Form 1 Alabama Outreach Standard applicaiton

Generic Clearance to Support the Safe to Sleep Campaign at the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD)

0925-0701_Substudy_AlabamaOutreach_ StandardApplication

Sub-Study Alabama Outreach (NICHD)

OMB: 0925-0701

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ALABAMA SAFE SLEEP OUTREACH PROJECT

Mini-Grant Application | 2017–2018 Funding Cycle

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), U.S. Department of Health and Human Services (HHS)


OMB # 0925-0701

Expiration Date: 02/2021

Alabama Safe Sleep Outreach Project

Announcement Type: New Request for Applications (RFA)


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Key Dates

Mini-Grant Application Released

September 22, 2017

Application Informational Call (optional)

October 12, 2017

Application Due Back to NICHD

November 3, 2017

Mini-Grant Status Notification Sent to Applicant

November 10, 2017

Mini-Grant Recipients Orientation Meeting

December 8, 2017

Funds Distributed to Mini-Grantee

January 8, 2018

Funding Cycle Begins

January 8, 2018

Funding Cycle Ends

July 31, 2018

Mini-Grant Recipients Closing Meeting

August 3, 2018

Final Report Due to NICHD

August 3, 2018


Purpose

This Alabama Safe Infant Sleep Outreach Project Mini-Grants RFA announces the availability of funding for a limited number of educational outreach projects to help reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death, such as accidental suffocation, in the state of Alabama. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), is offering funds to support community education efforts that:


  1. Increase public awareness about the impact of SIDS and other sleep-related causes of infant death

  2. Teach ways to create safe infant sleep environments and reduce the risk of SIDS and other sleep-related causes of infant death


The RFA emphasizes outreach efforts within African American communities, although activities can include other racial/ethnic communities.


NICHD staff will provide an orientation on safe infant sleep using a train-the-trainer approach and will offer ongoing technical assistance to support mini-grantees in carrying out educational outreach activities in Alabama. Priority audiences for this project include but are not limited to mothers-to-be, new mothers, fathers, grandparents, infant caregivers, and health care providers. NICHD will also provide Safe to Sleep® campaign materials that can be used in educational sessions.


Background

SIDS is the sudden death of a baby younger than 1 year of age that remains unexplained even after a thorough case investigation—including a complete autopsy, examination of the death scene, and review of the clinical history. SIDS claims the lives of thousands of infants in the United States each year. Since the 1970s, NICHD has been working to understand SIDS and the behaviors that reduce the risk of SIDS. In 1994, NICHD launched the Back to Sleep campaign to educate parents and caregivers about ways to reduce the risk of SIDS. Prior to the launch of the Back to Sleep campaign, almost 5,000 U.S. babies died from SIDS every year. Since the launch of the campaign, the overall U.S. SIDS rate has declined by more than 60%.


In September 2012, NICHD and its campaign collaborators expanded the Back to Sleep campaign into the Safe to Sleep® campaign to continue educating parents and caregivers about safe infant sleep practices and ways to reduce the risk of SIDS and other sleep-related causes of infant death, such as accidental suffocation.


Despite the overall success of the campaign in helping to reduce U.S. SIDS rates, challenges continue. African American infants remain at higher risk for SIDS than do white babies. NICHD and Safe to Sleep® collaborators and partners are working together with and within African American communities to help eliminate this disparity and keep babies safe during sleep.

Eligible Applicants

The following organizations are eligible to apply:

  • Nonprofits with tax-exempt IRS status (other than for-profit institutions of higher education)

  • Nonprofits without tax-exempt IRS status (other than for-profit institutions of higher education)

  • Faith-based organizations

Mini-Grant Activities

The mini-grants are designed to support educational outreach activities that address safe infant sleep and help reduce risks for SIDS and other sleep-related causes of infant death. Activities and related promotional efforts that are responsive to this application include but are not limited to the following:

  • Safe infant sleep demonstrations

  • Trainings and workshops

  • Community awareness events

  • Community infant safety events (e.g., “safety baby showers”)


Mini-Grant Requirements

All mini-grantees and organizations whose mini-grant applications are approved will be required to:

  • Identify an organizational representative as a point of contact and provide contact information to Amber Mosher. This individual will report on project activities at two in-person mandatory mini-grantee meetings (date/time subject to change):

    • An orientation meeting is tentatively scheduled for Friday, December 8, 2017, in Montgomery, Alabama, from 9:30 a.m. to 3:30 p.m.

