[Federal Register Volume 59, Number 133 (Wednesday, July 13, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-16961]
[[Page Unknown]]
[Federal Register: July 13, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[CDC-435]
Announcement of Cooperative Agreement to the State of North
Carolina Department of Environment, Health, and Natural Resources
Summary: The Centers for Disease Control and Prevention (CDC) announces
the availability of fiscal year (FY) 1994 funds for a cooperative
agreement program for Diabetes Intervention: Reaching and Educating
Communities Together (Project DIRECT) with the State of North Carolina
Department of Environment, Health, and Natural Resources (DEHNR) to
further develop and carryout multi-level, community-based interventions
to reduce the burden of diabetes and its complications in an African-
American community.
Project DIRECT is a multiyear demonstration project of the Division
of Diabetes Translation (DDT), National Center for Chronic Disease
Prevention and Health Promotion (NCCDPHP), CDC, incorporating the
principal translation functions of the division of: (1) Defining the
burden of diabetes, (2) developing innovative approaches to the
prevention and control of diabetes, (3) implementing these approaches
through the State-based diabetes control programs, and (4) coordinating
national, State, and local resources for improved diabetes care.
Approximately $650,000 is available in FY 1994 to fund this
program. This funding is to support administrative start-up costs, to
include staffing and awarding competitive subcontracts with community
institutions and organizations conducting specific work related to the
execution of the intervention plan. Operational funding for
intervention and evaluation is expected to increase in years 02 through
05.
It is expected that the award will begin on or about September 30,
1994, and will be made for a 12-month budget period within a project
period of up to 5 years. This funding estimate may vary and is subject
to change.
The purpose of Project DIRECT is to: (1) Improve the health-related
quality of life of an African-American community by reducing the burden
of diabetes and its complications through a multilevel, community-based
intervention(s), and (2) develop, carry out, and evaluate strategies
that will be incorporated into State-based diabetes control programs
nationwide. The research design of the project is to conduct a baseline
population survey of a predominantly urban and suburban African-
American community, implement targeted interventions for at least 5
years, monitor a longitudinal cohort of persons with diabetes, and
conduct a follow-up survey at the end of the intervention phase to
detect and document community level changes. There will also be a
comparison community that will be surveyed at baseline and at follow-
up. This multilevel community intervention will be conducted by a
consortium of public and private agencies and organizations with
management and leadership provided by the official State health
department.
The CDC will assist in the design of interventions and evaluation
protocols used in conducting and evaluating the project, provide
technical assistance in the design of demonstration protocols, provide
programmatic consultation and guidance in support of the project,
coordinate with DEHNR in sharing and distributing information, data,
and successful strategies and interventions to States and other
appropriate organizations, agencies, and institutions. CDC will also
provide DIRECT Intervention Plan guidelines and assist in the
development of a plan for Diabetes Care, Outreach, and Health Promotion
interventions.
The Public Health Service (PHS) is committed to achieving the
health promotion and disease prevention objectives of ``Healthy People
2000,'' a PHS-led national activity to reduce morbidity and mortality
and improve the quality of life. This announcement is related to the
priority area of Diabetes and Chronic Disabling Conditions, with
particular attention to populations at disproportionate risk of
developing diabetes, including minorities and the elderly. (For
ordering a copy of ``Healthy People 2000,'' see the section WHERE TO
OBTAIN ADDITIONAL INFORMATION.)
Authority: This program is authorized under Section 301(a) and
317(k), 42 U.S.C. 241(a) and 247b, of the Public Health Service Act,
as amended.
Smoke-Free Workplace: The Public Health Service strongly encourages all
grant recipients to provide a smoke-free workplace and promote the non-
use of all tobacco products. This is consistent with the PHS mission to
protect and advance the physical and mental health of the American
people.
Eligible Applicant: Assistance will be provided only to DEHNR for this
project. No other applications are solicited. The Program Announcement
and application kit have been sent to DEHNR.
DEHNR and North Carolina are uniquely situated to conduct this
project for the following reasons:
A. In 1990, following an open competition, a contract for the pilot
phase of Project DIRECT was awarded to a research institution in North
Carolina. Developmental activities associated with Project DIRECT have
been conducted in Wake County, North Carolina. Considerable community
organization and development have occurred to ensure community support
and involvement in Project DIRECT. A community advisory board of over
30 local representatives have been actively involved in the project
since March 1992. Regular coverage through all media channels that
serve this community has occurred and widespread name recognition of
the project has been achieved in this community.
