A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes in Colorado - The Colorado Department of Public Health and Environment (CDPHE) is submitting an application to the CDC-RFA-DP-23-0020 A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes funding opportunity. CDPHE is a state health department and is applying for Component A. The focus area is Colorado (statewide) and CDPHE has the experience and capacity to work statewide, as well as with specific priority populations, including rural/frontier populations, low-socioeconomic status (SES) communities, Black and Hispanic populations, and older adults. CDPHE is located at the following permanent address, in the state of Colorado, relevant to the service area proposed in this response: 4300 Cherry Creek Drive South Denver, CO 80246. Although the prevalence of diabetes in Colorado is 7%, several populations experience higher diabetes burden, including rural/frontier populations, low SES communities, Black and Hispanic populations, and older adults. Coloradans identifying as Black, non-Hispanic (10.7%) and Hispanic (9.5%) have the highest prevalence of diabetes. Colorado is becoming more racially and ethnically diverse and seeing considerable growth in the proportion of residents who are over 65. Colorado’s state demographer projects that one in five Coloradans will be over the age of 65 by 2050. Among Colorado adults aged 65 or older, 16% have a diagnosis of diabetes. As Colorado’s population grows and ages, it is imperative to work with entities serving low SES, older adults, Medicare beneficiaries, and those providing culturally-tailored services for racial and ethnic populations to prevent diabetes and support self-management. CDPHE is well poised to achieve the outcomes of this funding opportunity. Over the last 10 years, CDPHE has built an infrastructure that includes dedicated staff with expertise in program development and sustainability, particularly in the areas of the National DPP and DSMES, and a network of partners that have deep subject matter expertise and have successfully reached priority populations with evidence-based diabetes prevention and management programs. Over the next five years, CDPHE will engage this infrastructure in communities across the state with high burden of prediabetes and diabetes to advance evidence-based diabetes management and type 2 diabetes prevention and risk mitigation strategies to reduce health disparities among priority populations. CDPHE will work with health systems and community-based organizations to increase National DPP and DSMES programs where access is low and burden is high. In areas where programs already exist, CDPHE will increase healthcare provider awareness of the programs and support health systems to improve identification of individuals with prediabetes and diabetes, and refer them to programs, with emphasis on increasing bi-directional referrals. CDPHE will work with existing National DPP and DSMES providers to tailor their programs and recruitment strategies to increase enrollment and retention among priority populations. CDPHE will increase sustainability of these programs by working with health payers to secure coverage for these services, such as Medicaid National DPP coverage. These efforts will result in the following outcomes: Increased number of organizations implementing evidence-based behavioral change programs; Increased adaptation/tailoring of effective programs for priority populations; Increased participation in evidence-based community behavioral change programs; Improved self-management of chronic disease(s); Increased multi-directional communication between clinical and community resources; Increased patient contact with CHWs or health care extenders; Decrease in the proportion of people with diabetes with an A1C > 9%; Increased number of program completers served by CDC-recognized National DPP delivery organizations who reduce their risk for type 2 diabetes.
