Begin Application - Breakthrough Accelerator

1. Innovation Background

Innovation Name:(Required)

What is the challenge you are trying to solve? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will clearly state the challenge and include an explanation of the underlying issues that cause the challenge—not just the symptoms. If you have numerical or statistical evidence to show the scope of the challenge, include it here. Your response to this question should be limited to the challenge and should not describe your innovation.)

Describe your innovation. (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will provide significant details, including but not limited to, who the end user/customer is, what the components of the innovation are, and exactly how an end user uses the innovation, step-by-step.)

How will your innovation solve for the challenge you described above? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will describe how your end users’ experience of the challenge will change [i.e., improve] as a result of your innovation and will specifically address how your innovation will improve adolescent sexual and reproductive health outcomes.)

In your eyes, what is innovative about your innovation? What sets it apart from what others are doing to address the challenge you described above or from the status quo? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will identify whether other solutions exist (i.e., “competitors,” and if so, what they are) and clearly describe how your innovation is an improvement over what is currently available.)

What is the current state of your innovation? Select the most appropriate response.(Required)

If you have launched your innovation, are any of these true? Select all that apply.(Required)

Tell us what components of your innovation currently exist (not what you plan to build or change). (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will list and clearly describe the elements of your innovation that have been developed to date.)

How did you engage your end user(s) in the development of your innovation? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will clearly describe the specific activities conducted with your end users, such as interviews, focus groups, testing, or other methods, and explain how those activities informed the development of your innovation.)

Describe one time you made a change—small or large—to your innovation based on end user feedback. (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will describe—in sufficient detail—a substantive change your team made to your initial idea based on what you learned directly from your end users.)

What information, insights, or evidence do you have from your end users that show this innovation can work? This can include data, testing results, or other forms of feedback. You do not have to have done any formal evaluation, but if you have any data, please share them. (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will provide numerical evidence that this is wanted by your end users, which may include: engagement/usage numbers, user ratings, or impact measurement, among other evidence.)

What are your TWO biggest challenges right now? What types of support would you like from Breakthrough to help with those challenges? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will clearly define two distinct challenges and identify concrete ways Breakthrough can provide support with these challenges.)

Why are you the “right” team to tackle the challenge you outlined in question #2 ("What is the challenge you are trying to solve?")? (maximum 1450 characters including spaces, approximately 250 words)(Required)

(A highly rated answer will clearly show how your team’s expertise, experience, skills, and/or passions relate to the challenge you outlined in question #2.)

2. Team Members

Team Information: Member 1

Name:(Required)

Email address:(Required)

Location (City, State):(Required)

I confirm I am over 18 years of age.(Required)

Yes

I am a young person (ages 18-26).(Required)

Yes

What is your main responsibility (title)?(Required)

Organization affiliation:(Required)

Teams may be composed of individuals who come from different organizations.

Role on the innovation team:(Required)

Current percentage of average work week spent on your innovation:(Required)

Anticipated percentage of average work week spent on your innovation if selected for Breakthrough:(Required)

Short bio highlighting experience that is relevant for your innovation. If applicable (not required), we welcome you to share any personal experiences that inform your perspective on the challenge your innovation is solving for. (maximum 1450 characters including spaces, approximately 250 words)(Required)

Team Information: Member 2

Name:(Required)

Email address:(Required)

Location (City, State):(Required)

I confirm I am over 18 years of age.(Required)

Yes

I am a young person (ages 18-26).(Required)

Yes

What is your main responsibility (title)?(Required)

Organization affiliation:(Required)

Teams may be composed of individuals who come from different organizations.

Role on the innovation team:(Required)

Current percentage of average workweek spent on your innovation:(Required)

Anticipated percentage of average work week spent on your innovation if selected for Breakthrough:(Required)

Team Information: Member 3

Name:(Required)

Email address:(Required)

Location (City, State):(Required)

I confirm I am over 18 years of age.(Required)

Yes

I am a young person (ages 18-26).(Required)

Yes

What is your main responsibility (title)?(Required)

Organization affiliation:(Required)

Teams may be composed of individuals who come from different organizations.

