Community Transformation Grants Frequently Asked Questions (FAQs)

• What is the purpose of the Community Transformation Grants?
• Who received CTG funds, and how many people will be reached?
• What is the distinction between the two types of grantees: Capacity Building and Implementation?
• What activities are the 59 grantees planning to undertake?
• What are health disparities, and how will CTGs address them?
• What is the rural/frontier reach of this program?
• How will CTGs specifically address the burden of heart disease and stroke, the number one and three killers of Americans?
• How will CTGs effectively serve smaller communities?
• The statement of work for the CTGs refers to policy, environmental, programmatic, and infrastructure changes. What does this mean?
• What is the National Dissemination and Support Initiative?
• How does the National Dissemination and Support Initiative complement the activities of the larger CTG program?
• What are Dissemination and Acceleration awards?
• When were the awardees of CTG Capacity Building and Implementation grants announced?

 

What is the purpose of the Community Transformation Grants?

The Community Transformation Grants (CTG) program provides an important opportunity for communities and states of all sizes to support intensive approaches to reduce risk factors responsible for the leading causes of death and disability and to prevent and control chronic diseases in the nation.

CTGs will support the planning and implementation of projects proven to reduce chronic diseases, which are responsible for 70% of deaths and 75% of health care costs in the United States. By promoting healthy lifestyles, especially among population groups experiencing the greatest burden of chronic disease, these grants will help improve health, reduce health disparities, and lower health care costs. More specifically, CTG-funded projects will aim to affect changes in weight, proper nutrition, physical activity, tobacco use, and emotional wellbeing and overall mental health.

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Who received CTG funds, and how many people will be reached?

Approximately $102 million was awarded to 59 communities and states to serve more than 115 million Americans. These awards are distributed among state and local government agencies, tribes and territories, and state and local non-profit organizations within 35 states, including seven tribes and one territory.

Grantees will serve one of five different areas: a large county (population over 500,000), an entire state (in cases where a state does not have a large county), a state minus its large counties, a tribe (or tribes), or a territory. The service-area breakout of the 59 grantees is as follows:

o Large counties                       28 (47% of grantees)
o Entire state                            10 (17%)
o State minus large counties     13 (22%)
o Tribes                                     7 (12%)
o Territory                                 1 (Republic of Palau)

 

A list of CTG grantees is available at www.cdc.gov/communitytransformation/funds/index.htm

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What is the distinction between the two types of grantees: Capacity Building and Implementation?

Two types of grants were awarded to communities and states: capacity building and implementation.

• 23 grantees will work to build capacity to implement changes by laying a solid foundation for community prevention efforts to ensure long-term success. Grantees will work to establish or strengthen multi-sectoral coalitions, summarize existing community health data, conduct health needs assessments of their areas to be served, and develop plans with specific health-impact measures. Funding amounts range from $147,000 to $500,000 depending on population size and scope of project.
• 36 grantees will implement evidence and practice-based programs to achieve changes by running programs designed to improve health and wellness. Funding amounts range from $500,000 to $10 million depending on population size and scope of project.

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What activities are the 59 grantees planning to undertake?

Funded states and communities will be expected to implement intensive approaches to reduce risk factors responsible for the leading causes of death and disability and to prevent and control chronic diseases within their jurisdictions, as well as to narrow gaps in health outcomes across population subgroups.

States and communities will work to address the following priority areas: 1) tobacco-free living; 2) active living and healthy eating; and 3) evidence-based quality clinical and other preventive services, specifically prevention and control of high blood pressure and high cholesterol. Other priority areas include social and emotional wellness and healthy and safe physical environments.

States and communities may also address additional areas of disease prevention and health promotion that will contribute to the overall goal of reducing chronic disease rates. These areas include adolescent health; arthritis and osteoporosis; cancer; diabetes; disabilities and secondary conditions; educational and community-based services; environmental health; HIV; injury and violence prevention; maternal, infant, and child health; mental health and mental disorders; health of older adults; oral health; and sexually transmitted diseases.

Applicants proposed specific activities in their applications, but grantee activities will not be finalized until plans are negotiated with CDC (by early 2012).

Examples of activities that grantees can pursue include providing greater opportunity for physical activity in school physical education programs and protecting residents from secondhand smoke. Other grantees may focus on eliminating "food deserts" in underserved neighborhoods and improving community design to promote walking and biking. Still others may partner with large health systems to promote control of high blood pressure and high cholesterol and to use automated systems to remind patients to get their scheduled checkups.

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What are health disparities, and how will CTGs address them?

Health disparities represent preventable differences in the burden of disease, disability, injury, and violence, or in opportunities to achieve optimal health. All Americans should have equal opportunities to make healthy choices that allow them to live long, healthy lives, regardless of their income, education, or race/ethnic background.

Reducing health disparities and advancing health equity is a core principle of the CTG program. All communities and states will work on both population-wide improvement and reducing disparities in health outcomes across identified population groups.