    • A closing meeting is tentatively scheduled for Friday, August 3, 2018, in Montgomery, Alabama, from 9:30 a.m. to 3:30 p.m.

    • Additional information regarding each of these meetings will be included in the notice of award letter sent to each mini-grantee.

  • Reach a minimum of 50 participants through its education efforts

  • Use Safe to Sleep® campaign materials for outreach efforts

  • Complete all required project forms and activity trackers

  • Participate in one mandatory technical assistance call to be scheduled after the award notices are sent

  • Provide NICHD with its event and activity schedule, if appropriate


Application Procedures

Please note:


  • Only one application per organization will be accepted.

  • The mini-grant amount requested may not exceed $2,000.

  • Applications should be limited to the forms provided and the requested information.

  • Incomplete applications will not be reviewed.

  • Each proposal will be considered on its own merits.

  • Additional information may be requested if it will assist in the review process.


Please enter requested information into the fillable sections below. The application must be received by November 3, 2017, at 5:00 p.m. CT. Applications submitted after this date will not be reviewed. Mini-grant applications can be sent by mail, email, or fax. Please use the contact information below to submit an application.


Mail:

Alabama Safe Sleep Outreach Project

Attn: Amber Mosher

Palladian Partners, Inc.

8484 Georgia Avenue

Silver Spring, MD 20910


Email: [email protected]


Fax: 1-866-760-5947

Q&A Call

NICHD will host a conference call on Thursday, October 12, 2017, from 12:00 to 1:00 p.m. CT to respond to any questions about the RFA. To join the call, please use the contact information below:


Conference Number: 1-866-866-2244; Passcode: 3838163#


For technical assistance or questions about application requirements, email Amber Mosher at [email protected].


Budget Information

Mini-grant funding cannot be used for any of the following:

  • Membership dues

  • Operating deficits

  • Purchase of baby-size cardboard boxes or other portable sleep areas that are not safety-approved by the Consumer Product Safety Commission. Current safety-approved sleep areas include cribs, portable play yards (e.g., playpens), and bassinets.

  • Publication/printing of any materials not part of the Safe to Sleep® campaign and/or Alabama Safe Sleep Outreach Project, including duplication of free print materials provided by the campaign

  • Projects to improve buildings or facilities

  • Chairs or professorships

  • Endowments, annual fund drives, direct mail solicitation, or fundraising events

  • Purchase of advertising space

  • Projects intended to influence legislation or support candidates for political office

  • Mini-grants to another foundation or organization that distributes funds to recipients of its own selection

Mini-grant funding can be used for the following:

  • Snacks for an education activity or event

  • Door prizes and general supplies for an educational activity or event

    • Grantees may raffle off prizes at outreach events, as long as prizewinners are chosen at random. Prizes purchased with mini-grant funds may not be provided to every event attendee.

    • No more than $100 in raffled items may be distributed per 15–20 event participants.

    • No more than 50% of the grant award may be spent on the purchase of products that are meant to be used as door prizes or giveaways. This limit does not apply to the purchase of snacks for events.

    • Grantees may design bags, pens, and other collateral to distribute as giveaways. However, the design must be sent in for pre-approval before print.

  • Safety-approved portable play yards and other items

    • Grantees may purchase and give away unopened portable play yards; however, grantees should budget to keep one portable play yard to use for display purposes at their events.

    • Grantees may purchase products such as T-shirts, mattress sheets, or infant sleep clothing, such as wearable blankets or one-piece sleepers.