Role on the innovation team:(Required)

Current percentage of average workweek spent on your innovation:(Required)

Anticipated percentage of average work week spent on your innovation if selected for Breakthrough:(Required)

3. Other

Who currently owns the intellectual property and/or copyright for your innovation? (maximum 700 characters including spaces, approximately 100 words)(Required)

What legal structure is currently supporting your innovation?(Required)

Please specify the legal structure (e.g. fiscal sponsor, informal project, etc.).

Who is your point of contact for communication with the Breakthrough team?(Required)

Who is your designated fiscal point of contact? This person will be responsible for receiving, distributing, and managing funds. This person can be the same person as the point of contact for communication.(Required)

Have any team members participated as a sub-grantee, prime, or consultant for and/or received any funding from the following grant programs from the U.S. Department of Health and Human Services, Office of Population Affairs (OPA)? Please check all that apply.(Required)

TPP23 Innovation Hubs

TPP20 Networks

TPP18 Formative Testing Projects

TPP152A Projects

TPP Tier 1 Projects

Title X Family Planning Grantees or Sites

None of the above

Please select which OPA Innovation Hub.

In/Tend

Launch

RYSE (Reimagining Young People’s Sexual Health Equity)

TISH (Theory and Innovation Support Hub)

youthink

How did you hear about the Breakthrough Accelerator? Please check all that apply.(Required)

Social media (e.g., LinkedIn, Instagram)

Breakthrough Accelerator Newsletter

OPA Newsletter

OPA Project Officer

Industry Event or Conference

Referral from another OPA Innovation Hub

Family, friend, colleague

Other

Please select which OPA Innovation Hub.

In/Tend

Launch

RYSE (Reimagining Young People’s Sexual Health Equity)

TISH (Theory and Innovation Support Hub)

youthink

Please specify how you heard about the Breakthrough Accelerator.

4. Fiscal Information

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Please complete and upload the linked budget template in accordance with the guidance given in the sheet. We acknowledge that you might not know how your funds will be used at this time. You will have the opportunity to make changes if selected as part of the cohort, but we ask that you provide budgetary information based on what you know so far. Please read the Instructions sheet in the template before filling it out. Important note: As stated in our eligibility requirements, selected teams must be able to provide a completed W-9 and ACH Transfer Form in order to receive funds.

Because the Breakthrough Accelerator is intended to help you refine and scale your innovation rather than implement it as it currently exists, Breakthrough funding should not be used to implement your innovation in its current form. This means, for example, that Breakthrough funding should not be allocated toward costs associated with ongoing programming, service delivery, or the purchase of routine program materials. Instead, Breakthrough funds are intended to support activities to test, strengthen, refine, prepare your innovation for evaluation and/or package it for broader use (i.e., “commercialization” or “going to market”).

Please use the Budget and Budget Narrative Templates (files provided below) to complete your submission. Instructions for completing both the templates are incorporated within the respective files. Be sure to read the Instructions Document before preparing your budget materials for general guidelines and key budget considerations.

Important note: As stated in our eligibility requirements, selected teams must have a fiscal sponsor that can receive and manage funds on their behalf. The fiscal sponsor is responsible for completing and submitting required financial documentation (i.e., W-9 and ACH Transfer Form), maintaining appropriate financial controls, processing payments,

Instructions Document

Budget Template

Budget Narrative Template

Upload Files(Required)

Drop files here or

Accepted file types: docx, doc, pdf, xlsx, xls, Max. file size: 50 MB, Max. files: 5.

5. Acknowledgment of Breakthrough’s Funding Source and Federal Requirements

The Breakthrough Accelerator is funded by the U.S. Department of Health and Human Services (HHS), Office of Population Affairs (OPA). Funding for the Breakthrough Accelerator, and for the teams selected to participate, is contingent on continued federal funding for the program.

As a federally funded program, Breakthrough must comply with applicable federal laws, regulations, executive orders, and other federal requirements. If selected, teams may be asked to work with the Breakthrough team to ensure that program-related activities and materials align with these requirements. We will work collaboratively with selected teams to navigate these expectations while supporting their innovations.

By submitting an application, you acknowledge that you understand the federal funding context of the Breakthrough Accelerator and are willing to participate in the program within these parameters if selected.

Acknowledgment(Required)

I acknowledge and understand this information.