[Federal Register Volume 77, Number 135 (Friday, July 13, 2012)]
[Pages 41428-41431]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-17182]



Indian Health Services


Healthy Lifestyles in Youth Project; Proposed Single Source 
Cooperative Agreement With National Congress of American Indians

    Application Due Date: August 16, 2012.
    Review Date: August 21, 2012.
    Earliest Start Date: September 1, 2012.

I. Funding Opportunity Description

    The Indian Health Service (IHS) proposes a single source competing 
continuation cooperative agreement with the National Congress of 
American Indians (NCAI) for the purpose of continued implementation of 
the Healthy Lifestyles in Youth Project in selected Native American 
Boys and Girls Clubs of America. This program promotes healthy 
lifestyles among American Indian and Alaska Native (AI/AN) youth using 
the curriculum ``Together Raising Awareness for Indian Life'' (TRAIL) 
among selected Boys and Girls Club sites.
    This program is authorized under the authority of the Snyder Act, 
25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001; and the Public Health 
Service Act, as amended, 42 U.S.C. 241(a). Under this cooperative 
agreement, IHS proposes to enter into a collaborative effort/initiative 
with NCAI, because of their unique experience partnering with the IHS 
and Boys and Girls Clubs of America in successfully establishing this 
program, as well as, their overall expertise and experience in 
addressing and evaluating healthy lifestyle techniques in AI/AN youth. 
This program is described in the Catalog of Federal Domestic Assistance 
(CFDA) under 93.933.
    The focus of the project continues to be on addressing healthy 
lifestyle development, emphasizing nutrition and physical activity for 
AI/AN children and youth 6 through 17 years of age. The long term goal 
is to prevent or delay the onset of obesity and related diseases such 
as type 2 diabetes. NCAI will continue partnering work with selected 
Tribal Boys and Girls Club sites to: (a) Provide health and physical 
education programs; (b) help youth achieve and maintain healthy 
lifestyles through participation in fitness programs; (c) help youth to 
acquire a range of physical skills; and (d) help youth develop a sense 
of teamwork and cooperation.
    These early intervention strategies provide evidence based 
opportunities to reduce and/or halt the increasing trend of obesity and 
diabetes among youth and young adults. Clubs that develop a health 
promotion program that includes the TRAIL curriculum may help curtail 
the effects of unhealthy eating behaviors and lack of physical activity 
that can lead to obesity, diabetes, and other chronic diseases later in 
life. The T.R.A.I.L. curriculum was developed to provide information on 
good nutrition and to promote physical activity among youth 
participating in Tribal Boys and Girls Clubs. T.R.A.I.L. is a three-
month (12 lessons) program that provides youth with a comprehensive 
understanding of healthy lifestyles in order to prevent diabetes. Woven 
throughout the program are self-esteem and prevention activities. 

[[Page 41429]]

draw from tribal traditions and history to learn about nutrition, 
healthy food choices, media influences, and the impact of diabetes. 
Clubs also implement the Nike Let Me Play and SPARK physical activity 
programs to foster Club-wide participation in fun activities and games 
for 60 minutes every day. T.R.A.I.L. emphasizes the importance of 
teamwork and community service. Members engage in service projects to 
improve healthy lifestyles in their communities, including starting 
community gardens to connect youth to their food source and organizing 
community-wide physical fitness events.
    This work will continue to support the IHS mission to improve the 
health of AI/AN youth through health promotion and health education 
programs. This work also represents a significant collaborative 
endeavor which is supportive of the IHS Director's Healthy Weight for 
Life Initiative and the First Lady's Let's Move Indian Country 
    Since the inception of the program in 2003, T.R.A.I.L. has been 
implemented at 79 AI/AN Boys and Girls Club of America (BGCA) sites 
located in 17 states. There are currently 35 sites in 15 states 
participating in the program.
    The overall results show improvement in participant knowledge of 
diabetes, health, and healthy food choices, as well as, improved 
fitness and level of physical activity. To support this project, NCAI 
will select and assist 50 Native American Boys and Girls Club sites to 
establish and implement this curriculum project. Boys and Girl Club 
sites that are located outside of Tribal communities will not be 
considered by the grantee. The Boys and Girls Club sites selected by 
the grantee may use IHS grant funds to provide services to members of 
Federally-recognized Tribes only. The grantee will be expected to: 
provide technical consultation; train; monitor; evaluate; as well as 
provide funds to support these activities.

II. Award Information

    Type of Award: Single Source Competing Continuation Cooperative 
    Estimated Funds Available: The IHS intends to commit $1,000,000 
each year.
    Anticipated Number of Awards: One award will be granted from this 
    Project Period: The project period will be for five years and will 
run consecutively from September 1, 2012 to August 31, 2017. The 
average award amount will be $1,000,000 annually. Competing and 
continuation awards issued under this announcement are subject to the 
availability of funds. In the absence of funding, IHS is under no 
obligation to make awards under this announcement.

