Clemson University is applying for Component B to expand access for rural, black, and Latino populations to diabetes self-management programs and services by spreading the Health Extension for Diabetes (HED) program into 4 states targeting 11 high-need counties with a total population of 2,144,545. HED was developed at Clemson and is an ADA-recognized DSMS program. Clemson spent 6 years expanding HED across our state through Extension and HED is now available in every county in South Carolina (SC). Counties in SC are predominantly rural with demographic mix including 26.8% black/AA and 6.9% Latino. HED has demonstrated outcomes improving diabetes related knowledge, behaviors, and health outcomes among participants. Clemson will draw upon lessons learned in SC to expand HED to additional states with high-need counties. Clemson will train and support Extension partners (CBOs) in TN, AL, NC, and TX to deliver HED. CBOs include traditional 1862 landgrant universities (UofTennessee, North Carolina State, AuburnU) and historically black 1890 landgrant universities in Texas (Prairie View A&M) and Alabama (Alabama A&M). CBOs will be trained to create contracts with DSMES clinicians to cofacilitate HED thereby connecting DSMES clinical services to more individuals at risk in the target communities. CBOs have expertise in engaging and enrolling rural, black, and Latino populations in their target counties; their DSMES clinical partners have expertise enrolling/referring individuals to DSMES services. CBOs and DSMES clinicians will be trained to screen/refer participants to organizations addressing social determinants of health (SDOH). The approach will result in 11 new HED programs with increased access to DSMES services in high need counties, 11 multidirectional referral pathways established between HED, DSMES, NDPP, and SDOH organizations, and 30 health workers in 4 states trained to screen for SDOH barriers to diabetes programs. Each CBO has su
bmitted a letter of support demonstrating commitment to partner, and each letter has been co-signed by DSMES clinicians in target counties. The CDC-identified counties include Sullivan County in TN, Northampton, Hertford, Bertie, and Halifax Counties in NC, Fayette, Montgomery, Limestone, and Tuscaloosa Counties in AL and Cameron and Hidalgo Counties in TX.