Call Script for A Cultural Approach to Good Health and Wellness in Indian Country

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Informational Webinar Call Script:
Informational Conference Call for A Cultural Approach to Good Health and Wellness in Indian Country (GHWIC), CDC-RFA-DP24-0025.

May 7, 2024 at 3:00 p.m. ET

Agenda:

Announcement and Housekeeping: Lynette Wasson
Introduction and Welcome: Julianna Reece
General Overview of NOFO: Lynette Wasson
Strategies, Activities, and Outcomes Component 1: Shannon Saltclah
Strategies, Activities, and Outcomes: Component 2: Lynette Wasson
Strategies, Activities, and Outcomes: Component 3: Shannon Saltclah
Eligibility Criteria: Brittany Fain
Application Submission and Recipient Selection Processes: Brittany Fain
Resources for Additional Information: Romy Mohelsky
Questions and Answers: Kelly Bishop
Closing Remarks: Julianna Reece

Announcements and Housekeeping [Lynette Wasson]

Hello everyone, and welcome to today’s informational webinar on the new Notice of Funding Opportunity – A Cultural Approach to Good Health and Wellness in Indian Country. I’m Lynette Wasson with CDC’s Healthy Tribes Program, and I will go over a few housekeeping items before we begin.

  • To minimize background nose, please mute your microphones
  • Feel free to type your questions into the chat as they come to you and we will try to answer within the chat. We will also have a Question & Answer session at the end of the presentation. The questions on this call will also be posted on our Frequently Asked Questions webpage, which we will share the link for shortly in the chat.
  • The presentation slides and Call Script from today’s informational webinar will be posted on the GHWIC NOFO Webpage.

I will now pass it over to Dr. Julianna Reece.

Introduction and Welcome [Julianna Reece]

Thank you, Lynette.

Welcome and thank you for taking the time to be on today’s call to hear about our new notice of funding opportunity or NOFO. My name is Julianna Reece, director of the Healthy Tribes program in the Division of Population Health. Our new NOFO, A Cultural Approach to Good Health and Wellness in Indian Country, or GHWIC, focuses on reducing health disparities among American Indian and Alaska Native populations. Because American Indian and Alaska Native communities have innate strengths and resilience rooted in tribal culture and traditional ways of life, we are emphasizing a culture-first approach to prevent, manage, and control chronic diseases and their risk factors.

CDC’s Healthy Tribes program seeks to promote health, prevent chronic disease, reduce health disparities, improve social determinants of health, and strengthen connections to culture and community practices among American Indian and Alaska Native populations. This new NOFO will join a robust portfolio of cooperative agreements that work together to improve health outcomes across Indian Country including strengthening tribal public health infrastructure, expanding evidence-based programs in American Indian/Alaska Native communities, and learning from innovative practices including cultural adaptations for chronic disease prevention. We are pleased you are interested in becoming a partner in this work.

GHWIC is a collaborative effort of 6 divisions within CDC’s National Center for Chronic Disease Prevention and Health Promotion and is administered by the Healthy Tribes program. The divisions supporting GHWIC include the following:

  • Division of Diabetes Translation
  • Division for Heart Disease and Stroke Prevention
  • Division of Nutrition, Physical Activity, and Obesity
  • Division of Oral Health
  • Division of Population Health
  • Office on Smoking and Health

We want to improve the health of American Indian and Alaska Native communities by:

  • Reducing the rates of death and disability from chronic diseases and
  • Reducing the prevalence of commercial tobacco use, pre-diabetes and diabetes, high blood pressure, obesity, oral disease, and other chronic disease risk factors and conditions.

This call is being hosted by staff from the Division of Population Health and the Office of Grant Services here at CDC.

I will run through today’s agenda and introduce the CDC staff you will be hearing from today.

