March of Dimes Chapter Community Grants Program

Transcription

1 March of Dimes Chapter Community Grants Program 2016 Request for Applications Application Guidelines March of Dimes Illinois Chapter 111 W Jackson Blvd, Suite 1650 Chicago, IL (312) PWilliams@marchofdimes.org

2 PURPOSE The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education and advocacy to save babies. Premature birth is the leading cause of newborn death worldwide. Even babies born just a few weeks too soon can face serious health challenges and are at risk of lifelong disabilities. In 2003, the Prematurity Campaign was launched to address the crisis and help families have healthy, full-term babies. The campaign funds research to find the causes of premature birth, and to identify and test promising interventions; educates health care providers and women about riskreduction strategies; advocates to expand access to health care coverage to improve maternity care and infant health outcomes; provides information and emotional support to families affected by prematurity; and generates concern and action around the problem. As part of this effort, the Illinois Chapter community grants program is designed to invest in priority projects that further the March of Dimes mission, support campaign objectives, and further our strategic goal of promoting equity in birth outcomes. The Illinois Chapter engaged in a year-long strategic planning process and identified an overarching mission goal to develop and strengthen partnerships with maternal and child health stakeholders in Illinois to reduce the state preterm birth rate To accomplish this goal, three core focus areas for Illinois Chapter mission investment include: addressing pregnancy outcome inequities, improving preconception/interconception care, and supporting maternal and neonatal quality improvement activities. The March of Dimes will fund grants that fall in the following priority areas: 1. Male involvement programs targeting males across the reproductive life span 2. Smoking reduction and/or cessation programs for women of reproductive age 3. Weight management and healthy lifestyle programming for overweight/obese women during and after pregnancy 4. Breastfeeding programming and education focused on improving maternal and neonatal health outcomes and reducing health inequities. 5. Management of chronic conditions during the prenatal and postpartum periods including, but not limited to gestational diabetes and hypertension *Note: Applicants may apply for funding for any or all 5 funding priority areas mentioned above. For agencies that would like to apply for multiple priority areas, a separate application must be submitted for each area. The March of Dimes will fund programs for one to three years. See Funding Period section below for specific guidelines. 2

3 Funding Priority 1: Male Involvement Preconception and interconception health care is important for both men and women. Programming for men however, is not widely available. Pre/interconception health for men is not only a crucial component for their health and wellbeing, but also for supporting their partner and for being a good role model. There is much that men can do to keep themselves and their partners healthy before and during pregnancy to ensure that their baby is born healthy. For example, men should visit their health care provider once a year for regular health screenings and avoid alcohol, tobacco and other drugs which can negatively impact their fertility (Preconception Health Council of California, 2014). Research shows that there are staggering social, psychological and economic effects as a result of male disengagement. The Federal Government spent at least $99.8 billion providing assistance to father-absent families in 2006 (Nock & Einolf, 2008). Men are crucial and influential in their partners lives and it is essential to include them in preconception and interconception health care programs and services. During the 2016 grant cycle, the March of Dimes aims to fund programs that focus on male involvement that concentrate on increasing educational awareness and social responsibility in regards to preconception and interconception health. Objective: During the 2016 grant cycle, the March of Dimes seeks to fund programs with the objective of focusing on male involvement programs targeting males across the reproductive life span. Population of Interest: Male youth, men of reproductive age, expecting and/or parenting fathers. Strategy: Fund existing or developing programs that seek to promote optimal health and wellness for men of childbearing age, regardless of their parenting status. 1. Improve the knowledge, attitude and behavior of men regarding preconception health. Please visit for male involvement related educational materials. 2. Identify and justify tools to be used for assessment and health promotion among males/fathers. Preference is given to applicants serving men in communities which demonstrate racial and/or ethnic disparity in pregnancy outcomes. 3. Engage expecting and/or parenting fathers and encourage paternal involvement in supporting the health and well-being of their partners. 4. Implement preconception and/or interconception programming which provides health education and awareness to young males. Intervention and Evaluation: It is an expectation that funded programs collect de-identified data on all participants and evaluate the impact and outcomes of their intervention. Applicants must clearly describe how they will recruit and enroll participants as well as complete the Project Objectives/Activities/Outcomes Form included in the RFA. Applicants must describe in detail the data collection points they are measuring. 3

