Appalachia Community Cancer Network

Request for Proposals

Community Development Funding

Applications must be received by 5 p.m. onFriday, August 22, 2008

INTRODUCTION

The Appalachia Community Cancer Network (ACCN) is requesting applications from ACCN community partners in Kentucky,Maryland, New York, Ohio, Pennsylvania, Virginia, and West Virginia for funding of up to $2,500 each to support evidence-basedand evidence-informedcancer education and outreach projects. Approximately, sevenproposals will be funded during this grant period. Projects must be conducted between September 9, 2008 and May 29, 2009. Requests for funds may not exceed $2,500. Proposals must address the priority categories specified on Page 2 of this Request for Proposals (RFP). Review criteria will include the scope of the project (i.e., whether it is do-able in the study period), the extent to which the project is evidence-based (i.e., shown in previous research or practice to be effective), and outreach capacity(i.e., demonstration of broad collaborations or partnerships with local, regional, and/or state screening programs). Proposals should place special emphasis on reaching people who are medically underserved or residents of rural areas with limited access to cancer education programs or services.

BACKGROUND

The Appalachia Community Cancer Network (ACCN) is a National Cancer Institute (NCI)-funded research initiative to reduce cancer health disparities in the Appalachian region through community participation in education, research, and training. Based at the University of Kentucky Prevention Research Center, the ACCN serves the Appalachian regions of Kentucky, Maryland, New York, Ohio, Pennsylvania, Virginia, and West Virginia. The ACCN collaborates with Appalachian communities and other partners to conduct cancer education and awareness activities, community-based participatory research projects, and to provide training opportunities throughout the region. The ACCN focuses on its efforts on but is not limited to prevention and early detection of cervical, lung, and colorectal cancers, all of which have high incidence and mortality rates in the seven-state region.

The rural nature of Appalachia, limited education, high unemployment and poverty levels contributes to the high incidence and mortality rates experienced by residents. Through the development of grass roots community-based cancer education, outreach and screening projects, the Appalachia Community Cancer Network Community Development Funding is able to address the unique barriers and issues that inherently contribute to increased cancer mortality and incidence among the population of Appalachia.

A study commissioned by the Appalachian Regional Commission showed that significant health disparities persist in Appalachia compared to Non-Appalachian U.S. Health disparities were observed for several chronic diseases including cancer, diabetes, and cardiovascular disease and for risk factors such as smoking. Cancer mortality in Appalachia is higher than it is in the remainder of the U.S. The elevated cancer mortality rates are what motivated the National Cancer Institute to recognize the residents of Appalachia as a population with “health disparities”.Higher mortality rates are observed for all cancer in Appalachia.Higher lung cancer mortality rates observed in Appalachia are most likely attributable to a high prevalence of smoking.

Residents of Appalachiaprimarily reside in largely rural areas and are more likely to be medically underserved due to lack of primary care physicians and greater travel distances to consult with specialists. Additionally, residents are less likely to receive early detection screening tests for cancer have a high prevalence of risk factors for cancer including tobacco use, high fat diet, physical inactivity, and inadequate access to medical care.

AWARD PRIORITIES

Award priorities are consistent with the goals of the ACCN to contribute to the reduction of cancer health disparities in Appalachia by developing, implementing, and evaluating community-based projects. Programs considered for funding must focus on one or more of the following priority cancers or health issues:

Cervical cancer

Colorectal cancer

Lung cancer

Other specific cancer health disparity

Cancer prevention (e.g., Nutrition, Physical Activity, Smoking Cessation)

Proposals should describe how your proposed project is evidence-based*or evidence-informed**and aims to:

increase knowledge of cancer risk factors for cervical, colorectal, lung cancer or other cancer health disparities; or
improve compliance with screening guidelines for cervical, colorectal or other cancer health disparitiesthrough community or provider education; or
increase awareness of tobacco cessation programs for youth and adults; or
increasecancer prevention through physical activity and nutrition programs; or
improve knowledge of and access to local resources to improve cancer survivorship.

*Evidence-based programs are programs that have been proven effective in the populations and settings through research and practice. Evidence-based programs are available on Cancer Control PLANET (

**Evidence-informed programs are based on data, literature, and similar successful programs.

ELIGIBILITY REQUIREMENTS

Grants will be awarded for projects that have a comprehensive plan for implementing and evaluating community programs on cancer issues of concern to the community. Proposals must target medically underserved community residents (rural, minorities, orindividuals with limited income and/or education).

Community coalitions/ groupsmust have an established Memorandum of Understanding (MOU) or Memorandum of Agreement (MOA) with the ACCN to apply. They must also have501c3 status or a designated lead fiscal agency (health agency or non-profit) to receive and manage the funding award. In addition, the community coalition/group must demonstrate broad community support, including specific plans for involving community members asmembers of the target population, cancer survivors, local health-related organizations, and local businesses.

FUNDING RESTRICTIONS(please review this area carefully)

Request for funds:

cannot exceed $2,500 total costs

mustbe used for project activities only

can not be used for salary, clinical services, equipment purchases, phone bills, rent, utilities, computer software, or alcohol..

Funding for administrative fees may not exceed 10% ofthe total budget (maximum $250 in administrative fees for a total budget of $2,500).

SUBMISSION REQUIREMENTS

Applicants must adhere to the following requirements for proposal submission:

Use 12 point type.

Submit electronically (by e-mail) or FedEX to:

Mark Cromo

Appalachia Community Cancer Network

CC444 RoachBuilding

800 Rose Street

Lexington, KY40536-0093

(859) 257-3833 (telephone)

(859) 257-0017 (fax)

All submissions must be received by 5:00 p.m on August 22, 2008.(Notice of receipt will be sent to all applicants.) No late applications will be accepted.