  • Lynette Wasson will provide an overview of the NOFO, including Components and funding levels.
  • Shannon Saltclah will provide an overview of the strategies, activities and outcomes that are required in this NOFO.
  • Brittany Fain from CDC’s Office of Grant Services will review the eligibility criteria, and the application submission and recipient selection processes.
  • Romy Mohelsky will share some resources available to you for additional information as you prepare your applications.
  • Kelly Bishop will lead us through the question-and-answer session.
  • I will then provide closing remarks.

If you have questions during the call, please drop them in the chat and we will try to answer them in real time. We have also structured the agenda to include time at the end to hear and answer some of your questions. Currently all attendees are muted. However, prior to the Q & A portion of the call, we will unmute the lines and provide instructions on how to ask your question. In the event your question is not answered on today’s call, you may submit it to GHWIC0025@cdc.gov.

I will now turn it over to Lynette Wasson who will give an overview of the program.

General Overview of the new NOFO [Lynette Wasson]

Thank you, Dr. Reece. Good morning or good afternoon to everyone; thank you for joining us today.

A Cultural Approach to Good Health and Wellness in Indian Country is designed to continue building evidence for a culturally responsive, community-driven approach to preventing, managing, and controlling chronic disease in American Indian and Alaska Native communities.

This NOFO has three separate, competitive components. Each component has its own required strategies, activities, outcomes, and performance measures.

  • Component 1 (C1) will fund federally recognized Tribes, including Alaska Native Villages, and Urban Indian Organizations, or (UIOs) to implement chronic disease prevention, management, and control strategies and activities within their community.
  • Component 2 (C2) will fund tribal organizations.

Tribal organizations will apply to serve either of the following:

  • All Tribes/Villages/UIOs and other tribal entities in their Indian Health Service (IHS) Area, OR
  • All 41 UIOs funded by the Indian Health Service.

Component 2 recipients will carry out the following two activities:

  • Use at least 50% of annual funding to offer subawards to at least two Tribes/Villages/UIOs, and other tribal entities within their award area, not funded under C1, to implement C1 strategies and activities.
  • Provide training, technical assistance, and support to all Tribes/Villages/ UIOs, and other tribal entities in their award area on:
    • C1 strategies and activities.
    • Policies, systems, and environmental (PSE) changes that promote health and prevent chronic diseases and their risk factors.

For the purposes of this NOFO, we use the words “award area” to mean either:

  • One of the 12 IHS Areas or
  • The 41 UIOs

Component 3 (C3) will fund a tribal organization to establish a Tribal Coordinating Center. The tribal coordinating center’s role will be to help all GHWIC recipients collaborate and share knowledge. It will focus on peer learning, sharing best practices, and coordinating a national evaluation that uses Indigenous and Western methods.

For All Applicants:

  • Be sure to state which component you are applying for in your application’s project abstract summary.
  • Federally recognized Tribes, Villages, and UIOs may only apply for Component 1. Tribal organizations may apply for both Component 2 and Component 3, but a separate application is required for each. A single tribal organization could be funded for both Components 2 and 3.
    We expect to make up to 30 awards under GHWIC depending upon the availability of funds and program priorities. We plan to award projects for five 12-month budget periods. In your application, make sure your budget is for one year only.
  • For Component 1, we anticipate funding up to 2 federally recognized Tribes or Villages in each of the 12 IHS Areas, and up to 4 Urban Indian Organizations. Component 1 applicants may apply for up to $400,000.
  • For Component 2, we anticipate funding up to 13 tribal organizations to include one tribal organization in each of the 12 IHS Areas, and one tribal organization with the ability to support all 41 UIOs. Funding ranges from $500,000 – $1,450,000.
  • Component 2 applicants who apply to support all 41 UIOs may apply for up to $1,250,000.
  • For Component 2 applicants who apply to support all the Tribes, Villages, and UIOs in their IHS Area are eligible for different amounts of funding. The amount they can apply for depends on the number of federally recognized Tribes or Villages in their Area.
  • IHS Areas with one federally recognized Tribes or Villages may apply for up to $500,000. This includes the Navajo IHS Area.
  • IHS Areas with 2 to 19 federally recognized Tribes or Villages may apply for up to $950,000. This includes Billings and Great Plains IHS Areas.
  • IHS Areas with 20 to 49 federally recognized Tribes or Villages may apply for up to $1,250,000. This includes Albuquerque, Bemidji, Nashville, Portland, Southern Plains and Tucson/Phoenix.
  • IHS Areas with 50 or more federally recognized Tribes or Villages may apply for up to $1,450,000. This includes Alaska and California
  • For Component 3, we will fund one tribal organization. Component 3 applicants may apply for up to $600,000.

