March of Dimes
Chapter Community Grants Program
2011 COMMUNITY AWARD APPLICATION
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 and in
2003 launched a campaign to address the increasing rate of premature birth.
As part of this effort, the Illinois Chapter invites you to participate in our 2011 Community Awards
Program. The goal of the community awards program is to identify and fund community-based programs
addressing the health concerns of pregnant women and infants in the state of Illinois. Community
Awards can be made to support activities such as: purchase and distribution of March of Dimes health
education materials, implementation of March of Dimes community programs (e.g. MOD consumer
education materials related to Quality Improvement Initiative to eliminate elective deliveries prior to 39
weeks gestational age or Becoming a Mom/Comenzando bien® curriculum), or an educational program or
conference for health professionals or consumers. To view our product catalog, visit the March of Dimes
Web site at marchofdimes.com. Please Note: Community Awards may not be used to support equipment
or furniture, individual tuition or conference fees, dues or membership fees, employee salary or programs
requiring long-term March of Dimes funding.
Available Funding and Eligibility
The Chapter's Community Award fund for the state of Illinois for 2011 is $16,000. Awards up a $2,667
may be granted to each Division in the state, and programs/services funded through Community Awards
must be provided in the State of Illinois. For larger scale projects, consider applying for a Chapter
Community Grant. Please check the MOD Illinois website or contact sknight@marchofdimes.com for
more information about applying for a Community Grant.
In order to be eligible to receive a March of Dimes community award, an organization must 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. Applicants must 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.
Application Instructions
1. Complete the attached Application Cover Sheet.
2. Include a two-page letter outlining the following:
Name of agency/organization requesting the award
Description of the program/project that the funds will support (see priority list attached)
Description of budget items requested (please detail)
How the program/project meets community needs and relates to the March of Dimes mission
Time frame in which the funds will be spent
3. Send an e-mail version of the letter and Cover Sheet to sknight@marchofdimes.com along with an
original, signed hard copy of your proposal to the address below by 4:00 p.m., Friday Aug. 12, 2011.
Susan Knight, Director of Program Services and Public Affairs
March of Dimes Illinois Chapter
111 West Jackson Boulevard, Suite 2200, Chicago, Illinois 60604
4. Notification of decisions and check disbursement will take place by 9/30/2011 and 10/15/2011
respectively. Proposals received after 8/12/2011 will be held for review in 2012.
5. Feel free to contact Susan Knight by phone at 312-596-4710 or by e-mail at
sknight@marchofdimes.com if you have questions about this application process.
March of Dimes – Illinois Chapter
Chapter Community Grants Program
COMMUNITY AWARD APPLICATION COVER SHEET
2011
Illinois Chapter
Applicant Organization __________________________________________
Project Title __________________________________________
Street Address __________________________________________
City/State/Zip Code __________________________________________
Contact Name __________________________________________
Phone/Fax __________________________________________
E-mail __________________________________________
Description:
(Please include a brief description of how Community Award funds would be used)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Please list the one primary funding priority that the application addresses from the numbered funding
priority areas on attached list.
_____________________________________________________________________________________
Please indicate the following:
Approximately how many individuals will be served by your project? _________________ _
List the race/ethnicity of the majority of individuals who will be served (if applicable): _______________
Total Community Award requested: (up to $2,667): $______________ ___
Check should be made out to: (Name and address) _______________________________________
A Form W-9 (Request for Taxpayer Identification Number and Certification) is enclosed. In order
to receive payment, this form will need to be completed, signed and returned.
___________________________ ___/___/___ ____________________ ___________
Signature - Primary Staff Person Date Type Name and Title
___________________________ ___/___/___ ____________________ ___________
Signature - Executive Director Date Type Name and Title
Applications must be received by 4:00PM on 8/12/2011. Late applications will not be accepted.
March of Dimes
Chapter Community Grants
ILLINOIS
2011 FUNDING PRIORITY AREAS
All grant proposals must address the March of Dimes mission of improving the health of babies by
preventing birth defects, premature birth and infant mortality. Priority will be given to projects that meet
one or more of the following criteria: a) help reduce racial/ethnic disparities in premature birth;
b) are evidence-based; c) include measurable outcomes. Projects may focus on consumers and/or health
care providers. The March of Dimes does not fund billable health care provider services.
1. Providing or enhancing preconception and interconception health education and/or services. For a
list of 14 specific risk areas, go to http://www.marchofdimes.com/professionals/19695.asp. For more
information, see the National Preconception Curriculum and Resources Guide for Clinicians at
http://beforeandbeyond.org/?page=model-programs.