4 Funding Priority 2: Smoking Reduction and Cessation Smoking during pregnancy increases a woman s risk of preterm birth and having a low birth weight baby, both of which increase a baby s risk for other serious health problems. In Illinois, 7.9% of women smoked during pregnancy, while in some parts of the state, up to 30.5% of women smoked during pregnancy (IDPH, 2009). Of women of childbearing age (18-44 years) in Illinois, 15.6% reported smoking (CDC, 2013). Objective: In 2016, the March of Dimes seeks to fund programs with the objective of reducing the rate of smoking among women of reproductive age in regions of Illinois where rates are higher than the Illinois average. Population of Interest: All women of reproductive age, regardless of pregnancy status. Strategy: Fund evidence-based or evidence-informed smoking reduction and cessation programs for women of reproductive age including, but not limited to: 5A s ( SCRIPT Program ( Baby and Me Tobacco Free ( Telephone Quitline Interventions ( For further detail on each of these smoking reduction and cessation programs, please see Appendix B (attached, pages 23-26). Intervention and Evaluation: It is an expectation that funded programs collect de-identified data on all participants and evaluate the impact and outcomes of their intervention. Applicants must clearly describe how they will recruit and enroll participants as well as complete the Project Objectives/Activities/Outcomes Form included in the RFA. Data points that must be collected on each participant and reported on include: Baseline: Data on participant demographics and tobacco use (number of cigarettes daily or weekly) and frequency prior to intervention During the intervention Post-intervention: Data on tobacco use and frequency post-intervention, including whether participants quit or reduced the number of cigarettes smoked and by how much Applicants must describe in detail the data collection points they are measuring. 4

5 Funding Priority 3: Weight Management About 1 in 4 women of reproductive age are obese and about one in five pregnant women are obese (March of Dimes, CDC). Obesity is defined as having a body mass index (BMI) equal to or greater than 30. In Illinois, 54.2% of all women of reproductive age are either obese or over weight; about 27% of women are obese and 27% are overweight (CDC, 2013). Women who are overweight are at greater risk for preeclampsia, gestational diabetes and preterm labor during pregnancy and their baby is at greater risk for obesity during childhood. Additionally, research has shown that pregnant women who are obese are at greater risk for maternal mortality (Society for Maternal Fetal Medicine, Kavanaugh, 2012). Objective: In 2016, the March of Dimes seeks to fund programs with the objective of reducing the rate of overweight and obese pregnant and parenting women. Population of Interest: Pregnant women who are overweight/obese. Overweight is defined as a BMI of 25.0 to 29.9 before pregnancy and obesity is defined as a BMI of 30 or more before pregnancy. Strategy: Fund weight management and healthy lifestyles programming for pregnant women and follow them into the postpartum period. Interventions demonstrating positive results include, but are not limited to: Nutritional and lifestyle counseling Tracking and monitoring of daily food intake Engaging in daily physical activity For further details on weight management interventions, please see Appendix C (attached, page 27). Intervention and Evaluation: It is an expectation that funded programs collect de-identified data on all participants and evaluate the impact and outcomes of their intervention. Applicants must clearly describe how they will recruit and enroll participants as well as complete the Project Objectives/Activities/Outcomes Form included in the RFA. Data points that must be collected on each participant and must be reported on include: Baseline: Data on participant demographics, pre-pregnancy weight, BMI, and blood pressure. During the Intervention: Data collection on the same measurable elements must take place at least once during the pregnancy (e.g. weight, BMI, level of exercise, blood pressure, knowledge and behavior change) Post-Intervention: Post-partum data on same measurable elements (e.g. weight, BMI, level of exercise, blood pressure, and measure of nutritious food choices) on participants Applicants must describe in detail the data collection points they are measuring. 5

