The Nebraska Department of Health and Human Services is submitting this application in response to CDC-RFA-DP18-1915PPHF18 entitled “Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke.” This application includes six diabetes prevention and management strategies that will improve access, referrals and participation in self-management programs and CDC-recognized lifestyle change programs; expand coverage for National DPP and DSMES; and increase engagement of pharmacists in the provision of medication management for people with diabetes. The application also includes five cardiovascular disease prevention and management strategies that promote team-based care, the use of standardized quality measures, and the adoption of medication management between pharmacists and physicians while also facilitating the use of self-measure blood pressure monitoring and referrals to community programs to improve treatment of hypertension and cholesterol.
Expected outcomes include (1) increasing participation in ADA-recognized/AADE-accredited DSMES programs by people with diabetes; (2) increasing enrollment and retention in CDC-recognized organizations delivering the National DPP lifestyle change program; (3) increasing medication adherence among patients with high blood pressure and high blood cholesterol; (4) increasing engagement in self-management among patients with high BP and high blood cholesterol; and (5) increasing participation in evidence-based lifestyle interventions among patients with high BP and high blood cholesterol. These should lead to three key long-term outcomes: (1) a decreased proportion of people with diabetes who have an A1C > 9; (2) increased number of people with prediabetes who enrolled in a CDC-recognized lifestyle change program who achieve 5-7% weight loss; and (3) increased control among adults with known high blood pressure and high cholesterol. Many of the activities proposed in the application will build on successes and efforts already in progress in Nebraska, utilizing existing partnerships and Department staff with extensive experience in health promotion, chronic disease epidemiology and surveillance, and program evaluation.