REQUEST FOR PROPOSALS Participatory Research Partnership Seeks Organizations for Planning Grants to Identify Indicators of Health Disparities The purpose of this Request for Proposals is to identify community-based organizations interested in planning a community-driven, participatory process for identifying indicators related to health disparities in communities. A. Background and Purpose of the Participatory Research Partnership (PRP) The PRP is currently a subcommittee of the Steering Committee for the Eliminating Health Disparities Initiative. The PRP reports to the Steering Committee, providing updates of Partnership activities and recommendations. The efforts of the PRP are aimed at identifying intermediate outcomes that can be used to monitor the progress Minnesota has made toward eliminating health disparities. These intermediate outcomes that impact the health of individuals and communities may include health behaviors, characteristics of health systems, environmental factors, community assets, historical, and cultural factors. The PRP will use a participatory research process to identify intermediate outcomes, identify possible sources of data, develop measurement tools, design a method for data collection, and disseminate results to the broader community. The PRP will work with communities to facilitate the process necessary for communities most affected by health disparities to be full participants and leaders in the identification of indicators and methods for collecting data to monitor Minnesota’s progress toward eliminating health disparities. The PRP is engaged in four phases of work and one ongoing operating activity as follows: Phase I: Create and develop the Participatory Research Partnership (initiation through May 2003, funded); Phase II(a): Work with communities to identify existing indicators of intermediate outcomes and develop a planning process for refining and expanding this list of indicators (September 2002 through October 2003, funded); Phase II(b): Work with communities to refine and expand upon existing indicators of intermediate outcomes (future phase, unfunded); Phase III: Work with communities to identify data collection methods and processes (future phase, unfunded); and Phase IV: Work with communities and MDH to collect and disseminate data (future phase, unfunded). Ongoing Operating Activity: Planning and identification of funding sources. Participatory Research Partnership Planning Grant RFP page 1 B. Purpose of the Planning Grants We need your assistance to identify existing intermediate outcomes related to health disparities. We also want to provide an opportunity for community members and community-based organizations to develop a plan to identify additional indicators to assess health disparities and monitor Minnesota’s progress toward eliminating health disparities in their communities. Please note that this RFP specifically focuses on Phase II(a) of the PRP’s work. We refer to it as the “planning process” throughout this document. In response to this RFP, we are asking applicants to propose how they would develop a plan to engage communities in the identification of indicators. In addition, the applicant should discuss how they would identify relevant information/indicators that have already been collected in their community (e.g. past focus groups or surveys). C. Criteria for Applicants The successful applicant should be a community member, community organization, or partnership of organizations that serve or represent communities/populations of color in the state. The PRP is especially interested in individuals and organizations whose proposals are broad in their reach across different aspects of their community (e.g., rural and urban communities both involved in the process or several immigrant groups from similar geographic locations addressed). The PRP will also be looking for grantees with experience with populations of color, community assessment and health issues. D. Available Funding The PRP has a total of $30,000 for the planning process and expects to award up to 5 grants. E. Application Requirements Proposals should be no longer than 10 pages, double-spaced, 12 point font. Proposals will be evaluated on clarity and the qualifications of the applicant rather than the length of the proposal. A budget with justification should be provided and does not count toward the 10-page limit. Budgets should include costs for personnel, travel, and community engagement activities. Detail should be provided as to the number of hours expected to be devoted to this project by each individual and their corresponding billing rate. The proposal should answer the following questions: 1) History and Description (3 pages or less) What are your goals or what is the mission and goal of your organization? How would you describe yourself or your organization to someone unfamiliar with your work? Participatory Research Partnership Planning Grant RFP page 2 What are your or your organization’s qualifications for doing this type of work? What experiences do you have engaging communities and collaborating with other organizations in your activities? 2) Definition of Community (1 page or less) How do you define the community you or your organization are interested in planning for? This could be one community or multiple communities. How will you ensure the community is broadly represented? 3) Workplan (6 pages or less) How will you use a participatory process to plan the indicator identification process (this includes identifying existing indicators and planning a process to refine and expand upon existing indicators)? How will you engage members of the community in this process? What steps will you undertake during the planning process? What will you do with the funds awarded? How will you identify research (qualitative and quantitative) already done in your community about potential indicators relevant to understanding health disparities? What other organizations will you consider collaborating with during planning? What current community or organization activities have taken place or are currently taking place that might inform this indicator project? Proposals should be sent to: Participatory Research Partnership Planning Grant Selection Committee The Urban Coalition 2610 University Avenue West, Suite 201 St. Paul, MN 55114 Electronic submissions are allowed and recommended: heather@urbancoalition.org. Proposals are due by 5:00 p.m. on June 30th, 2003. F. Timeline Proposals are due June 30th, 2003 by 5:00 p.m. Grants will be awarded by July 15th, 2003. Planning process must be completed by October 15th, 2003. We expect that organizations awarded planning grants will attend monthly meetings to share their experiences, ask questions, and discuss progress with members of the PRP and other grantees. Participatory Research Partnership Planning Grant RFP page 3 G. Project Deliverables The planning process supported by these grants should result in a final report that includes the following items: Indicator Identification Workplan Detailed workplan to be used for the indicator identification process including the planned engagement methods and activities your organization will use with community members to identify indicators; Detailed timeline for the indicator identification process; Detailed budget for the indicator identification process (estimating the number of weeks or months as opposed to specifying dates); Definition of communities served by this process, including