Advancing Health Equity for Priority Populations with or at Risk for Diabetes in Hawaii - For more than fifteen years, the Diabetes Prevention and Control Program (DPCP), housed in the Hawaii Department of Health (HDOH), Chronic Disease Prevention and Health Promotion Division, Chronic Disease Management Branch, has provided statewide leadership and coordination for diabetes prevention and control. The HDOH is located at 1250 Punchbowl Street, Honolulu, Hawaii 96813. The DOH is applying for Component A of CDC-RFA-23-0020. Despite being ranked as one of the healthiest states in the nation, many of the same pressing health trends observed nationally are present in Hawaii, especially among vulnerable populations. Overweight and obesity rates have been increasing over the years, with 33.6% and 24.5% of adults falling into these categories respectively (Behavioral Risk Factor Surveillance System [BRFSS] 2020). In addition, 16.5% of adults report being diagnosed with prediabetes, and 9.4% report being diagnosed with type 2 diabetes (BRFSS 2020). Among Hawaii’s federally qualified health centers, 16.3% of patients have type 2 diabetes, and 37.4% of those patients report a hemoglobin A1C (A1C) > 9.0%, indicating that their condition is poorly controlled (Uniform Data System 2021). The DPCP will reduce the burden of type 2 diabetes in Hawaii by increasing participation in Diabetes Self-Management Education and Support and the National Diabetes Prevention Program (DPP), improving clinical care to reduce diabetes complications, and implementing system-level interventions to support statewide infrastructure for pharmacists and community health workers (CHW) to address diabetes prevention and management (Strategies 1, 3, 5, 7, 9, and 12). These efforts will focus on addressing social determinants of health (SDOH) that impact Native Hawaiian, Other Pacific Islanders, Filipinos, and persons insured by Medicaid statewide by using data effectively to target activities, bringing diverse stakeholders together, and collaborating with communities and health care systems from the entire state to identify realistic and appropriate solutions. The DPCP expects to achieve the following outcomes: Increase in the number of organizations implementing evidence-based community behavioral change programs Increased adaptation and/or tailoring of effective programs for priority populations Increased number of patients screened and referred to community resources Increased SDOH screenings in clinical settings 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 CHW or health care extenders Increased proportion of the population receiving the health care services they need and want 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
