are 
    scientifically sound and capable of producing the intended results.
        4. The extent to which the intervention represents a careful 
    application of a theoretically, empirically, and programmatically 
    justified prevention approach; can be expected to produce the intended 
    effect; and can be evaluated by using a scientifically rigorous 
    evaluation design and methods.
        5. The extent to which the intervention implementation process can 
    be measured and findings used to replicate the intervention in other 
    settings;
        6. The extent and rigor of the quality assurance monitoring plan 
    for both research activities and intervention activities.
        7. The extent to which the plans for data management, analysis, and 
    interpretation are clear and innovative (for example, integrate 
    qualitative and quantitative data) and will result in the timely 
    generation of papers, reports and other products that can be used by 
    program planners and other interested parties.
        8. The degree to which the applicant has met the CDC Policy 
    requirements regarding the inclusion of women, ethnic, and racial 
    groups in the proposed research. This includes: (a) The proposed plan 
    for the inclusion of both sexes and racial and ethnic minority 
    populations for appropriate representation, (b) The proposed 
    justification when representation is limited or absent, (c) A statement 
    as to whether the design of the study is adequate to measure 
    differences when warranted, and (d) 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.
    
    C. Research and Intervention Capacity (25 Points)
    
        1. The feasibility of the proposed research and intervention plan 
    and the adequacy of the timeline with specific products.
        2. The applicant's demonstrated capacity to obtain the 
    participation of, and retain for follow-up, adequate numbers of the 
    targeted population for assessment; and the extent of the applicant's 
    familiarity with, access to, and good working relations with, young 
    women at risk (and young men, if applicable), as evidenced by previous 
    service or research involving this population.
        3. The extent to which the proposed research staff for the project 
    represent an interdisciplinary team of behavioral and social scientists 
    with the scientific training and the previous scientific and practical 
    experience needed to conduct and complete high quality research within 
    the specified timeline, as evidenced by the successful completion of 
    past research in the areas proposed in this application.
        4. The adequacy of the proposed staff to conduct all proposed 
    activities (i.e., sufficient in number, percentage of time commitments, 
    behavioral scientists in key project positions, and qualifications), 
    and the adequacy of the staff time allocated for specific 
    responsibilities, with at least a 50 percent time Ph.D.-level research 
    director and a 100 percent time project director, as evidenced by their 
    curriculum vita and position descriptions.
        5. The adequacy of facilities, data processing and analysis 
    capacity, and systems for management of data security and participant 
    confidentiality.
        6. The extent to which the applicant is willing to work with other 
    funded sites and CDC to modify research questions, sampling plans, 
    instruments, and protocols, and is committed to working with other 
    sites and CDC on data analysis, presentation, and publication of 
    research findings.
    
    D. Collaboration (15 Points)
    
        The extent to which the applicant includes both academic, program, 
    and community partners in developing, conducting, and evaluating the 
    proposed research. Specifically, the extent to which the applicant has:
        1. Involved other appropriate key organizations, and members of the 
    targeted population (as evidenced by letters of support, etc.).
        2. Clearly defined the responsibilities of these other 
    organizations and individuals.
        3. Previously worked with the proposed collaborators and provided 
    evidence of past successful collaboration and commitment to 
    participation in the proposed project.
    
    [[Page 35512]]
    
    E. Dissemination and Sustainability (10 Points)
    
        The extent to which the dissemination plan is clearly articulated 
    and includes the timely sharing of findings with local partners, 
    reasonable efforts to secure separate funding for continuation of 
    effective interventions, and a plan to work with other sites and CDC to 
    ensure that analysis and production of papers, presentations, and 
    reports give priority to findings that can be used to develop national 
    prevention recommendations for young women at risk for unplanned 
    pregnancy, HIV, and other STDs.
    
    F. Budget (Not Weighted)
    
        Extent to which the budget is reasonable, itemized, clearly 
    justified, and consistent with the intended use of the funds.
    
    G. Human Subjects (Not Weighted)
    
        The extent to which the applicant adequately describes the 
    procedures that will be used to protect human subjects, and provides 
    assurance to demonstrate that the project will be subject to initial 
    and continuing review by appropriate institutional review committees.
    
    Content of Noncompeting Continuation Applications
    
        In compliance with 45 CFR 74.51(b)(d), 45 CFR 92.10(b)(4) and 
    92.40(b), noncompeting continuation applications submitted within the 
    project period need only include:
        A. A brief progress report that describes the accomplishments of 
    the previous budget period.
        B. Any new or significantly revised items or information 
    (objectives, scope of activities, operational methods, evaluation, 
    etc.) not included in the year 01 application.
        C. An annual budget and justification. Existing budget items that 
    are unchanged from the previous budget period do not need 
    rejustification. Simply list the items in the budget and indicate that 
    they are continuation items. Supporting justification should be 
    provided where appropriate.
    