2. Providing or enhancing risk reduction education and/or services. Risk reduction projects include,
but are not limited to:
Providing smoking cessation education and/or services. Preference should be given to prenatal health
education and information/referral services that utilize the "5 A's" counseling approach. For more
information, go to www.acog.org/from_home/departments/smoking/smokingslides.ppt .
Increasing health education and information/referral services available to pregnant women who use
alcohol or other drugs.
Focusing on preterm birth recurrence prevention for women who have had a previous singleton
preterm birth.
Focusing on quality improvement programs that address late preterm birth or medically
unnecessary early term births through systems that ensure compliance with ACOG guidelines
regarding elective labor inductions and c-sections performed prior to 39 weeks.
Projects aimed at increasing public awareness of why the last weeks of pregnancy count.
3. Implementing disparity-related community programs that aim to decrease racial and ethnic
disparities in birth outcomes.
4. Increasing pregnant women’s participation in state or local maternal child health programs (e.g.
Medicaid, SCHIP, WIC) through enhanced outreach, education and public awareness.
5. Enhancing the availability, quality and utilization of genetics services and/or other patient services
related to preventable birth defects (i.e. outreach and education on newborn screening).
6. Increasing rates of breastfeeding initiation and duration of breastfeeding through first six months of
infant’s life.
National Preconception Resources
California Department of Public Health
Preconception Health and Health Care Initiative Fact Sheet
http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Pages/PreconceptionHealth
andHealthCareInitiativeFactSheet.aspx
Centers for Disease Control (CDC), Consumer Work Group of the Preconception Care
Implementation Committee, Preconception Screening and Assessment Tools
Provides a catalog of existing preconception screening and assessment tools
http://mombaby.org/PDF/Summary%20of%20Preconception%20Tools.pdf
Journal Articles on Preconception Health:
http://www.beforeandbeyond.org/index.php?page=key-articles-and-studies
CDC and March of Dimes, California Chapter
Presentations and handouts from the 2nd National Summit on Preconception Health and
Health Care, Oakland, CA
http://cdc.confex.com/cdc/pcs2007/techprogram/MEETING.HTM
March of Dimes
Preconception Care:
http://www.marchofdimes.com/professionals/preconception.asp
Minnesota Department of Health, Preconceptional Care (PCC) Visit Recommendations
This informational fact sheet compares preconception care guidelines of the American
College of Obstetricians and Gynecologists (ACOG), American Academy Family
Physician (AAFP), Mayo Clinic, Institute for Clinical Systems Improvement (ICSI), and
March of Dimes (MOD).
http://www.health.state.mn.us/divs/fh/mch/preconception/handouts/careguidelines.pdf
The Preconception Health Council of California, Every Woman California
Every Woman California is a statewide initiative through the California Department of
Public Health to provide residents with relevant and current information regarding
preconception health. The website provides information for consumers and providers and
includes information on developing a reproductive life plan and a preconception
knowledge quiz.
http://www.everywomancalifornia.org/
Trust for America’s Health (TFAH), Healthy Women, Healthy Babies: An Issues Brief from
Trust for America.s Health
TFAH finds that the deteriorating health of American women, due in part to wide-spread
chronic disease epidemics like obesity and diabetes, is taking a toll on American infants,
resulting in stagnated improvement when it comes to infant health. TFAH’s report offers
recommendations for Congress and the American health system to aggressively improve
the health of new-born infants (TFAH, 2008).
TFAH. (June 2008). Reports: Healthy Women, Healthy Babies.
http://healthyamericans.org/report/44/healthy-women-healthy-babies
Access the Issue Brief at:
http://healthyamericans.org/reports/files/BirthOutcomesLong0608.pdf
UNC Center for Maternal Infant Health, Preconception Section
Before, Between, and Beyond Pregnancy
In conjunction with the CDC Select Panel on Preconceptional Care, the website provides
education and resources on preconception health for health professionals.
http://www.beforeandbeyond.org/
Wisconsin Association of Perinatal Care (WAPC).
Becoming a Parent: Preconception Checklist
This document is aimed at consumers considering becoming pregnant. The brochure
includes a checklist for consumers to fill out regarding their physical, mental and social
well being as well as concerns and expectations they might have about pregnancy and
being a parent. The checklist is intended to be reviewed with a health care provider once
the individual or couple has filled it out.
WAPC. (2005). Becoming a Parent: Preconception Checklist. (2nd ed.). [Brochure].
Madison, WI. WAPC.
A free copy is available at:
http://www.everywomancalifornia.org/content_display.cfm?contentID=65&categoriesID
=7
Content from Qureshi, M. (2010). Catalog of Preconception Health Initiatives in Region V States. Developed for
the Office on Women’s Health, Region V, U.S. Department of Health and Human Services. For complete catalog,
visit: http://beforeandbeyond.org/?page=model-programs