I will now turn it over to Shannon Saltclah to share the NOFO’s required strategies, activities, and outcomes with you.

Strategies, Activities, and Outcomes: Component 1 [Shannon Saltclah]

Thanks Lynette.

As mentioned earlier, this NOFO has three separate, competitive components. The NOFO provides an approach, logic model, strategies and activities, outcomes, and performance measures that are specific to each Component. Component 1 starts on page 13, Component 2 on page 18, and Component 3 on page 22. Feel free to turn to those pages as I walk through each component.

Recipients are required to implement all strategies and activities listed for their Component over the course of the five-year period of performance.
I’ll briefly mention each Component’s approach, followed by each Component’s strategies and activities.

The Component 1 approach is to create community engagement through shared cultural experiences and to lay the foundation for a comprehensive approach to help prevent, manage, and control chronic diseases. We designed the strategies and activities to meet you where you are.

Beginning on Page 16, the NOFO describes the required Component 1 strategies and activities in the logic model and provides details about the expectations.

Strategy 1 is to provide a foundation for chronic disease prevention by implementing community-chosen, traditional AI/AN practices that build resilience and strengthen connections to family, culture, and community.

  • Required activity is to implement family-centered community activities that respect, support, teach, build upon, celebrate, and strengthen cultural practices and teachings. These might include Native language, seasonal cultural events, and intergenerational programs.

Strategy 2 is to establish and enhance systems that connect community members to community, clinical, and social services, and programs to prevent, manage, and control chronic diseases and their risk factors.

Required activities for Strategy 2 include:

  • Engage community members of all ages in traditional and contemporary wellness activities focused on chronic disease prevention. These might include community walking programs, healthy eating classes, or virtual wellness classes.
  • Develop a new or expanded coordinated system for screening, testing, and making referrals for community members to community, clinical, and social services and programs for chronic disease prevention, management, and control.
    Required activities also include:
  • Identify or offer culturally appropriate programs for preventing and managing chronic diseases that you can refer community members to. These might include the National Diabetes Prevention Program (National DPP), blood pressure (BP) monitoring, and family healthy weight programs.
  • Recruit clinical and social service providers to participate in your community clinical linkages program.
    Implement systems for screening, testing, and making referrals to clinical, social, and community-based services and resources for chronic disease prevention, management, and control.
    Another required activity is to build partnerships to help the community address disparities related to chronic disease by:
  • Training health care providers and social service organizations about preventing, managing, and controlling chronic diseases. Providers might include pharmacists, physicians, dentists, and community-based health care workers.
  • Establishing and expanding two-way referral systems between clinical providers, social services, and community resources.

The required Diabetes activities include Diabetes screenings and type 2 diabetes prevention:

  • For Diabetes Screening: Screen tribal members at risk for diabetes using the American Diabetes Association/CDC Prediabetes Risk Test. Refer those at risk to a health care provider for blood glucose testing and a type 2 diabetes prevention program. See options in the next required activity.
  • There are 2 options for type 2 diabetes prevention. Pick one of the following based on your community’s needs. The choices are:
    • Establish a new (or maintain an existing) CDC-recognized, culturally relevant version of the National DPP lifestyle change program for adult tribal members with prediabetes using the Prevent T2 curriculum. OR
    • Establish a new (or maintain an existing) community-selected, evidence-informed type 2 diabetes prevention program using elements of the National DPP PreventT2 curriculum. This could include “Eat Well to Prevent T2,” “Commit to Change,” “Coping with Challenges,” “Support,” and other modules.