No changes or additions can be made to a proposal once it has been submitted.

SUBMISSION GUIDELINES AND INSTRUCTIONS

Each proposal should include the following:

Section Heading / Number of point awarded / Page Requirements
Cover Sheet –included in this document / Required / 1 page
Proposed Community Program or Project / 20 / Maximum of 1 page
Background and Narrative Statement of Need / 25 / Maximum of 2 pages
Work Plan Form –included in this document / 35 / Form provided - (Copy form as needed - maximum of 3 pages)
Budget Plan Form –included in this document / 20 / Form Provided- (Copy form as needed - maximum of 2 pages)
Total / 100 / Maximum of 9

SECTION DESCRIPTIONS

Application Cover Sheet (Please use or recreate the form provided with this RFP)

Proposed Community Program or Project (Maximum of 1 page, 12 point type)

Provide a brief summary of the proposed community program or project, including a general overview of goals and objectives

Background and Narrative Statement of Need (Maximum of 2pages, 12 point type)

Provide some background information including a brief demographic profile of the community or target population. Explain why your proposed program is needed and providerelevant data, statistics, or needs assessment information that supports your claim. Describe how the proposed program is evidence-basedor evidence-informed and how it will address the community problem described. Briefly describe the community coalition/group, including its mission/purpose, length of time it has existed and make-up of the membership. Describe collaborations and partnerships with other local, regional and statewide agencies and organizations anda description of individuals and groups who will be involved with the program and their specific roles.

Work/Evaluation Plan Form(Please use form provided with the RFP, maximum of 3 pages)

Identify the goals of the proposed program and expected date of completion for the project. Quantify the specific objectives. Describe all activities planned to achieve these objectives. List partners involved in these objectives. Project the number of people the project intends to reach with each objective. Specify the plan to evaluate each objective.

Budget Form(Please use or recreate the form provided with the RFP, maximum of 2 pages)

List the amount of funds requested for each specific category. Under “funding restrictions” remember that administrative fees may not exceed 10% of the total budget(maximum $250 in administrative fees for a total budget of $2,500). Funds can not be used for salary, clinical services, equipment purchases, phone bills, rent, utilities, computer software, or alcohol.

NOTIFICATON AND REPORTING TIMELINE

Tuesday,July 1, 2008 Funding announcement sent to coalitions
Friday, August 22, 2008 Applications due by 5 p.m. (Confirmations will be sent

electronically or by fax on or before October 16th)

Monday, August 25, 2008 Electronic copies sent by University of Kentuckyto reviewers

Friday, September 5, 2008 Final award decisions made

Tuesday, September 9, 2008 Telephone notification of awards

Friday, September 12, 2008Invoice Form, W-9 Form,University of Kentucky Independent Contract Form, and Report Form sent to awardees (funds will be dispersed 4-6 weeks after receipt of these completed forms)

Friday, May 29, 2009 Program completion date

Tuesday, June 30, 2009 Final report due

Appalachian Community Cancer Network Community Development Funds

Application Cover Sheet

Titleof proposal: ______

Name of Group/ Organization applying for funding: ______

Priority Category of Proposal: (Please check) ____Cervical ____ Colorectal ____ Lung

____Cancer Prevention (Nutrition, Physical Activity, Smoking Cessation)

____Other specific cancer health disparity. Specify: ______

Contact person: ______

Address: ______

Phone: ______Fax: ______Email: ______

County or counties serviced by this proposal: ______

Project Coordinator: (if different from above)______

Address: ______

Phone: ______Fax: ______Email: ______

Fiscal agent/Lead Agency: ______

Contact person: ______

Address: ______

Phone: ______Fax: ______Email: ______

Federal Employer Identification Number (FEIN) of Lead Agency: ______

Budget amount requested: (cannot exceed $2,500 total costs) ______

Check payable to: ______

Mail check to: (name/address) ______

______

Project CoordinatorSignatureDate

______

Fiscal Agent/Lead Agency SignatureDate

Proposed Community Program/Project Goals

Background and Narrative Statement of Need

Work/Evaluation Plan

Goal I:
Expected date of completion:

Objectives

(quantifiable measures) / Activities Planned to Achieve this Objective
(what will be done) /

Partners

/ Projected people reached / State how each objective will be evaluated
I,
II.
III.

Work/Evaluation Plan

Goal II:
Expected date of completion:

Objectives

/ Activities Planned to Achieve this Objective /

Partners

/ Projected people reached / State how each objective will be evaluated
I,
II.
III.

Work/Evaluation Plan

Goal III:
Expected date of completion:

Objectives

/ Activities Planned to Achieve this Objective /

Partners

/ Projected people reached / State how each objective will be evaluated
I,
II.
III.

BudgetForm

Provide amount of funds requested for each category and include total amount of in-kind contributions, if any, for each category (2 pages maximum).

Budget Categories

/ Justification / Requested
Funds / In-Kind
Contributions / Total Funds
for this category
Example: Printing / 500 flyers @ $0.28 each, paper, printing, staff time = $140.00; 1000 brochures, paper, printing, staff time = $280.00; Total printing: $420.00 / $389.40 / $30.60 / $420.00
ADMINISTRATIVE COSTS(limited to 10% of total funding request or a maximum $250 in administrative fees for a total budget of $2,500).
ADVERTISING

EDUCATIONAL

MATERIALS
FOOD/REFRESHMENTS
INCENTIVES

OPERATIONAL

SUPPLIES
POSTAGE
PRINTING
SPEAKER FEES
TRAVEL EXPENSES
OTHER
TOTALS