6 Funding Priority 4: Breastfeeding Breastfeeding has been shown to have extensive health benefits for both mothers and their infants. Breastfed babies have fewer health problems than babies who aren't breastfed. Research shows that exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhea and pneumonia, and helps for a quicker recovery during illness (World Health Organization, 2015). Exclusive breastfeeding can also help mothers return to their pre-pregnancy weight more quickly and may also help lower her risk for diabetes, breast cancer and ovarian cancer (March of Dimes, 2015). Objective: In 2016, the March of Dimes seeks to fund programs with the objective of increasing the rate of breastfeeding initiation and duration among women. Population of Interest: Pregnant and postpartum women. Strategy: Fund breastfeeding programming and education for pregnant and postpartum women and follow them post-intervention. For further details on Illinois specific statistics and general breastfeeding information, please see Appendix D (attached, page 28). Intervention and Evaluation: It is an expectation that funded programs collect de-identified data on all participants and evaluate the impact and outcomes of their intervention. Applicants must clearly describe how they will recruit and enroll participants as well as complete the Project Objectives/Activities/Outcomes Form included in the RFA. Data points must be collected on each participant and must be reported to the March of Dimes. Suggested data points include, but are not limited to: o Breastfeeding initiation or within 24 hours of delivery o 2 weeks post-partum o 6 weeks post-partum o 6-months post-partum o Breastfeeding exclusivity Applicants must describe in detail the data collection points they are measuring. 6

7 Funding Priority 4: Chronic Condition Management Many studies show that an increasing number of pregnant women in the United States have chronic health conditions such as hypertension, diabetes, and chronic heart disease (CDC, 2014). These conditions may put a pregnant woman and her unborn child at higher risk of developing pregnancy complications and can result in maternal or infant mortality. Many of these [complications] can be prevented through improvements in preconception care, access to health care and social services, quality of care received, and behaviors and health care practices of women (2015). Objective: In 2016, the March of Dimes seeks to fund programs with the objective of. Population of Interest: Pregnant and postpartum women. Strategy: Fund existing or developing programs that monitor and manage gestational and chronic conditions during the prenatal and postpartum periods. Intervention and Evaluation: It is an expectation that funded programs collect de-identified data on all participants and evaluate the impact and outcomes of their intervention. Applicants must clearly describe how they will recruit and enroll participants as well as complete the Project Objectives/Activities/Outcomes Form included in the RFA. Data points should be collected during the following: Baseline During the Intervention Post-Intervention: Applicants must describe in detail the data collection points they are measuring. 7

8 ELIGIBILITY In order to be eligible to receive a March of Dimes BaM/CB chapter grant, an organization must: 1) Be an incorporated not-for-profit 501(c)(3) or for profit organization or government agency. The March of Dimes does not award grants to individuals. 2) Disclose any conflict of interest due to representation by their organization on the chapter s Program Services Committee or the Chapter or Division Board of Directors. 3) Strong preference will be given to applicants working in and serving women in communities with high preterm birth rates. 4) Provide services in the state of Illinois. GRANTEE REQUIREMENTS Grantees must submit two written progress and expenditure reports by 6 and 12 months of the grant cycle to the March of Dimes Illinois Chapter office for each year funded. Grantees must get written approval for any changes in project design or implementation, variance from the submitted budget or changes in staff overseeing the project. If your organization requires Institutional Review Board (IRB) approval, please state how you will go about obtaining such approval GRANT SCHEDULE Applications due November 12, 2015 Notification of awards January 18, 2016 Grant period February 15, 2016-February 14, 2017 Please Note: March of Dimes chapter community grants do not fund scientific research projects. For information about research grants funded by the March of Dimes national office, please go to marchofdimes.org/research. FUNDING AMOUNT AND PERIOD A select number of projects will be funded during the grant cycle and up to $15,000 will be granted per year. (See Application Format, Section F. Budget for details). Current 2015 Grantees (grant year of 9/2015-8/2016): Current 2015 grantees MUST contact Priscilla Williams, Associate Director of Program Services, by 5pm on Thursday, October 29, 2015 if they are interested in applying for 2016 funding. Contact information can be found on the following page Grant Applicants: Applicants may apply with the intent for a one, two or three-year project period. To be considered for multi-year funding, project proposals must include a budget request and objectives for the three year time period under consideration, as well as a copy of the applicant's most recently audited financial statement. Please Note: All chapter community grants are approved for one year only. Applicants may choose to submit a proposal that covers a three-year project period. However, March of Dimes only awards funds for one year at a time (maximum three consecutive years). Funding for the second and third years are not guaranteed and will be based upon March of Dimes review of progress and expenditures and the availability of funds. 8