Strategy 3 is to promote the implementation of multidisciplinary team-based care to prevent, manage, and control chronic diseases and to connect patients to community and social service providers to address health-related social and economic needs.

Required activities include:

  • Promote the implementation of team-based care teams to include community, social, and clinical service providers. Examples of providers include community health workers (CHWs), community health representatives (CHRs), patient navigators, social workers, pharmacists, and dentists.
  • Engage multidisciplinary teams to improve team-based care coordination and provide more comprehensive and holistic care.
  • Facilitate referrals from health care settings to community and social services for patients reporting health and social economic needs.

For example activities, please refer to the GHWIC Implementation Guide [PDF – 1,007 KB] on the CDC GHWIC Webpage.

I will now turn it over to Lynette Wasson to review Component 2.

Strategies, Activities, and Outcomes: Component 2 [Lynette Wasson]

The Component 2 approach is to expand the reach of GHWIC through utilizing at least 50% of your total award for subawards. The subrecipients will use this funding to implement C1 strategies and activities to reach additional Tribes, Villages, UIOs, and other tribal entities beyond directly funded C1 recipients.

The Component 2 strategies and activities begin on Page 21.

Strategy 1 is to provide funding, training, technical assistance, and evaluation support to all Tribes, Villages, UIOs, or other tribal entities within your award area to conduct activities across all Component 1 (C1) strategies.

Required activities are:

  • Expand the implementation of C1 strategies and activities to reach at least two additional Tribes, Villages, UIOs, and other tribal entities not funded under C1.
  • Provide technical assistance, training, and resources to all Tribes, Villages, UIOs, and other tribal entities to support developing, implementing, and evaluating activities across all C1 strategies.

Other required activities include:

  • Help all Tribes, Villages, UIOs, and other tribal entities link clinical sectors to community resources to support C1 strategies and activities.
  • Work with all Tribes, Villages, UIOs, and other tribal entities to develop and implement tailored health communication and messaging strategies. Focus on increasing awareness and encouraging healthier behaviors in AI/AN populations at greatest risk for:
    • Commercial tobacco use
    • Diabetes, including prediabetes
    • High blood pressure
    • Obesity, including from physical activity and nutrition
    • Oral disease

Strategy 2 is to provide training, technical assistance, and support to all Tribes, Villages, UIOs, and other tribal entities within your award area to establish policy, systems, and environmental (PSE) changes that promote health and prevent chronic diseases and their risk factors.

Required activities include:

  • Assist all Tribes, Villages, UIOs, and other tribal entities in establishing policies that promote healthier behaviors, such as commercial smokefree air, worksite wellness, and public locations for physical activity.
  • Provide technical assistance, training, and resources to all Tribes, Villages, UIOs, and other tribal entities on evidence-based PSE changes.
  • Assist all Tribes, Villages, UIOs, and other tribal entities in increasing awareness among community members and leaders about how PSE changes promote health and encourage healthier behaviors.

For example PSE change activities, refer to the GHWIC Implementation Guide. [PDF – 1,007 KB] I will now turn it over to Shannon Saltclah to review Component 3.

Strategies, Activities, and Outcomes: Component 3 [Shannon Saltclah]

Thanks Lynette.

The approach for Component 3 is to establish a Tribal Coordinating Center, to engage GHWIC recipients and CDC to learn from each other by establishing at a minimum, a Community of Practice and hosting routine videoconferences.

Component 3 strategy and activities begin on Page 23:

Strategy 1 is to establish a Tribal Coordinating Center (TCC) to collaborate with all GHWIC recipients to foster peer-to-peer learning, share best- or promising practices, and coordinate national and recipient evaluation efforts.

