The Iowa Department of Public Health (IDPH) proposes to implement an Iowa approach to “Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke-Financed in party by 2018 Prevention and Public Health Funds (PPHF)”- CDC-RFA-DP18-1815 in order to decrease the burden of diabetes and heart disease and stroke throughout the state. IDPH has identified and prioritized the delivery of its selected approach and strategies in four high burden Target Areas (focused in 13 Iowa counties) and through implementation of identified strategies and activities across the state.
The project will be implemented with financial support of $1,602,110, and the efforts of 5.6 FTE. Staff are subject matter experts in pre-diabetes, diabetes, heart disease and stroke, program direction, data use and analysis, and contract management. Evaluation efforts will be led through a contract with the University of Iowa Center for Public Health Evaluation and Research which has provided evaluation expertise to the IDPH for the past five years. The evaluation work brings a continued, knowledgeable focus to the team’s efforts and for working with the Centers for Disease Prevention and Control to evaluate the full impact of Iowa’s project and the national program. The team brings continuity of experience, structured and well-developed partnerships, and passion to the planning, implementation and evaluation of the proposed project.
The IDPH will implement and evaluate the following evidence-based strategies to prevent and manage diabetes and decrease heart disease and stroke mortality in Iowa’s targeted high-burden areas and populations:
• Category A: The IDPH will increase payer coverage and support development of new Diabetes Prevention Programs (DPP) and Diabetes Self Management Education/Support (DSMES) programs in underserved areas; increase healthcare provider patient referrals to DPP and DSMES, and raise awareness and educate providers on best practices and diagnosis, screening and referral to evidence-based programs; and increase use of patient care processes that promote medication management and DSMES in work with pharmacists. These activities will impact the long-term goals of a decreased proportion of people with diabetes with an A1C>9 and an increased number of people with prediabetes enrolled in a CDC-recognized lifestyle change program who have achieved 5-7% weight loss.
• Category B: The IDPH will expand electronic health record (EHR) and health information technology (HIT) use to identify and decrease healthcare disparities and report clinical quality measures; implement evidence-based models, programming and best practices proven to increase high blood pressure control and high cholesterol management; train and certify non-physician staff; implement evidence-based practice that engages non-physician members as partners and increases their clinical capacities for team care and care coordination; promote and implement medication therapy management (MTM) for high blood pressure and high cholesterol, self-measured blood pressure (SMBP), and undiagnosed hypertension detection, rescreening, diagnosis and treatment. These activities will impact the long-term goal of increased control of high blood pressure and management of high blood cholesterol levels (LDL and HDL).