A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes in Wisconsin - Organization: Wisconsin Department of Health Services, 1 West Wilson Street, Madison WI 53703-3445 Serving: State of Wisconsin Application for: Component A, A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes (CDC-RFA-DP-23-0020) The Wisconsin Department of Health Services’ Chronic Disease Prevention Program (CDPP) has the experience, staff expertise, capacity, and organizational infrastructure to implement the proposed approach for CDC-DP23-0020 Component A. Wisconsin is home to robust networks of National Diabetes Prevention Programs (National DPP), Diabetes Self-Management Education and Support (DSMES) programs and services, community health workers (CHWs), community pharmacies, local and tribal health departments, community-based organizations (CBOs), and coalitions. Addressing diabetes and childhood obesity disparities through an equity lens in partnership with these networks requires intentionally centering the people and places affected most. Our approach leverages those who know their communities’ resources and needs best. CDPP will draw on the lessons learned and evaluation data from CDC 1815 and 1817 diabetes and heart disease cooperative agreements and previous iterations. Collectively, the CDPP staff who will directly work on 2320 have over 87 years of experience working with diabetes prevention and management efforts. CDPP and its partners have a history of engaging communities in grant work and addressing Social Determinants of Health (SDoH) needs. Many of our partners regularly engage their communities to provide guidance for their work. As an example, under 1815 and 1817 CDC funding was used for a participatory approach has allowed National DPP suppliers to best address the needs and desires of their communities by offering cohorts on days and times that best fit the participants, delivering the program in a culturally appropriate manner, and resolving barriers to participation and retention by establishing relationships with and connecting participants to community resources. Marshfield Clinic Health System (MCHS), a National DPP supplier, uses electronic medical records to successfully identify priority populations, specifically rural, low income, Hmong, and Medicare recipients. MCHS addresses SDoH needs by screening participants at enrollment for potential barriers to participation and retention and then referring to MCHS’s Community Care program to address identified barriers. YMCA of Metropolitan Milwaukee (Y-MKE), a National DPP and Medicare DPP supplier, serves as a lead organization for a YMCA-based Umbrella Hub Arrangement in Wisconsin. Y-MKE does extensive work to address SDoH, including integration of 211 Community Connect services, connecting Y-MKE members and National DPP/Medicare DPP participants to community resources; working to distribute food to members of their priority populations who experience food insecurity; and partnering with organizations to provide programming in the area’s Senior Centers. Additional community-based partners and local and tribal health departments will be key partners in the implementation of this proposal. These organizations have been identified through a survey process to engage and fund agencies that haven't traditionally received funding. The CDPP is positioned well to implement statewide practice and policy change, and tailor prevention and management strategies for priority populations.