CTG awardees will work to advance health equity and reduce disparities by implementing targeted efforts for populations experiencing health disparities, working with and in organizations and settings that can reach underserved populations. Awardees also will adapt jurisdiction-wide strategies to address barriers and avoid negative unintended outcomes for populations experiencing disparities, including:

• Low-income populations, including those in food or housing assistance programs, low-wage employees, and Medicaid recipients.
• Racial/ethnic minorities including African-American/Black, Hispanic/Latino, Asian, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native populations. People with disabilities, including people with mental health conditions.
• The LGBT (lesbian, gay, bisexual, and transgender) community.
• Other population groups experiencing disparities including the uninsured, people with substance abuse conditions, the homeless, and those in underserved geographic areas.
• Children, youth, and older adults.
  

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What is the rural/frontier reach of this program?

Twenty percent of CTG funds are directed at rural or frontier areas and will reach a combined rural/frontier population of over 20 million persons. These areas are defined as follows:

• All counties that are not part of a Metropolitan Statistical Area are considered "rural." The Office of Management and Budget (OMB) designates all U.S. counties as metropolitan, micropolitan, or neither. Counties designated as either "micropolitan" or "neither" are considered rural for the purposes of CTG funds.
• The term "frontier" is defined in the Affordable Care Act as it relates to "frontier county" and "frontier state." A "frontier county" is one with a population per square mile less than 6. A "frontier state" is one in which at least 50% of the counties in the state are frontier counties.
  

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How will CTGs specifically address the burden of heart disease and stroke, the number one and three killers of Americans?

The CTGs will give priority attention to key risk factors for heart disease and stroke including tobacco use, poor diet, physical inactivity, and unhealthy weight. In addition, funded communities will work to improve the control of high blood pressure and high cholesterol, which plays a major role in cardiovascular health.

These activities will amplify the efforts of Million Hearts™, an initiative announced earlier this month by HHS to prevent one million heart attacks and strokes in the next five years.

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How will CTGs effectively serve smaller communities?

A primary goal of the Community Transformation Grants is to create healthy environments and promote healthy lifestyles nationwide, especially among population groups experiencing the greatest burden of chronic disease. These populations include people living in smaller, as well as rural and frontier, communities. At least 20 percent of the grants will provide funding to rural and frontier areas. In addition, all grantees will work with local organizations within their jurisdiction to ensure local participation, support, and effective implementation and sustainability of the program.

In addition, CDC is funding seven national networks of community-based organizations for one of two activity areas: 1) promoting partnerships and leveraging opportunities and 2) accelerating dissemination, uptake, reach, and spread of evidence-based and practice-based prevention strategies in communities nationwide. These efforts will seek to address health disparities and the needs of rural and frontier grantees.

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The statement of work for the CTGs refers to policy, environmental, programmatic, and infrastructure changes. What does this mean?

These changes include activities such as the following:

• Policy—Educate the public, policy makers and stakeholders about evidence- and practice-based policy interventions to improve population health and foster healthy behaviors.
• Environmental—Create social and physical environments that support healthy living and ensure that the healthy choice is the easy choice.
• Programmatic—Increase access to prevention programs to support healthy choices and contribute to wellness, ensuring integration of their use in a variety of community and clinical settings (such as schools, community recreation centers, workplaces, and Federally Qualified Health Centers).
• Infrastructure—Establish systems, procedures, and protocols within communities, institutions, and networks that support health behaviors. These activities include improving linkages between public health and health care systems.

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What is the National Dissemination and Support Initiative?

The National Dissemination and Support Initiative (also known as the National Network or "CTG-2" initiative) of the CTG program funds national networks of community-based organizations to support, disseminate, and amplify the evidence-based strategies of the CTG program in communities and states nationwide, including rural and frontier areas and in those areas with health disparities. Seven grantees received a total of $4.2 million under this initiative.

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How does the National Dissemination and Support Initiative complement the activities of the larger CTG program?

These funded organizations will help support, disseminate, and amplify the evidence-based strategies of the CTG program in communities nationwide, including in rural and frontier areas and in those areas with health disparities.

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What are Dissemination and Acceleration awards?

Dissemination and Acceleration are the two separate categories of funding for the National Dissemination and Support Initiative. They are defined as follows:

• Dissemination grantees will support, disseminate, and amplify the evidence-based strategies of the CTG program nationally. Funded organizations will engage and collaborate with governmental, private, and non-governmental sectors and work to disseminate CTG strategies within their national network of local affiliates, including reaching rural and frontier areas and those experiencing health disparities.
• Acceleration awards are intended to help spread CTG work across the country and in particular to help reach rural and frontier areas and areas with health disparities. Funded organizations are required to award at least 50% of their funds to local affiliates to support local communities to assess and address CTG health priorities.
  

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When were the awardees of CTG Capacity Building and Implementation grants announced?

These awards were announced by HHS on September 13, 2011, in concert with the launch of the HHS-wide Million Hearts™ initiative.

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