  • Honoraria/speaker fees (may not exceed 10% of grant award)


Please note: Each grantee will be provided one doll-size play yard and “crib clutter” items, such as a doll-size blanket, stuffed toy, and bottle, so you will not need to purchase a play yard for demonstration purposes, unless you want an additional set. You will, however, need to buy a doll. Additionally, repeat grantees will not be given another play yard, since they previously received one.

Individuals are not eligible to receive mini-grant funding. NICHD reserves the right, under certain circumstances, to make exceptions to the above criteria.


Application Form


Please enter requested information in the spaces provided below. Required fields are marked with an asterisk (*).


Organization Information


*Legal Name of Organization:


*Mailing Address:





*Phone:


Fax:


*Date When Organization/Program Was Launched or Started (MM/DD/YYYY):


*Brief History of Organization’s Mission and Previous Experience Working with Population to Benefit from Project (limit to 150 characters):





Type of Organization*: Health Department Community Health Center

Hospital/Clinic Community-Based Organization Faith-Based Organization

Social/Family Service Organization Other (Please specify) _______________


*IRS Classification of the Organization/Program:


*Tax ID Number:


*Total Operating Budget for Program:


Contact Information


*Name of Authorized Contact Person:


*Title:


*Mailing Address (if different from above):





*Phone:


Fax:


*Email Address:


*Name of Secondary Contact Person:


*Title:


*Mailing Address (if different from above):





*Phone:


Fax:


*Email Address:


Project Information


*Date of Proposed Project (MM/DD/YYYY through MM/DD/YYYY):


*Mini-Grant Amount Requested:


*Project Description (at a minimum, please include the following and limit to 500 characters):

  • Primary audience to be served

  • Geographic area served by the project

  • Proposed date(s) of project activities

  • Description of the activities that will help reduce the risk of SIDS and other sleep-related causes of infant death and that will promote safe infant sleep in your community

  • How you will conduct or carry out the project with mini-grant funds

  • Types of events you plan to host

  • Number of people you expect to reach

  • Changes you hope to bring to your community through the project

  • Description of sustainability efforts once the funding ends

  • Whether you plan to collaborate with other organizations (if so, provide their names)

  • Whether you plan to have a social media component (if so, provide an explanation and include any related costs in the budget justification section)









Alabama Safe Sleep Outreach Project Mini-Grant Budget Justification


Please enter requested information in the sections below and provide a brief description of how funds will be used in each section.


Project Activity

Provide brief overview of project activities.






Giveaways (no more than $100 in raffled items distributed per event with 15–20 participants) $

Enter text




Design/Printing/Duplication of Project Promotion/Administrative Materials $

Enter text




Facility Rental $

Enter text




Equipment Rental $

Enter text




Mileage $

Enter text




Honoraria/Speaker Fees (may not exceed 10% of grant award) $

Enter text




General Supplies $

Enter text




In-Kind Donations $

Enter text




TOTAL AMOUNT REQUESTED $




















Appendix



Sample Budget Justification for an Outreach Event


Please enter requested information in the fillable sections below and provide a brief description of how funds will be used in each section.


Project Activity

Our organization will host three community “baby shower” themed health fairs. We will purchase four play yards (est. cost $50 each) and keep one for display purposes. The remaining three play yards will be given away as door prizes. A doll, toys, and a pillow/blanket (est. cost $10–$20) will be purchased and used to conduct a safe infant sleep environment demonstration.


Giveaways (no more than $100 in raffled items distributed per event with 15–20 participants) $300

Unopened portable play yards will be raffled off at the end of each event. Wearable blankets, diapers, wipes, and other baby items will also be purchased and randomly given to participants as door prizes.


Design/Printing/Duplication of Project Promotion/Administrative Materials $300

Print color copies of the workshop flyer at a local printer. Create and print event posters. Print black and white pre-tests, post-tests, and post-training evaluation forms.


Facility Rental $300

Room rental and facility room coordinator fees for community center for three Saturdays.


