A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes. - The Kentucky Cabinet for Health and Family Services, located at 275 East Main Street in Frankfort, Kentucky, houses the Kentucky Department for Public Health’s (KDPH), Kentucky Diabetes Prevention and Control Program (KDPCP). The KDPCP is applying for Category A of this funding opportunity and will collaborate and their extensive network of stakeholders and partners, to decrease the risk for type 2 diabetes among adults with prediabetes and improve self-care practices, quality of care, and early detection of complications among people with diabetes with emphasis on reducing health disparities for priority populations at both the state and local level. The priority populations identified in this application are diverse in geography, race and ethnicity, and socio-economic status and include rural, low SES populations – particularly the eastern/Appalachian region of the state, the African American, Black population, those greater than 65 years of age and the Hispanic/Latino population. With its long history of diabetes prevention and management work, highly skilled and experienced team and extensive network of public and private partners, KDPCP is well positioned to engage in this work. KDPCP has a strong infrastructure with local health departments across the state that facilitates state as well as local access to communities and priority populations across Kentucky. KDPCP will continue to build upon these networks to further engage and collaborate with communities and target populations to address needs related to social determinants of health. To address diabetes management, the KDPCP will maintain its nationally accredited/recognized innovative umbrella diabetes self-management and support (DSMES) program, "Healthy Living with Diabetes." Under this umbrella accreditation, all Kentucky counties will continue to have access to accredited DSMES services via virtual programming, as well as in-person programs in some locations. Further innovations to expand access to priority populations, including a facilitated remote model, are described in this application. To address diabetes prevention, KDPCP will continue to work with Kentucky's National Diabetes Prevention Program (DPP) network to support initial and advanced coaches training, support messaging around prediabetes and the National DPP, advocate for reimbursement/sustainability for DPP, and promote messaging to priority populations such as the unique story-telling approach targeting the Appalachian population via "Appalshop." In addition, health systems quality improvement efforts include learning collaboratives with primary care practices and health care team members to improve referrals and multi-directional communication regarding DSMES and DPP. Continuing work with the Kentucky Office of Community Health Workers will include defining and supporting the CHW role in diabetes and diabetes prevention efforts. This will include training and the development of practice models for CHWs in the diabetes health care team including addressing SDOH needs. Further training for diabetes staff and partners around SDOH is planned as well. Lastly, KDPCP will reenergize its efforts around prevention of complications from diabetes, specifically eye and kidney disease. This will include engaging new and "old" partners and learning best practices for prevention efforts among priority populations. KDPCP is well positioned to engage in this work to advance health equity among priority populations with and at risk for diabetes.