9 APPLICATION INSTRUCTIONS Organizations interested in submitting an application that meets at least one of the listed funding priorities may apply for a grant up to $15,000. Funds may be applied to support new or existing projects. Applications must be no longer than 15 double-spaced pages (excluding supplemental information.) Font size must be at least 12 point and margins must be at least 1 inch. Applications must include all items listed in the Application Format. The Project Narrative section must include the six required components, addressing each lettered bullet listed. Application forms are attached. Optional supplemental information may be included; however, all information requested under each of the required components must be provided within the Project Narrative, observing page limitations. An original application and an electronic version of the application must be received by the deadline date. Applications may not be faxed. Applications that exceed the maximum page limitation will not be reviewed. Applicants must submit both an electronic and original hardcopy of their application by 4:00PM on Friday, November 12, Applications should be sent to: Priscilla Williams, MA, Associate Director of Program Services March of Dimes Illinois Chapter 111 W Jackson Blvd., Suite 1650 Chicago, IL PWilliams@marchofdimes.org If you have questions regarding the March of Dimes Illinois Chapter community grants application or need additional application forms, please contact Priscilla Williams, Associate Director of Program Services, at , PWilliams@marchofdimes.org 9

10 APPLICATION FORMAT I. PROJECT OVERVIEW- 2 pages Completely fill out attached Project Overview II. PROJECT NARRATIVE suggested length 5-7 pages A. Project Abstract - 1 page Provide a one-page summary of the project (attached) B. Description - suggested length 2-3 pages Please include the following information/address the following questions in your description: Funding Priority: Which of the funding priorities is the project addressing? Please select from the previously mentioned funding priorities listed on page 2. Do not alter wording. Target Population: Of the target population in your area, what needs are you addressing in this initiative? How will the project have an impact on these needs? NOTE: Strong preference will be given to applicants serving those in communities which demonstrate racial &/or ethnic disparity in pregnancy outcomes. Please include information in your narrative about the population you will serve. Organizational capacity and staffing: What is the capacity of the applicant to carry out the project (include agency s mission, key staff, clientele, and experience working with the target population group)? What will be the responsibilities of the staff members listed in the proposal? Collaborating organizations: If applicable, list names and roles of collaborating organizations. What is the role of collaborating organizations? Project timeline: Provide the timeline on which project activities and results are expected to occur. What planning activities will take place before project startup? Project implementation: Please note how you plan to recruit participants and how you will follow up with participants to collect outcome data. How will the project be announced to the community? How will progress be monitored, and data collected? C. Project Objectives, Activities & Outcomes Please completely fill out the Methods, Activities & Outcomes form including information on baseline data, evaluation method and staff responsible. D. Evaluation Plan - suggested length 1-2 pages Please consider the following questions when describing your evaluation plan: What is the measurable objective(s) the proposed project aims to achieve? For example: 10

11 One measurable objective of this project is to decrease the number of women of childbearing age enrolled in the project who smoke cigarettes six months after intervention. How will you measure whether this objective was achieved? What data or information will be needed to measure this? How will this information be gathered? What tools will be used? Who will be responsible for gathering this data and summarizing it for reporting to the March of Dimes? Please include any evaluation tools (i.e. surveys, attendance sheets, summary health information) you will use to capture participant information, evaluate progress, etc. Who will design and carry out the project evaluation? If at all possible, have someone other than the program managers determine evaluation results. E. Project Visibility and Sustainability - suggested length < 1 page Please consider the following questions when describing your plan: Visibility: Describe the ways in which March of Dimes will be visible throughout the project period. How will the project be announced to the community? Sustainability: Describe the plan for sustainability beyond the funding period through alternate sources of funding or a change in organizational systems or procedures that will sustain the project's impact. F. Budget Please complete the attached budget form, and provide a one-page written budget justification to detail each item on the budget form. Please include the calculation(s) used to estimate costs. The attached budget form is not acceptable without a written budget justification for each item, including any incentives, bus tokens, or educational materials you will be using. Please review allowable and non-allowable costs noted below. If you are applying for a multi-year grant, please also include a copy of your agency's most currently audited financial statement including: Statement of Income and Expenditure and Balance Sheet. III. SUPPLEMENTAL INFORMATION (optional) 1. Letters of Support from collaborating organizations. 2. Evidence of Institutional Review Board (IRB) submission as deemed appropriate. 3. Other supporting materials relevant to the proposed project. 11