B. A survey of over 900 randomly sampled households in Wake County,
North Carolina, is complete, and over 250 extensive medical
examinations were performed on a subsample of the household
respondents. Response rates exceeded 80%, indicating that expanded
survey work is feasible in this community. There is no other community
in the United States for which this type of data exists. Replication of
work completed to date in another community could only be achieved at
considerable cost to the government.
C. The data gathered through the household and medical
examinations, along with information from a community resource analysis
for Wake County, provides the database from which a comprehensive,
multilevel community intervention plan has been developed. The
intervention strategies match closely with the health care and
educational needs of this community and the resources available to
support the interventions in Wake County.
D. CDC's traditional constituency is State health departments, and
the intervention components of Project DIRECT are intended to serve as
model programs for eventual implementation by other official State
health departments. This cooperative agreement with DEHNR allows CDC to
evaluate the effectiveness of Project DIRECT in a State health
department, and to identify the additional liaisons that will be
required to ensure the viability of diabetes control programs in State
health departments in a reformed health system. DEHNR has expertise,
administrative and technical capacity, and public health orientation
represented in State health departments nationally.
E. DEHNR has collaborated successfully with universities and
research institutions in the State. These are important liaisons for
the successful implementation of Project DIRECT. DEHNR presently has
established contractual relationships with these academic institutions:
East Carolina University to develop and teach an
introductory course in the etiology and management of diabetes
mellitus.
The Cancer Control Program at Duke University.
The Department of Nutrition at the University of North
Carolina-School of Public Health.
The Department of Ophthalmology at the University of North
Carolina-School of Medicine to implement the eye care objectives for
Diabetes 2000.
F. DEHNR has an Office of Minority Health that can provide policy
and programmatic technical assistance to Project DIRECT.
G. DEHNR participated as a member of the DIRECT Community Advisory
Board during the pilot phase of the project and they are familiar with
the philosophy and design of this complex community intervention.
Executive Order 12372 Review
This application is subject to Intergovernmental Review of Federal
Programs as governed by Executive Order (E.O.) 12372. E.O. 12372 sets
up a system for State and local government review of proposed Federal
assistance applications. The applicant should contact their State
Single Point of Contact (SPOC) as early as possible to alert them to
the prospective application and receive any necessary instructions on
the State process. A current list of SPOCs is included in the
application kit. If the SPOC has any State process recommendations on
the application submitted to CDC, they should send them to Elizabeth M.
Taylor, Grants Management Officer, Grants Management Branch,
Procurement and Grants Office, Centers for Disease Control and
Prevention (CDC), 255 East Paces Ferry Road, NE., Atlanta, GA 30305, no
later than 60 days after the application deadline. The granting agency
does not guarantee to ``accommodate or explain'' State process
recommendations it receives after that date.
Public Health System Reporting Requirement
This program is not subject to the Public Health System Reporting
Requirements.
Catalog of Federal Domestic Assistance Number
The Catalog of Federal Domestic Assistance Number is 93.283.
Other Requirements:
Paperwork Reduction Act
Projects that involve the collection of information from 10 or more
individuals and funded by this cooperative agreement will be subject to
review by the Office of Management and Budget (OMB) under the Paperwork
Reduction Act.
Human Subjects
If the proposed project involves research on human subjects, the
applicant must comply with the Department of Health and Human Services
Regulations, 45 CFR Part 46, regarding the protection of human
subjects. Assurance must be provided to demonstrate that the project
will be subject to initial and continuing review by an appropriate
institutional review committee. The applicant will be responsible for
providing assurance in accordance with the appropriate guidelines and
form provided in the application kit.
Where to Obtain Additional Information: If you are interested in
obtaining additional information regarding this project, please refer
to Announcement 435 and contact Bernice A. Moore, Grants Management
Specialist, Grants Management Branch, Procurement and Grants Office,
Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry
Road, NE., Room 305, Mailstop E-16, Atlanta, GA 30305, telephone (404)
842-6802.
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 Summary may be obtained through the
Superintendent of Documents, Government Printing Office, Washington, DC
20402-9325, telephone (202) 783-3238.
Dated: July 7, 1994.
Martha Katz,
Acting Associate Director for Management and Operations, Centers for
Disease Control and Prevention (CDC).
[FR Doc. 94-16961 Filed 7-12-94; 8:45 am]
BILLING CODE 4163-18-P