A. IHS Cooperative Agreement Activities

    1. Identify a core group of IHS staff to work with the grantee in 
providing technical assistance and guidance.
    2. Meet with the grantee to review grantee work plan and provide 
guidance on implementation and data collection tools.
    3. Participate in quarterly conference calls. Work with the grantee 
to showcase the results of this project by publishing on shared Web 
sites as well as in jointly authored publications.

B. Grantee Cooperative Agreement Award Activities

    1. Develop a written plan for the planning, implementation, and 
evaluation of this project to include selection of at least 50 sites as 
agreed upon with the IHS. This task will be completed within 30 days 
from award and approved by the IHS.
    2. Develop selection criteria for new sites, announce, evaluate, 
and select sites. Sites must submit documentation verifying they serve 
only AI/AN youth from Federally recognized Tribes as a requirement for 
selection by the grantee. A start-up planning meeting with new sites 
will be conducted within 2 months of each site's initial selection and 
    3. Plan and facilitate an orientation and training meeting for new 
sites within 2 months of selection. Submit agenda, training goals and 
objectives, and participant list to IHS within 1 month of completion of 
each orientation session.
    4. Update T.R.A.I.L. curriculum and implement use.
    5. Develop, in consultation with the IHS, the implementation and 
technical assistance plan for the coordination of the 50 sites (35 
existing and 15 new). Submit criteria to the IHS for approval. Grantee 
will continue work with sites to develop and report measurements for 
assessment of physical activity and nutrition behaviors among club 
    6. Each site will implement the T.R.A.I.L. program, emphasizing 
healthy behaviors such as physical activity and nutrition. Each program 
plan will also include a parent component describing approaches for 
involving the families of participants.
    7. Each site will implement a 6-minute walk test three times, six 
to eight weeks apart. Physical activity data will be collected and 
    8. Grantee will promote and facilitate local, state, and national 
partnerships for the purpose of establishing or enhancing program 
support that involves increasing physical activity and good nutrition 
for the Tribally-managed Boys and Girls Club sites. This includes but 
is not limited to establishing other partners such as American Indian-
Alaska Native Program Branch (AI-ANPB) of Head Start Programs, Wings of 
America, United National Indian Tribal Youth, Inc. (UNITY), Tribal 
colleges, Boys and Girls Club of America, Tribal organizations, local 
community health providers and other private organizations as 
    9. Grantee will continue to implement current evaluation processes 
in consultation for the T.R.A.I.L. project. At a minimum, the 
evaluation will include:
    (a) Training attendance (gender, age, grade level); and
    (b) Pre- and post- tests to assess participant knowledge.
    (c) Monthly activity logs from each site on the physical activity 
portion of their program. Daily data to be collected includes the date, 
number of minutes of physical activity, and number of children 
    (d) Information/log on parent and family participation in education 
and activity programs, community involvement and partnerships.
    Submit collated and summarized data to the IHS. Work with the IHS 
in drafting an evaluation summary at the end of the project period for 
publication. Submit collated and summarized data and project evaluation 
summaries to all sites. Provide a minimum of annual reports (feedback) 
to each site on how their data compare to data (mean, median, and 
range) from other selected sites.
    10. Provide ongoing technical support to the sites for the duration 
of the initiative. Provide training and technical assistance in all 
forms, i.e., on-site, on-line, by phone, and mail. The planning, design 
and delivery of training and technical assistance will support the 
local organization's long-term planning and outreach efforts. The 
training will be customized based on sites' capability and experience. 
Technical assistance will also be provided on program planning and 
implementation. Collaborate with IHS to provide services to club sites. 
Maintain records and reports.
    11. Provide technical consultation to the sites in developing a 
written work plan, with measurable goals, objectives, and activities.

[[Page 41430]]

    12. Establish a formal agreement with Tribal Boys and Girls Club 
sites which involves minimal fiscal assistance but substantial 
technical support to make sure clubs successfully implement the 
T.R.A.I.L. program.
    13. Submit to the IHS a written work plan and report describing 
each site's demographics, information on the number of youth in the 
eligible age range in the catchment area, the number that attend the 
Boys and Girls Clubs regularly, and the number served by this project, 
goals, objectives, activities, partnerships, and proposed outcomes.
    14. Provide IHS written quarterly reports on the evaluation 
outcomes, activity reports at each site, any parent involvement 
activities and other participation, description of the community 
partnerships, and other activities as appropriate. Quarterly reports 
shall coincide with dates for IHS quarterly reports to HHS and shall 
highlight work supporting Healthy Weight for Life and Let's Move Indian 
    15. Conduct quarterly conference calls with IHS to review project 

C. Continuation of Ongoing and Prior Activity as a Cooperative 

    All of the identified activities are continuation activities 
associated with the previous cooperative agreement. This collaboration 
for the implementation of the T.R.A.I.L. program at selected sites, 
along with the evaluation process and reporting are deemed very 
successful and supportive of ongoing Agency and Administration 
activities and initiatives. This agreement is proposed for the purpose 
of continuation of these activities.

