Delta State Rural Development Network Grant Program (DELTA) - Methodist Le Bonheur Community Outreach (MLCO), the lead applicant organization for the GrowWell TN-Delta Rural Health Initiative requests $2,886,804 in funding support over a three-year grant period (2026-2029) to expand obesity and diabetes prevention and self-management services for rural populations in 19 counties of the Mississippi Delta Region of West Tennessee (Tennessee Service Region A). Other GrowWell TN-Delta Rural Health Initiative members that will participate in the project include Paris Henry County Healthcare Foundation, Henry County Medical Center, Hardeman County Community Health Center, University of Tennessee Extension Service, and 13 rural school districts. The GrowWell TN Network partners have collaborated and provided services to the region for over 13 years. All programs of the Network are delivered in partnership with state and county agencies, schools, healthcare providers, and community-based agencies throughout the Tennessee Delta. Focus areas for the project are obesity and diabetes prevention and management for adults and youth. The target population includes adults and children in rural communities in the region’s eligible counties who have or are at risk for obesity and diabetes based on lifestyle and other factors. It is anticipated that the project will serve 7,115 people across all programs. The project will utilize multiple evidence-based and promising practice models, including Care Coordination, the National Diabetes Prevention Program, Pharmacy Assistance, school-based health services, case management, Motivational Interviewing, Cognitive Behavioral Therapy, referrals for behavioral health services, group health education on healthy lifestyles, and 85210 Every Day!, an adaptation of the 5210 Let's Go! Model. In addition, partners will work to build network members and capacity to deliver obesity and diabetes prevention and management services, including professional development, program evaluation, quality improvement and sustainability planning. The expected long-term impact of the proposed programs and activities is the empowerment of families to overcome access barriers to healthy lifestyles and primary health care, thereby optimizing population health. This will include increased public/patient awareness of the serious nature and risks of obesity in causing chronic diseases, greater understanding of ways to prevent obesity and diabetes through healthy lifestyles, increased availability and participation in programs that fight obesity and diabetes, and improved access to clinical interventions for children and adults identified with obesity, diabetes and/or related diseases. The collective aim of these services and programs will be to reduce morbidity and mortality and improve the health status of rural West Tennessee residents.