12 Allowable Costs Include: Salary - grant funds may be used to cover salaries for project-related employees only. Please include the percentage of time designated employees will be committing to the project in the budget justification. Consultant fees Materials and supplies (e.g. office supplies, health-related materials, refreshments) Printing and travel that are reasonable and necessary for project implementation. March of Dimes funds will not pay for first class travel. Non- Allowable Costs Include: These items should not be included in the grant budget request: Salary costs for staff who are already employed full-time by their organization and have no connection to the grant related project. Construction, alteration, maintenance of buildings or building space Dues for organizational membership in professional societies Tuition, conference fees or awards for individuals Billable services provided by physicians or other providers Permanent equipment (e.g. computers, video monitors, software printers, furniture) unless essential to project implementation and not available from other sources Educational materials from non-march of Dimes sources if comparable materials are available from the March of Dimes Indirect costs for grants under $25,000 Advertising materials and purchase of media time/space: Budget costs relating to these items may not be allowable depending on project specifics. Please consult with the chapter contact listed in this application regarding whether proposed items are allowable. 12

13 Project Overview (2 pages) Applicant Organization: Address: City: State: Zip: Project Title: Contact Name: Phone: Fax: Institution Type (choose one): [ ] Clinic [ ] Community-based Organization [ ] Educational Institution [ ] Health Department (State/Local) [ ] Other For-Profit Organization [ ] Professional Association [ ] Other Have you previously received March of Dimes grant funding for the same project in the last 5 years? [ ] Yes, please specify years [ ] No Is this a proposal for a multi-year project? [ ] Yes, please specify # of years [ ] No Please provide a brief synopsis of your project (2 sentences are sufficient): Please list the one primary March of Dimes priority funding area that the proposal addresses (Male involvement, smoking cessation/reduction, weight management, breastfeeding programming or chronic condition management) Please list the one primary and one secondary purpose category that the proposal addresses (categories listed in Appendix A on page 22): Primary: Secondary: 13

14 Approximately how many unduplicated individuals will be served during year one? Does this project target adolescents (17 and under)? [ ] Yes [ ] No Does this project aim to reduce disparities? [ ] Yes [ ] No Select the race/ethnicity of the majority of individuals expected to be served by this project (if applicable): RACE: [ ] White [ ] Black or African American [ ] American Indian or Alaska Native [ ] Asian [ ] Native Hawaiian or Other Pacific Islander [ ] Other ETHNICITY: [ ] Hispanic If you are awarded funds, your agency is required to participate in the statewide evaluation, which means you will be collecting personal health information (PHI) from any participants. The March of Dimes is working with an External Evaluator who has received IRB approval through an accrediting institution. Will your agency or an evaluator require the following? [ ] Full review by an Institutional Review Board (IRB) [ ] Expedited review by an Institutional Review Board (IRB) [ ] No review by an Institutional Review Board (IRB) Total amount requested: $ Cost per individual: $ Is your agency willing to accept partial funding? [ ] Yes [ ] No If awarded, check should be made out to: Organization Name: Address: Attention to: / / Signature - Primary Staff Person Date Type Name and Title 14

15 Project Abstract (1 page) Problem Statement: What is the problem that this project will try to address? Why do we care about the problem? What gaps will the project fill? Methods: What activities will you undertake to achieve results? Expected Results: What changes do you expect to occur as a result of the activities described above? Conclusions/implications: What are the larger implications of your findings? What impact will this project have on the problem identified above? 15