III. Justification for Single Source Award

    NCAI is identified as the single source for the award, based on 
their successful record of performance with this project, their unique 
relationship and work in developing and maintaining: (1) Relationships 
with the Boys and Girls Clubs organization and staff, (2) being able to 
successfully implement the T.R.A.I.L. program curriculum, (3) the 
project web site information, and (4) the project data and evaluation 
systems. The award is for a continuation of activities identified. 
These activities, the collaboration with the network of Native American 
Boys and Girls Clubs, and the evaluation process have been effectively 
undertaken by NCAI for the past 8 years. The process, as well as, the 
outcomes have been deemed very successful and clearly supportive of 
Agency initiatives for youth (including Healthy Weight for Life), as 
well as the Administration's Let's Move Indian Country initiative.
    The grantee has documented success in (1) Recruiting and working 
with sites, (2) developing and implementing the T.R.A.I.L. curriculum 
at the sites, (3) implementing a method for collecting data from the 
sites, (4) fostering collaboration between sites and their communities, 
and (5) collecting and reporting data that demonstrates participant 
increases in health and food choice knowledge and increases in 
participant physical activity and level of fitness. Some of the data 
for the current 3 year cooperative agreement (2008-2011) and 1 year 
extension (2012) are as follows:

                        Year One Data (2008-2009)
 of AI/AN Children              1691 (811 males/880 females).
 Participating in Training.
Age Range of Children Participating....  ages 4-14 (67% were 8-10 year
 of Children Participating in   668 (542/81% showed
 the Walk Challenges.                     improvement).
Hours of Physical Activity.............  19,688.
Program test scores indicate: (a) Increased knowledge about diabetes,
 (b) increased physical activity, and (c) increased ability to identify
 healthier food options (increase in post test scores vs. pre test
                        Year Two Data (2009-2010)
 of AI/AN Children              1673 (767 males/906 females).
 Participating in Training.
Age Range of Children Participating....  ages 4-14 (72% were 8-10 year
 of Children Participating in   654 (438/67% showed improvement
 the Walk Challenges.                     in level of physical
Hours of Physical Activity.............  14,527.
Program test scores indicate: (a) Increased knowledge about diabetes,
 (b) increased physical activity, and (c) increased ability to identify
 healthier food options (increase in post test scores vs. pre test
                       Year Three Data (2010-2011)
 of AI/AN Children              1762 (839 males/923 females).
 Participating in Training.
Age Range of Children Participating....  Ages 4-14 (average age was
 of Children Participating in   509 (360/71% showed improvement
 the Walk Challenges.                     in level of physical
Hours of Physical Activity.............  12,150.
Program test scores indicate: (a) Increased knowledge about diabetes,
 (b) increased physical activity, and (c) increased ability to identify
 healthier food options (increase in post test scores vs. pre test

    The T.R.A.I.L. curriculum was developed by the grantee as a part of 
the initial agreement. The requested update to the curriculum and 
subsequent implementation will be more efficiently and cost effectively 
performed as the grantee is very familiar with the existing curriculum 
and the implementation.
    The grantee uses a sub-contractor (First Pic) to develop and 
implement the evaluation and reporting process for individual sites and 
for analysis and reporting of aggregated data. This unique and program 
specific evaluation system has been beneficial to sites and to IHS. All 
of the tools for using this system have been made available via the 
Native American Boys and Girls Clubs Web site--www.naclubs.org/
trailCurrent information about health and fitness activities is 
available at--http://www.naclubs.org/media/pdf/ClubNotes_2012V1.pdf.
    The grantee (NCAI) has been effective, timely, and cooperative, and 

[[Page 41431]]

consistently achieved or exceeded requirements of the previous 
agreement. NCAI and First Pic are uniquely qualified to continue to 
receive the award and provide the identified program activities based 
on their history with this project and project sites, their evaluation 
system, their knowledge of the curriculum, and their documented 
performance achievements with the sites under the previous agreement.
    All HHS and IHS policies, regulations, grants management and 
programmatic reporting requirements from the prior funding segment 
remain in effect under this renewal announcement unless otherwise 
stated or modified in the terms and conditions of the new Notice of 

Agency Contacts

    1. Questions on the programmatic issues may be directed to: 
Lorraine Valdez, MPA, BSN, RN, Acting Director, IHS Division of 
Diabetes Treatment and Prevention, 5300 Homestead Road NE., 
Albuquerque, NM 87110, 505-248-4182, s.lorraine.valdez@ihs.gov.
    2. Questions on grants management and fiscal matters may be 
directed to: Mr. Andrew Diggs, Grants Management Specialist, 801 
Thompson Avenue, TMP Suite 360, Rockville, MD 20852, 301-443-2262, 

Other Information

    The Public Health Service strongly encourages all cooperative 
agreement and contract recipients to provide a smoke-free workplace and 
promote the non-use of all tobacco products. In addition, Public Law 
103-227, the Pro-Children Act of 1994, prohibits smoking in certain 
facilities (or in some cases, any portion of the facility) in which 
regular or routine education, library, day care, health care, or early 
childhood development services are provided to children. This is 
consistent with the HHS mission to protect and advance the physical and 
mental health of the American people.

    Dated: June 27, 2012.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2012-17182 Filed 7-12-12; 8:45 am]