PILOT STUDY Grant COMMUNITY-ACADEMIC RESEARCH PARTNERSHIPS GRANTS PROGRAM REQUEST FOR APPLICATIONS 2015

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PILOT STUDY Grant COMMUNITY-ACADEMIC RESEARCH PARTNERSHIPS GRANTS PROGRAM REQUEST FOR APPLICATIONS 2015 I. Background The Community Engagement Research Program (CERP) is a core component of the Atlanta Clinical Translational Science Institute (ACTSI), a collaborative effort of Emory University, Morehouse School of Medicine, and Georgia Institute of Technology (Georgia Tech). The CERP aims to support community-university research partnerships, facilitate community input into university research, and build community capacity to conduct health research that is both responsive and relevant to the health needs of the community. This grants program is designed to meet these aims through the provision of funding and technical assistance to community-based organizations (CBOs) to build capacity and skills to conduct research in collaboration with academic researchers. The CERP invites proposals from CBOs interested in conducting a research project in partnership with academic researchers affiliated with Morehouse School of Medicine, Emory University, or Georgia Tech. CBOs can request that CERP help them find an academic partner or CBOs can request a grant for a pilot study to be conducted with an existing academic partner from one of the three ACTSI universities. If selected, the CBO and academic partner will conduct a pilot study that positions them for future collaborative research. The grant will provide $10,000 over an 18 month period. The partnership will also be provided with a graduate research assistant to help with the pilot study (10 hours per week). The project will be funded in two phases as follows: Phase 1 (November 16, 2015 to May 31, 2016): During this period, grantees and researchers will attend a half day meeting and begin planning in collaboration with their new/existing faculty partner. Funding for Phase 1 will be up to $5,000. The deliverables include a one-page summary of the proposed pilot study and submission of the study protocol to the Institutional Review Board of the partner university (a required step in conducting research that involves human subjects ). Phase 2 (June 1, 2016 to May 31, 2017): During this period, grantees will conduct the pilot study planned in Phase 1 and work with academic researchers to write a summary of the results. Funding for Phase 2 will be $5,000. Deliverables for this phase include: 1) data collection for the pilot study (e.g., surveys, interviews, focus groups, pre-post evaluation); 2) a brief report of the results, and 3) description of next steps for the academic research partnership, such as plans for a grant proposal submission to a federal agency. All grantees will be required to participate in a cross-site evaluation. 1

II. Eligibility Criteria Community-based organizations that are eligible to apply for this grant opportunity must: 1. be not-for-profit under Section 501c(3) of the Internal Revenue Code, 2. express interest in partnering or have already partnered with faculty affiliated with Morehouse School of Medicine, Emory University, or Georgia Tech on a research project to address a community-identified health disparity, 3. commit to have at least 2 staff attend a half day kick-off meeting, and 4. serve communities within Atlanta s core metropolitan areas including Clayton, Cobb, DeKalb, Douglas, Fulton and Gwinnett counties or communities within Southwest Georgia counties including Atkinson, Baker, Ben Hill, Berrien, Brooks, Calhoun, Clay, Clinch, Coffee, Colquitt, Cook, Crisp, Decatur, Dougherty, Early, Echols, Grady, Irwin, Lanier, Lee, Lowndes, Miller, Mitchell, Quitman, Randolph, Seminole, Sumter, Terrell, Thomas, Tift, Turner, and Worth. No grants will be made to individuals. Institutions of higher education are NOT eligible. III. Funds Available A maximum of two grants of up to $10,000 will be awarded over an 18 month period beginning in November 2015. Budgets may include personnel (salaries and fringe), consultants, supplies, local travel, and study participant incentives. Budgets may not include capital expenditures, charges for patient care, or rental costs of off-site facilities. IV. Application Requirements A cover letter that includes: i. Organization Name ii. Contact Person (Name, address, phone and fax number, and e-mail address) iii. County Represented iv. A statement that you are applying for the Community Engagement Research Program Community-Academic Research Partnerships Grants Program Pilot Study Grant A proposal narrative (using template in Section X) that: i. Is no more than 5 pages (the budget and budget justification are not included in this count) ii. Is in black font color, and a font size of 11 points or larger (Times Roman, Arial, Courier) iii. Includes a detailed description of the community you serve and a high priority health disparity that you would like to address through a pilot study iv. Explains how a pilot study would be helpful in addressing the disparity 2

v. Describes organizational experience and capacity to address the selected health disparity/research topic vi. Describes interest in conducting collaborative research to address the health disparity vii. Describes an existing academic community research partnership that will conduct the pilot study OR describes the type of faculty partner (e.g., expertise) you are seeking to engage viii. Describes organizational capacity to maintain a long-term research relationship. Identify a staff person to serve as the researcher s main liaison. Not included in the 5-page limit: A budget and budget justification A copy of the organization s 501(c) 3 status, Resumes from two staff who will attend the half day kickoff meeting and be involved in the project, and A letter of commitment from the faculty partner if appropriate. All items should be submitted in one pdf document with the name of your organization clearly marked on the hard copy or saved with your organization name on the electronic copy. V. Selection Process A selection committee appointed by the CERP Community Steering Board will review all proposals. Selection will include review and input by the CERP Community Steering Board. Decisions will be based on the following criteria: 1. Background: extent to which the description of the community and health disparity demonstrates an understanding of the health problem, its causes and possible solutions and the rationale for a pilot study to address the health disparity (25 points) 2. Experience and Leadership: organizational history and leadership needed to address the identified health disparity through research. Consideration will be given to applicants with a track record of addressing the health disparity (25 points) 3. Interest in Research Partnerships: description of why the CBO is interested in partnering with academic researchers to address the health disparity and/or a description of the existing partnership; commitment to participate in all project-related activities (25 points) 4. Organizational Capacity: description of at least two staff, one of whom will serve as the primary liaison to the researcher and who has adequate time to commit to the project (25 points) 5. Budget and Justification: clarity of the budget and justification (no points) Total Points: 100 3

