Kentucky ranks 46 in health outcomes and 22.2% of adults consider themselves to have fair or poor health. Kentucky has a median diabetes prevalence of 13.4% and a high blood pressure prevalence of 39%, both significantly above the national rates. The Kentucky Department for Public Health’s (KDPH), Kentucky Diabetes Prevention and Control Program (KDPCP), Kentucky Heart Disease and Stroke Prevention (KHDSP) Program and their partners aim to address the poor health status of Kentuckians by implementing and evaluating a set of evidence-based strategies to prevent and control diabetes and cardiovascular disease (CVD) in high-burden populations in Kentucky. The high-burden populations identified in this application’s activities are diverse in geography, race and ethnicity, and socio-economic status.In 2011 KDPH in collaboration with many government and community partners developed Unbridled Health – A Plan for Coordinated Chronic Disease Prevention and Health Promotion. This plan identified strategies and action items that created policy and systems change to support healthy choices, expanded access to health screening and self-management programs, built strong community-clinical linkages, and translated data into useful information for program decision making. That plan aligned with CDC RFA-DP13-1305 and the two combined created the successful foundation on which this application response to CDC-RFA-DP18-181PPHF18 (NOFO 1815) is built. To address diabetes management, KDPCP will maintain its nationally recognized innovative accreditation structure to support local Health Departments provide AADE7™ self-management classes to patients with diabetes as part of the Healthy Living with Diabetes program. Under this umbrella accreditation, 83 Kentucky counties will continue to have access to accredited DSMES services. These strategies and activities include innovative expansions geographically and demographically through technology and creative problem solv
ing to reach underserved communities. Participants have experienced statistically significant drops in A1c levels after completing the program in the two and a half years it has been active. The Diabetes Prevention efforts use CDC recognized Diabetes Prevention Programs and supporting communication and outreach activities to educate communities, providers, and people at risk for diabetes about healthy lifestyle behaviors that can delay the onset of type 2 diabetes or reduce its impact. Under these sets of strategies and activities KDPCP will work toward CDC recognized DPP as a covered benefit for a variety of types of insured groups. Both sets of strategies require innovative thinking using limited resources for Kentucky’s high burden medically underserved populations. To address cardiovascular risk, KHDSP will continue to promote the adoption of evidence-based quality measurement at the provider level through the consistent modeling and implementation of the Cardiovascular Assessment, Risk Reduction and Education (CARE) Collaborative. The CARE Collaborative is a free blood pressure awareness program that aims to increase the number of people who are taking action to self-manage elevated blood pressure through appropriate counseling about health behaviors and/or lifestyle changes. CARE is the primary cardiovascular health change strategy of the Kentucky Heart Disease and Stroke Prevention Task Force facilitated by KHDSP. KHDSP will expand CARE into new underserved populations, settings, and geographic locations. KHDSP will develop and implement a statewide strategic quality improvement plan to assist partners with their own quality data measures, specifically National Quality Forum #0018. The CARE Collaborative is also adapting programming to non-traditional settings like worksite wellness and community settings for people with disabilities.