16 OUTCOMES Reporting outcomes for your grant funded project does not have to be complicated. Outcomes are benefits to clients from participation in the program. Outcomes for March of Dimes projects are usually in terms of changes in knowledge, behavior or birth outcomes. Outcomes are often mistaken with program outputs or units of services such as the number of clients who went through a program. To measure outcomes, baseline data is needed for comparison with data collected during and after project implementation. Proposals are expected to include at least one objective that seeks to change knowledge, behavior or birth outcomes. Proposals that meet this expectation will score higher in the review process. Information found on this website may help you identify outcome objectives for your project: Here are some sample objectives to give you ideas for content and wording. Please notice the references to baseline data. Intent to Change Behavior - By August 2016, 80% of participants will agree to make at least one positive behavior change as a result of attending the prenatal classes as measured by client interviews. (Baseline will come from intake interviews.) Behavior Change - By August 2016, at least 50% of participants enrolled in the program will have improved eating habits by reporting increased intake of fruits/vegetables and water consumption as measured by client surveys. (Baseline will come from intake interviews.) Behavior Change - By August 2016, the number of women accessing adequate perinatal care (at least 13 prenatal visits beginning in the first trimester of pregnancy) at XYZ Health Center will increase from 125/year (baseline) to 150/year through the services of a Patient Navigator as measured by a review of client records. Change in Birth Outcome - By August 2016, decrease the percentage of preterm births among women enrolled in the project from 18% (baseline) to 16.5% as measured medical records review. Knowledge Change By August 2016, 60% of program participants will demonstrate an increase in the perinatal knowledge test as measured by pre/post-tests. (Baseline will come from pre-test results.) 16

17 Project Objectives/Activities/Evaluation Methods/Outcomes Template. Proposals are expected to include at least one objective that seeks to change knowledge, behavior or birth outcomes. Description of Objective and Activities to Achieve Objectives OBJECTIVE # 1 Person/ Agency Responsible Start/End Dates MM/DD/YY Number of Individuals Expected to be Served/ Reached/ Educated Description of Expected Outcomes/Impact 1. Activity 2. Activity 3. Activity Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data. 17

18 Description of Objective and Activities to Achieve Objectives OBJECTIVE # 2 Person/ Agency Responsible Start/End Dates MM/DD/YY Number of Individuals Expected to be Served/ Reached/ Educated Description of Expected Outcomes/Impact 1. Activity 2. Activity 3. Activity Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data. 18

19 Description of Objective and Activities to Achieve Objectives OBJECTIVE # 3 Person/ Agency Responsible Start/End Dates\ MM/DD/YY Number of Individuals Expected to be Served/ Reached/ Educated Description of Expected Outcomes/Impact 1. Activity 2. Activity 3. Activity Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data. 19

20 Organization: Project Title: Contact Name: Budget Form and Written Justification. Complete the form below to describe your proposed budget. Provide a onepage written budget justification. Allowable and non-allowable costs have been provided in the RFA. BUDGET PROPOSED (see application guidelines for an explanation of allowable/not allowable expenses) Year 1 Year 2 (if submitting a multi-year proposal) Year 3 (if submitting a multi-year proposal) A. Salaries (include name, position, and FTE) B. Expendable Supplies Sub-total A $ $ $ C. Equipment Sub-total B $ $ $ D. Other Expenses/Fees Sub-total C $ $ $ Sub-total D $ $ $ TOTAL COSTS (Sub-total A+B+C+D) $ $ $ TOTAL AMOUNT REQUESTED $ $ $ / / Signature Fiscal Officer Date Type Name and Title / / Signature Primary Staff Person Date Type Name and Title Please Check Budget Totals 20

21 APPLICATION SUBMISSION CHECKLIST Please refer to the following checklist to ensure that your application submission is complete. Application is no longer than 15 double-spaced pages Font size is at least 12 point and margins are at least 1 inch. Project narrative (including one page abstract) includes all required components and addresses all questions. Grant amount requested falls within the allowable range, and requested line items fall within allowable cost items. Project Objectives/Activities/Evaluation Methods/Outcomes Template Budget totals have been checked for accuracy. If applying for more than one year of funding, a copy of the applicant's most recently audited financial statement must be attached. Application includes all required attachments Completed and signed Project Overview Completed and signed Budget Form Documentation of IRB submission as deemed appropriate For multi-year projects, a copy of most currently audited financial statement including Statement of Income and Expenditure, and Balance Sheet. W-9 Application includes optional attachments as deemed relevant to the application. Application must be submitted electronically and an original, signed copy must be sent by regular mail to: Priscilla Williams, MA, Associate Director of Program Services March of Dimes-Illinois Chapter 111 W. Jackson Blvd., Ste Chicago, IL PWilliams@marchofdimes.org Applications must be received by 4:00PM Thursday, November 12, Late applications will not be accepted. / / Signature - Primary Staff Person Date Type Name and Title 21