specification of whether communities are urban/rural, defined by country of origin, geographic and so on; and If relevant, a list of organizations to be involved in the indicator identification process, including letters of support from these organizations. Indicator Inventory Comprehensive review/inventory of current indicators gathered by organizations serving or connected with your community. Implementation Recommendations Ideas for the implementation process to follow the planning process when funding is secured. A separate deliverable must be provided containing a final financial report for the planning process, and detailing all expenditures incurred during the planning process compared to the budget approved for this grant. H. Next Steps Building upon the reports provided by grantees, the PRP in cooperation with grantees, will seek funding for future implementation phases. Funding may be secured in entirety or in portions across grantees. At this time we cannot promise money for implementation of plans or that the organizations involved in the planning will necessarily be those implementing the indicator identification process. The PRP will offer, following the planning period, an opportunity for all planning organizations to come together and work on a comprehensive indicator identification plan reaching all communities. Participatory Research Partnership Planning Grant RFP page 4 APPENDIX: ADDITIONAL RESOURCES AND INFORMATION What do we mean by participatory? Community-based participatory research is a "collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community, has the aim of combining knowledge with action and achieving social change to improve health outcomes and eliminate health disparities." WK Kellogg Foundation Community Health Scholars Program See http://www.futurehealth.ucsf.edu/ccph/commbas.html for more information. What is a community? A common definition of community, according to participatory public health research, is “a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.” (From: “What Is Community? An Evidence-Based Definition for Participatory Public Health”) Core elements of community are: Locus—a sense of place; Sharing—common interests and perspectives; Joint action—a source of cohesion and identity; Social ties—the foundation for community (interpersonal relationships forming the foundation for community); and Diversity—social complexity within communities. See http://www.advocatesforyouth.org/publications/transitions/transitions1403_2.htm#2 for more information. Participatory Research Partnership Planning Grant RFP page 5 What is an indicator? Put simply, an outcome is a desirable result and an indicator is a way to measure the desirable result. The indicators we are interested in are those things you want to cultivate or change (and measure) in society or in communities, those factors affecting the desirable outcome. Indicators are those factors that make it easier or harder for individuals to take the healthy path versus the unhealthy path (and may be contributions to risky behavior). Criteria for indicators include: The indicator should reflect community values. o The community must feel that it owns the process defining the indicators. o The voice of the community must be heard in this project. o The choice of the indicators must reflect what seems important to the community. The indicator should be valid and measurable. o The indicator can be measured through established or innovative methods in order to serve of some community and/or research use. Communities must trust the indicator. Community members must understand the indicator. Participatory Research Partnership Planning Grant RFP page 6 Potential Questions to Guide Indicator Identification What does a healthy community and a healthy society look like? What makes a healthy community and a healthy society? What can individuals do to become and stay healthy? What do individuals do to make themselves less healthy? What fosters or prevents healthy attitudes and behaviors? What can the system (government, healthcare, other) do to help communities stay healthy? How do systems keep communities from being healthy? Often systems are not aware of how they enable or inhibit communities from being healthy. Why should systems help keep communities healthy? How can communities teach systems and how can systems learn from communities? What predicts changes in the systems’ attitude and behaviors? What can society do to help communities stay healthy? How does society keep communities from being healthy? Often the society does not know how it enables or inhibits communities from being healthy. Why should society help keep communities healthy? How can communities teach society and how can society learn from communities? What predicts changes in society’s attitude and behaviors? What can communities offer to help individuals stay healthy? How do communities make it hard for individuals to be healthy? What predicts changes in communities’ attitudes and behaviors? In what ways is your community healthy? In what ways is your community not healthy? How do you keep babies healthy in your community? How do you keep young people healthy? How do you keep adults healthy? What needs to be done to make your community healthier? What are particular strengths of your community? How do we allow communities and families to build on their assets? What are some gaps or needs in your community? How do your community’s culture, identity and history influence your community’s health? What are the factors that influence health disparities? Are the indicators selected actionable? Which indicators do communities care about? An example of indicators related to a specific health outcome, infant mortality, is attached. Participatory Research Partnership Planning Grant RFP page 7 Example of Indicators of Intermediate Outcomes for Infant Mortality The Minnesota Department of Health developed an example of possible indicators related to infant mortality. These indicators are included below and are intended to serve as a demonstration of how community-identified indicators could be used to evaluate efforts toward eliminating health disparities. A. Systems Factors Cultural competency of providers Access to health care including clinic hours Health care workforce issues Location of clinics and hospitals Insurance (rate of coverage among community members) B. Risk and Protective Factors Smoking during pregnancy (% of women who smoke during pregnancy) Drinking during pregnancy (% of women who drink during pregnancy) Use of drugs during pregnancy (% of women who use drugs during pregnancy) Exercise (% of women who exercise during pregnancy) Nutrition (% of women who practice good nutrition habits during pregnancy) Prenatal care (Gindex or Kottelchuck) C. Community Assets Social support and cohesion (% of residents who report adequate social support) Access to clinics and facilities in near vicinity (% of residents who report accessible facilities in their neighborhood) Extended families (% of residents who report) Cultural strengths (% of residents who report) D. Social and Environmental Factors Poverty (federal poverty rates, free and reduced lunches) Racism (report of discrimination based on race) Employment (employment rates and self-report) Housing (% of income used for housing) Education (education attainment and % of students meeting graduation Requirements) Transportation Crime/violence Participatory Research Partnership Planning Grant RFP page 8