The Houston Health Department (HHD) is pleased to submit this application for Component B of the CDC Grant: A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes. The geographic area of focus is Houston, TX which is located in Harris County, identified as a high need county, with a population of 4,078,030 people. Houston is the 4th most populous city and is a minority-majority city. Houston presents a unique case of high population density, incredibly broad ethnic diversity, and high socioeconomic segregation. These factors combined, create a setting for health inequities and disparities in diabetes, hypertension, obesity, and other chronic issues.
The title for the project outlined in this proposal is ‘Advancing Health Equity for Houstonians with or at Risk for Diabetes’. The purpose of this project is to implement evidence-based strategies to decrease the risk for type 2 diabetes among adults with prediabetes, improve self-care practices and quality of care for people with diabetes and implement an evidence-based, family-centered childhood obesity intervention as a type 2 diabetes risk reduction strategy.
Through the implementation of the selected strategies and activities, HHD expects to have achieved the following performance period outcomes by the end of year 5:
Increase in the number of organizations implementing evidence-based community behavioral change programs.
Increased adaptation/tailoring of effective programs for priority populations.
Increase in the # of patients screened and referred to community resources.
Increased SDOH screenings in clinical settings.
Increased participation in evidence-based community behavioral change programs.
Increased multi-directional communication between clinical and community resources.
HHD will implement four ‘Component B’ strategies to achieve the performance measure targets and 5- year outcomes. This includes the implementation of both strategy 1 and strategy 5 as required by the NOFO, in addition to strategy 8 and 13. Equity and inclusiveness will be ingrained into the planning and implementation of each strategy and activity to ensure that barriers to access are addressed.
HHD’s Office of Chronic Disease, Health Education, and Wellness (OCDHEW) will be the lead division for the management, implementation, and evaluation of selected strategies. HHD will partner with multiple community-based and faith-based organizations, diabetes subject matter experts, organizations that provide services to individuals with or at risk for diabetes, and organizations that provide services to or engage with priority populations to implement strategies and activities outlined in the Work Plan. These collaborations will be centered on shared goals related to health equity and/or reducing SDOH-related barriers that impact access to and successful participation in the proposed evidence-based programs and services including DSMES, DPP, family centered approaches for the prevention and/or reduction of childhood obesity, and in training providers to identify and address the social determinants of health.