22 Appendix A: Primary and Secondary Purpose Categories Primary purpose category (select one): Interconception education and healthcare Preconception education and healthcare Prenatal care services Prenatal adjunct services Prenatal education and social support Professional education and training Quality improvement Other (please specify) Secondary purpose category (select one): Care coordination (case management, patient navigator, medical home, etc.) Chronic disease management in pregnancy (hypertension, diabetes, obesity, etc.) Early elective delivery prevention Early entry into prenatal care Education materials Fertility treatment education Folic acid Genetic services for pregnant women Genetic services for non-pregnant women Group prenatal care (CenteringPregnancy ) Group prenatal care (other than CenteringPregnancy ) Home visiting Interconception education Maternal/Child Health (MCH) program enrollment (getting women into WIC, Medicaid, CHIP, etc.) Newborn screening Post-polio activities Preconception education Prenatal education/incentive (Stork s Nest ) Prenatal education/incentive (models other than Stork s Nest ) Preterm labor prevention Project Alpha Preterm birth recurrence prevention education (about 17P) Preterm birth recurrence prevention education (other than 17P) Risk reduction education/services (alcohol and drug use) Risk reduction education/services (smoking cessation) Sudden Infant Death Syndrome (SIDS) prevention Other (please specify) 22

23 Appendix B- Smoking Cessation Strategies Evidence Based Interventions for Pregnant Women Baby & Me: Tobacco Free TM Developed by: Baby & Me: Tobacco Free Website: Women enrolling the program agree to quit smoking and remain tobacco free after delivery. They attend 4 cessation interventions during pregnancy. At each intervention they are tested tobacco-free for tobacco using CO monitoring and random saliva tests. After delivery, if the mother tests negative for tobacco, she receives a voucher for free diapers. Depending on the program site, she may be able to return monthly for up to one year and receive a diaper voucher each time she tests negative for tobacco. Currently implemented in 8 US States; Colorado, Illinois, Indiana, Louisiana, Nebraska, North Dakota, New York, and Oregon Pilot Project - Western NY Funded as a pilot research project in NY Department of Health. Study showing 60% tobacco free at 6 months postpartum was published by Maternal and Child Health Journal, January Assisted over 1,200 pregnant, smoking women NACCHO Model Practice Award NY The published results show that 60% of the women enrolled in the program successfully quit while pregnant and stayed smoke free for 6 months postpartum MOD Leading Practice OR Seventy-nine percent were smoke-free during pregnancy. One-hundred percent of the women who delivered during the term of the project were smoke free at the time of delivery. Fifty percent of the women who were smoke-free during pregnancy remained smoke free during the postpartum period. 23

24 Appendix B- Smoking Cessation Strategies The Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program Developed by: Dr. Richard Windsor, NIH Principal Investigator in the Department of Prevention and Community Health at The George Washington University School of Public Health and Health Services. Distributed exclusively by Society for Public Health Education (SOPHE). Website: SCRIPT is an award-winning, evidence-based program shown to be effective in helping thousands of pregnant women quit smoking. It is designed to be a component of a patient education program for prenatal care providers. The SCRIPT Program includes the following intervention components: A Pregnant Woman's Guide to Quit Smoking: A 40-page tailored guide that outlines a self-evaluation process to help build women's smoking cessation success over a sevenday period; written in the 5-6th grade reading level Commit to Quit Smoking During and After Pregnancy: A 15-minute motivational DVD that presents testimonials of pregnant smokers who quit; helps demonstrate behavioral skills to quit smoking and reduce counseling time Comprehensive counseling: To help pregnant smokers quit or significantly reduce smoking during pregnancy Counseling and encouragement to establish a non-smoking home: Follow up components are a part of the SCRIPT Program to help prevent smoking relapse 2000 Agency for Healthcare Research & Quality AHRQ includes SCRIPT in its smoking cessation clinical practice guidelines 2011 Program published in Health Education and Behavior, August Quit rates documented as 12% compared to control group of 10% and significant reduction rates of 18% compared to control group of 13% 2012 Webinar by Healthy Start Introduces program and discusses ways to implement SCRIPT program into Healthy Start Initiatives SOPHE provides one-day trainings on how to implement the SCRIPT program. 24