VI. Important Dates/Timeline 9/2/2015 Release of RFA 9/11/2015-10:00am Grant Application Teleconference 9/18/2015 5:00pm Letter of Intent Due 10/2/2015 5:00pm Deadline for Receipt of Applications 11/9/2015 5:00pm Award Notification 11/13/2015 TBA Half-day grantee kick-off meeting 11/16/2015 -TBA Anticipated Project Start Date for Phase 1 VII: Letters of Intent Letters of intent are strongly recommended but are not required. If your organization chooses to submit a letter of intent, letters must be received by 5:00pm EST 9/18/15 via U.S. mail, fax, or e-mail at the address specified in Section VIII below. (Letter should contain title of project and a description of the community identified health disparity maximum two pages). The letter of intent is not binding. VIII. Application Submission A hard copy or an electronic copy of the application must be received by 5:00pm EST October 2, 2015. When sending an electronic version, please submit one pdf document and save the document with your organization name. Send U.S. mail or e- mail the application to: Winifred Wilkins Thompson, PhD, MSW Research Assistant Professor Emory University Rollins School of Public Health Department of Behavioral Sciences & Health Education 49 Jesse Hill Jr. Drive SE, Office 110 Atlanta, GA 30303 O - 404-778-1349 F - 404-778-1315 E-mail: wthomp3@emory.edu IX. Technical Assistance: Grant Application Teleconference A teleconference will be held to discuss the purpose of the funding, review the application process, and answer questions from potential applicants. Please dial 1-866-730-7514. PIN 978973#. Materials for the call can be downloaded from the CERP website (http://www.actsi.org/areas/cerp/), or the Morehouse School of Medicine Prevention Research Center website (http://web.msm.edu/prc/). Materials will be available after 9/4/15. 4

If you have any questions about this Request for Applications or the application process, please contact Dr. Winifred Thompson (contact information in Section VIII). Technical Assistance will be provided throughout the grant funded timeframe. X. Proposal Narrative Template (5 pages max) 1. Background: describe the community served by the CBO and the community- identified health disparity you would like to address through research. Describe the impact of the health problem in your community, the possible causes and potential solutions. Describe why a pilot study is appropriate for addressing the disparity (e.g., why would it be helpful? What do you hope to learn?). (25 points) 2. Experience and History: describe the CBO s organizational history and leadership to address the identified health disparity. Consideration will be given to applicants with a track record of addressing the health disparity and with strong community ties. Be sure to include a description of past and current programs and services to address the health disparity. (25 points) 3. Interest in Research: describe why the CBO is interested in partnering with academic researchers to address the health disparity and document commitment to participate in all project activities (full day meeting, regular meetings with faculty partner, technical assistance, cross-site evaluation, and the pilot study). If you are seeking an academic partner, describe the expertise you need in a partner. If you already have an academic partner, describe the partnership including past projects and experience in jointly conducting research projects. (25 points) 4. Organizational Capacity: describe the qualifications of at least two staff who will work on this project, including who will be assigned as the main contact person for the CERP and faculty partner (include their resumes as attachments). Describe the capacity of the CBO to be a stable and longterm research partner. Include the number of FTE in the organization and the annual operating budget (total dollars per year). (25 points) 5

COMMUNITY ENGAGEMENT AND RESEARCH PROGRAM MINI-GRANT SAMPLE BUDGET PROPOSAL PAGE The following is an example worksheet for completing the grant budget. The specific categories and line items presented here are merely examples, and not all of them may be relevant to your proposal. Provide a detailed budget for Phase 1 and for Phase 2. Type of Expense Personnel Supplies Coordinator Administrative Assistant Consultants (Not to exceed $400 per day) Office Supplies Computer Software Printing Incentives for Study Participants Travel (Example) Local Travel (500 miles x.505 per mile) Lodging at $200.00 per night Per Diem at $50 per day Contractual Costs Recruiter or Facilitator TOTAL: 6

COMMUNITY ENGAGEMENT AND RESEARCH PROGRAM MINI-GRANT SAMPLE BUDGET JUSTIFICATION PAGE Narrative Budget Justification Personnel Explain the specific need addressed and/or project responsibilities of each identified staff person included in the budget. Supplies Generally self-explanatory; however, if not, briefly describe the need for specific supplies and an explanation of how the cost has been estimated. (e.g., flipcharts needed for data collection staff (5 @ $15/chart = $75) Travel Explain need for all travel and anticipated expenses. Travel must be directly related to proposed activities. Contractual Costs Explain the need for each contractual arrangement and how these components relate to the overall project. Consultant Fees Cannot exceed $400.00 per day. If consultants are included in this proposal, explain the need and project responsibilities Grant funds may not be used for the following types of expenses: Grant funds cannot be used for large equipment or entertainment expenses. Food may only be covered with very strong justification (e.g., for a recruitment event or a community meeting). Grant funds cannot be used to pay salary or consulting fees for Morehouse, Emory, or Georgia Tech faculty. 7