Required activities include:

  • Collaborate with CDC evaluators to develop and implement an evaluation plan for the national program. As part of this work, you will work with CDC to develop an evaluation measurement framework that includes performance measures for C1, C2, and C3 recipients.
  • Develop and implement a coordinated, collaborative Community of Practice (COP). This COP will focus on chronic disease prevention (including oral health) to facilitate peer-to-peer learning, knowledge sharing, problem solving, and communication across the network using regular videoconferencing sessions.

With all components, the outcomes that you will be required to report on are noted by asterisks within the logic model.

In addition to the strategies and activities listed in the NOFO, recipients must also participate in the GHWIC Community of Practice and other meetings related to the cooperative agreement.

Applicants must submit an application that includes all of the required items described in the NOFO, and an itemized budget narrative.

I will now turn the call over to Brittany Fain from CDC’s Office of Grant Services. She will go over the eligibility criteria and application submission information for this NOFO.

Eligibility Criteria [Brittany Fain]

Thanks, Shannon.

Eligibility to apply for this GHWIC funding is based on the intent of the Good Health and Wellness in Indian Country Congressional line-item funding, CDC/ATSDR’s Tribal Advisory Committee counsel, and previous GHWIC NOFOs. GHWIC will support the following entities which are defined in the NOFO’s glossary, starting on page 77 of the NOFO.

  • Federally recognized Native American tribal governments, which includes Alaska Native Villages, as defined by 25 U.S.C. 1603(14)
  • Native American tribal organizations, as defined by 25 U.S.C. 1603(26) and Section 4 of the Indian Self Determination and Education Assistance Act (25 U.S.C. 5304(l)), other than federally recognized tribal governments, and
  • Urban Indian Organizations, as defined by 25 U.S.C. 1603(29)

The following additional qualifying information applies to tribal organization applicants only:

  • In your application, you must provide official documents that identify the Tribes, Villages, or UIOs your organization serves. This might include your organization’s charter, resolution, bylaws, or letters on official letterhead.
  • If you do not provide this official documentation in your application, it will be considered nonresponsive. This means your application will not move forward in the application review process and your organization will not receive funding under this NOFO.

Application Submission and Recipient Selection Processes [Brittany Fain]

Now let’s talk about what you need to do before you submit your applications. You must be registered in both SAM.gov and grants.gov to apply. The registration process may take a while, so please don’t wait until you’re ready to submit your application. Applications are due by June 28, 2024, 11:59 p.m. U.S. Eastern Standard Time, on www.grants.gov. We recommend registering now if you haven’t already.

You must have an active account with SAM.gov, which includes having a Unique Entity Identifier, or UEI. SAM.gov registration can take several weeks. There is a registration link in the NOFO on Page 3. Applicants must include their UEI as the Federal Entity Identifier on the application’s SF-424.

You must also have an active account with Grants.gov. You can see step-by-step instructions in the Grants.gov Quick Start Guide for Applicants. There is a link to the quick start guide on Page 43 of the NOFO.

If you need assistance with your registrations or with submitting your applications, you will find contact information for both SAM.gov and grants.gov on Page 3 of the NOFO.

To help you prepare your applications, there is an application checklist on Page 68 of the NOFO. It includes everything that needs to be included in your application, page limits, and other submission instructions. There are three forms that must be completed for your application. Those include the following:

  • Application for federal assistance, or SF-424.
  • Budget Information for Non-Construction Programs, or SF-424A.
  • Disclosure of Lobbying Activities, or SF-LLL.

When you submit your budget, be sure to follow CDC’s budget preparation guidelines. There is a link to the guidelines on Page 75 of the NOFO. If you’re requesting funds for contracts or consultants, be sure to include all the required elements in your budget justification. Also, in your budget justification, be sure to itemize all costs and show us the calculations for how you came up with costs for each item in each line item category. We can’t express enough how important this is.

All applications go through a three-step review process.