25 Appendix B- Smoking Cessation Strategies Telephone Quitline Interventions Website: Quitlines are telephone-based tobacco cessation services that help tobacco users quit. Services offered by quitlines include coaching and counseling, referrals, mailed materials, training to healthcare providers, Web-based services and, in some instances, free medications such as nicotine replacement therapy (NRT). Due to their ability to reach and serve tobacco users, regardless of location, quitlines have quickly spread across North America. All states have contracts with a telephone quitline vendor. There are three primary vendors serving the U.S. The North American Quitline Consortium is a non-profit member organization including quitline vendors and funders, researchers and strategic partners. Several meta-analytic reviews have established that proactive telephone counseling is an effective intervention for smoking cessation (Lichtenstein et al. 1996, Fiore et al. 2000, Hopkins et al. 2001, Stead et al. 2004). The current U.S. Public Health Clinical Practice Guideline and the Guide to Community Preventive Services both recommend proactive telephone counseling as a method to help smokers quit (Fiore et al. 2000, Hopkins et al. 2001). In 2005, the CDC published a guidance document entitled Telephone Quitlines: A Resource for Development, Implementation, and Evaluation The Regions IV and VI CoIIN Smoking Cessation Strategy Team has adopted the expansion of Quitline services, including specialized protocols for pregnant women, as one of their priorities. 25

26 Appendix B- Smoking Cessation Strategies The 5 A s (Ask, Advise, Assess, Assist, Arrange) _Care_for_Underserved_Women/Smoking_Cessation_During_Pregnancy This approach remains the gold standard for pregnant women. There are a number of published studies documenting its effectiveness as a brief intervention model. ACOG confirmed its endorsement of this approach in Committee Opinion #471 in A comprehensive implementation guide entitled Smoking Cessation During Pregnancy: A Clinician s Guide to Helping Pregnant Women Quit Smoking is available on the ACOG website. 26

27 March of Dimes- Illinois Chapter Appendix C Weight Management Interventions Asbee, S., Jenkins, T., Butler, J., White, J., Eliot, M., & Rutledge, A. (2009). Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstetrics and Gynecology, 114(1), Phelan, S., Jankovitz, K., Hagobian, T., Abrams, B. (2011). Reducing excessive gestational weight gain: lessons from the weight control literature and avenues for future research. Women s Heatlh, 7(6), Wolff, S., Legarth J., Vangsgaard K., Toubro S, Astrup A. (2008). A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. International Journal of Obesity, 32, \ Abrams, B. (2011). Lifestyle Intervention Trials During Pregnancy. 112th Abbott Nutrition Research Conference. Phelan, S., Phipps, M. G., Abrams, B., Darroch, F., Grantham, K., Schaffner, A., & Wing, R.R. (2014). Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial. The American journal of clinical nutrition, 99(2), content/99/2/302.short 27

28 March of Dimes- Illinois Chapter Appendix D- Breastfeeding Information Resources The Illinois Breastfeeding Blueprint includes both qualitative and quantitative analysis of existing and emerging data, identifies demographic trends in statewide breastfeeding rates, and prioritizes areas in which breastfeeding efforts should be focused. The CDC Breastfeeding Report Card provides state-by-state data and measure types of support in key community settings as well as the most current data on the breastfeeding goals outlined in Healthy People Through advocacy, awareness campaigns, media projects, professional education and material development, the Illinois State Breastfeeding Task Force strives to create change that results in breastfeeding as the cultural norm. Phelan, S., Phipps, M. G., Abrams, B., Darroch, F., Grantham, K., Schaffner, A., & Wing, R. R. (2014). Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial. The American journal of clinical nutrition, 99(2),