    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 governments review of proposed Federal 
    assistance applications. Applicants 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 for 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 305, Mail Stop E-18, Atlanta, GA 30305, no later than 30 days 
    after the application deadline date (the appropriation for this 
    financial assistance program was received late in the fiscal year and 
    would not allow for an application receipt date that would accommodate 
    the 60-day State recommendation process period). The granting agency 
    does not guarantee to accommodate or explain State 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 
    department(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 or local health department 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 should 
    include the following:
        1. A description of the population to be served.
        2. A summary of the services to be provided.
        3. A description of the coordination plans with the appropriate 
    State and local health departments.
        If the State or local health official should desire a copy of the 
    entire application, it may be obtained from the 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 individuals and funded by 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 committees. The applicant will be responsible for 
    providing assurance in accordance with the appropriate guidelines and 
    form provided in the application kit.
    
    Racial and Ethnic Minorities
    
        The policy of the Centers for Disease Control and Prevention (CDC) 
    and the Agency for Toxic Substances and Disease Registry (ATSDR) is to 
    ensure that individuals of 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 Indian 
    or Alaskan Native, Asian or Pacific Islander, Black, and Hispanic. 
    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, dated Friday, 
    September 15, 1995.
    
    HIV/AIDS Requirements
    
        Recipients must comply with the document entitled Content of AIDS-
    Related Written Materials, Pictorials, Audiovisuals, Questionnaires, 
    Survey Instruments, and Educational Sessions (June 1992) (a copy is in 
    the application kit). To meet the requirements for a program review 
    panel, recipients are
    
    [[Page 35513]]
    
    encouraged to use an existing program review panel, such as the one 
    created by the State health department's HIV/AIDS prevention program. 
    If the recipient forms its own program review panel, at least one 
    member must be an employee (or designated representative) of a State or 
    local health department. The names of the review panel members must be 
    listed on the Assurance of Compliance for CDC 0.1113, which is also 
    included in the application kit. The recipient must submit the program 
    review panel's report that indicates all materials have been reviewed 
    and approved.
    
    Application Submission and Deadlines
    
    Preapplication Letter of Intent
        A nonbinding letter of intent-to-apply is required from potential 
    applicants. An original and two copies of the letter should be 
    submitted to the Grants Management Officer, Grants Management Branch, 
    CDC (see Applications for the address). It should be postmarked no 
    later than July 15, 1997. The letter should identify the announcement 
    number, name of principal investigator, and specify the activity(ies) 
    to be addressed by the proposed project. The letter of intent does not 
    influence review or funding decisions, but it will enable CDC to plan 
    the review more efficiently, and will ensure that each applicant 
    receives timely and relevant information before the application is 
    submitted. Notification may be provided by facsimile or postal mail to 
    Sharron P. Orum, Grants Management Officer, Grants Management Branch, 
    Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry 
    Road, NE., Room 305, Mailstop E-18, Atlanta, GA 30305, facsimile (404) 
    842-6513.
    
    Application
    
        An original and two copies of the application PHS Form 5161-1 (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 305, Mail Stop 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 the U.S. Postal Service. Private 
    metered postmarks shall not be acceptable 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 (404) 332-4561. You 
    will be asked to leave your name, address, and telephone number. Please 
    refer to Announcement #774. 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 Gladys T. Gissentanna, 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) 842-6801.
        Programmatic technical assistance may be obtained from Christine 
    Galavotti, Ph.D., Division of Reproductive Health, National Center for 
    Chronic Disease Prevention and Health Promotion, Centers for Disease 
    Control and Prevention (CDC), 4700 Buford Highway, NE., Mail Stop K-34, 
    Atlanta, GA 30341-3724, telephone (770) 488-5245. The announcement will 
    also be available on one of two Internet sites on the publication date: 
    CDC's homepage at http://www.cdc.gov>, or at the Government Printing 
    Office homepage (including free access to the Federal Register) at 
    http://www.access.gpo.gov>. Other CDC Announcements are also listed on 
    the Internet on the CDC homepage.
        Please refer to Announcement Number 774 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 25, 1997.
    Joseph R. Carter,
    Acting Associate Director for Management and Operations, Centers for 
    Disease Control and Prevention (CDC).
    [FR Doc. 97-17123 Filed 6-30-97; 8:45 am]
    BILLING CODE 4163-18-P
    
    
    

Document Information

Published:
07/01/1997
Department:
Centers for Disease Control and Prevention
Entry Type:
Notice
Document Number:
97-17123
Dates:
CDC's homepage at , or at the Government Printing Office homepage (including free access to the Federal Register) at . Other CDC Announcements are also listed on the Internet on the CDC homepage.
Pages:
35506-35513 (8 pages)
Docket Numbers:
Program Announcement 774
PDF File:
97-17123.pdf