Equipment Rental $150

Projection screen rental fee for SIDS PowerPoint presentations is $50 per day.


Mileage $54

Two of the organizations’ shuttle buses will be providing transportation to participants to prevent barriers to attending the event. We anticipate that this will be 100 miles, total, for all of the events. We will use the GSA reimbursement rate of $0.535 per mile.


Honoraria/Speaker Fees (may not exceed 10% of grant award) $90

A $30 honorarium will be provided to the main speaker at each event.


General Supplies $300

Healthy snacks will be purchased and provided at each event. Purchase of pens and 100 gift bags to provide to each participant. Design will be sent in for pre-approval before print (bags will be filled with in-kind donations).


TOTAL AMOUNT REQUESTED $1,494



Sample Budget Justification for a Classroom-Style Training


Please enter requested information in the fillable sections below and provide a brief description of how funds will be used in each section.


Project Activity

Our group will conduct a series of four educational workshops on the last Thursday of every month from January to April. Workshops will be 90 minutes each and will include interactive activities. We will use the 30-minute Safe to Sleep® PowerPoint presentation. A life-size play yard, a doll, toys, and a pillow/blanket (est. cost $70) will be purchased and used to conduct a safe infant sleep environment demonstration.


Giveaways (no more than $100 in raffled items distributed per event with 15–20 participants) $430

Raffle off a safety-approved play yard ($50) and two wearable blankets ($20 each) at each event. Wearable blankets, diapers, wipes, and other baby items ($70 total) will also be purchased and randomly given to participants as door prizes.


Design/Printing/Duplication of Project Promotion/Administrative Materials $250

Print color copies of the workshop flyer at a local printer. Create and print event posters. Print black and white pre-tests, post-tests, and post-training evaluation forms.


Facility Rental $400

The room rental for the community center for is $75 per day, plus a mandatory $25 room coordinator fee for each event.


Equipment Rental $200

Projection screen rental fee for SIDS PowerPoint presentations is $50 per day.


Mileage $0

Not applicable


Honoraria/Speaker Fees (may not exceed 10% of grant award) $120

A $30 honorarium will be provided to the main speaker for each event.


General Supplies $350

Healthy snacks, pens, and 200 gift bags will be purchased and provided at each event. The design will be submitted to NICHD for pre-approval. (Bags will be filled with in-kind donations.)


TOTAL AMOUNT REQUESTED $1,750


Sample Budget Justification for a Combo Event (Health Fair with Classroom Training)


Please enter requested information in the fillable sections below and provide a brief description of how funds will be used in each section.


Project Activity

Our hospital will partner with local faith-based groups to host three community health fairs. Each event will have local vendors providing information and resources to parents/caregivers and a 30-minute workshop presentation on SIDS. For demonstration purposes, we will purchase a play yard (est. cost $50), a doll, toys, and a pillow/blanket (est. cost $20) to conduct a safe infant sleep environment demonstration.


Giveaways (no more than $100 in raffled items distributed per event with 15–20 participants) $249

An additional play yard and three packages of disposable diapers (est. cost $11 each) will be purchased and raffled off at the end of each event.


Design/Printing/Duplication of Project Promotion/Administrative Materials Events $250

Print color copies of the event flyer at a local printer. Create and print event posters. Print black and white pre-tests, post-tests, and post-training evaluation forms.


Facility Rental $0

Not applicable. All events will take place at the hospital.


Equipment Rental $150

The projection screen rental fee for SIDS PowerPoint presentations is $50 per day for 3 days.


Transportation $390

Faith-based organizations will rent two shuttle buses to provide transportation to participants, to prevent barriers to attending the event. Rental fees are $65 per day.


Honoraria/Speaker Fees (may not exceed 10% of grant award) $90

A $30 honorarium will be provided to the main speaker per event.


General Supplies $100

Purchase of pens and 100 gift bags to provide to each participant. Design will be submitted to NICHD for pre-approval. (Bags will be filled with in-kind donations.)


TOTAL AMOUNT REQUESTED $1,380

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