  • During Phase I, each application will be reviewed to see if it meets the responsiveness requirements that can be found on Page 53 the NOFO. We won’t move an application forward to Phase II if the application:
    • Is from an organization that doesn’t meet the eligibility requirements that start on Page 9 of the NOFO,
    • Was submitted after the deadline,
    • Proposes research activities, or
    • Is from a tribal organization that does not submit their official charter, resolution, or letters with their application.
  • During Phase II, a panel of reviewers will conduct a merit review and score each application based on the scoring criteria listed for each Component. There are too many to cover on this call, and you can find the Component-specific criteria starting on Page 53 of the NOFO. After the merit review, we will develop 3 separate rank order lists, one for each Component.
  • During Phase III, we may decide to fund out of rank order depending on the geographic distribution of the highest scoring applications, including distribution across all IHS Administrative Areas. We will provide a justification for any decision to fund out of ranked order.

The GHWIC project will begin on September 30th, 2024. The five-year period of performance is from September 30th, 2024, through September 29th, 2029.

I will now turn the call over to Romy Mohelsky to share other application resources with you.

Resources for Additional Information [Romy Mohelsky]

Thanks, Brittany.

We’re excited to announce that for the first time ever, we have created a GHWIC Implementation Guide [PDF – 1,007 KB] to accompany this NOFO. The purpose of the implementation guide is to help you develop work plans and implement activities that are aligned with the GHWIC logic model, and to meet the NOFO’s required outcomes. The implementation guide is organized by chronic diseases and their risk factors. Each section provides example activities and resources. In some cases, the required activities are included, which includes Component 1, Strategy 2 and Strategy 3, and Component 2, Strategy 2. The Implementation Guide is not an exhaustive list of activities and resources. The Implementation Guide can be found on the NOFO’s webpage on grants.gov under “related documents.” You’ll also find links to the Implementation Guide within the NOFO, or you can find it on our NOFO webpage.

We have set up a webpage for this GHWIC NOFO that includes links to the NOFO, frequently asked questions, or FAQs, a link to submit questions about this NOFO, and after this call, the script and slides from today’s call will be posted. If you have questions about the NOFO, you can submit those via email to GHWIC0025@cdc.gov.

Before you submit a question, we strongly recommend you review all the frequently asked questions in case someone has already submitted the same or similar question and an answer has already been posted. The deadline to submit questions is June 25, 2024. This will allow enough time to receive a response back before the application due date, June 28, 2024, 11:59 p.m. ET. The links to submit a question, the FAQ page, and the NOFO webpage can be found on Page 75 of the NOFO under “Agency Contacts”.

You should check the FAQ website frequently for new questions and answers.

I will now turn it over to Kelly Bishop for questions and answers on today’s call.

Question and Answers [Kelly Bishop]

Thanks, Romy.

We’ve been trying to answer questions as they have come into the chat. Those questions and answers, along with others we have during this session of the call will be posted on our NOFO FAQs webpage within a couple days. If we are not able to provide an answer today, we will provide an answer on our NOFO FAQs webpage. There is link to the FAQs page on a previous slide and on Page 75 of the NOFO. At this time, we will unmute the lines so you may ask your question. Please raise your hand to ask a question. When called upon, please state your name and the organization you represent. After you have asked your question, please put your phone on mute. Thanks. Let’s get to our first question.

Thank you for your questions. Remember you can find this information on our FAQ webpage in a couple days. And if you have questions after this call, please submit your questions to GHWIC0025@cdc.gov.

You will see a list of helpful links, which will be entered into the chat shortly. That concludes the question and answer portion of this call. I will turn the call back over to Dr. Reece.

Closing Remarks [Julianna Reece]

On behalf of the Division of Population Health, thank you all for your time on the call today, and for your interest in this notice of funding opportunity. This concludes our call today. Thank you and have a good afternoon.

Information Call:
May 7, 2024 at 3:00 p.m. ET

Application Due Date:
June 28, 2024