CDC-RFA-23-0020 - The WV Department of Health and Human Resources, Bureau for Public Health (WV DHHR BPH), Division of Health Promotion and Chronic Disease Prevention (HPCD) submits this funding application for CDC-RFA-DP-23-0020 Component A. As the second-most rural state in the nation, West Virginia (WV) is the only state located entirely within the Appalachian region, an area distinguished by mountainous terrain, geographic isolation, and historical economic hardship and exploitation. The COVID-19 pandemic greatly emphasized the disparities suffered by many in rural WV, further stressed by the lack of access to healthcare, broadband internet, and transportation. Those with intersecting identities, such as racial and ethnic minorities, LGBTQIA+ individuals, etc., in rural areas continue to experience the most significant health disparities in access to care, incidence, prevalence, mortality, and burden of chronic disease. HPCD has a history of strong partnerships within WV communities. Under DP1815 and DP1305, HPCD utilized a partner-based approach to develop a team of “Synergy Partners”. These Synergy Partners work with HPCD in a mutually supportive capacity to achieve meaningful change, and include small, grassroots Community-based Organizations (CBO), as well as larger statewide organizations and institutions of higher learning. HPCD seeks to utilize its partnerships to decrease the risk for type 2 diabetes among adults with prediabetes, and to improve self-care practices, quality of care, and early detection of complications and risk factors. HPCD will work with partners throughout the state to identify and remove barriers to care by addressing the Social Determinants of Health (SDOH) and will work with partners to target populations that have systematically experienced a greater burden of disease due to historical discrimination or exclusion. This includes racial and ethnic minorities, LGBTQIA+ individuals, and populations historically marginalized due to religion, socioeconomic status, age, mental health, and/or disability. By the end of this grant HPCD will have increased access for the priority populations to a wider spectrum of diabetes support services, as well as staff who have been trained in SDOH strategies that are inclusive of racial and ethnic minorities, LGBTQIA+ individuals, etc. HPCD will have incorporated ADA guidelines for each year of the DP2320 grant into training for health care teams and CBOs. HPCD will have grown the number of lifestyle-coaches representative of racial and ethnic minorities, LGBTQIA+ individuals, etc., thus allowing for greater recruitment and retention of individuals from priority populations. HPCD has a target of 10% of all new participation in diabetes prevention and treatment services to be from priority populations. Current and new organizations will have been provided ongoing training sessions on the utilization of equitable and sustainable billing models that increase the accessibility for target populations using their services.