Cooperative Agreement NU58DP007396

A STRATEGIC APPROACH TO ADVANCING HEALTH EQUITY FOR PRIORITY POPULATIONS WITH OR AT RISK FOR DIABETES - ABSTRACT INTERNATIONAL PRE-DIABETES CENTER A STRATEGIC APPROACH TO ADVANCING HEALTH EQUITY FOR PRIORITY POPULATIONS WITH OR AT RISK FOR DIABETES COMPONENT: B; POPULATION SELECTED FROM CDC LIST:" HIGH RISK" LOS ANGELES COUNTY INTERNATIONAL PRE-DIABETES CENTER (IPDC) AND ITS PRE-DIABETES PROFESSIONAL TRAINING CENTER IS A NONPROFIT COMMUNITY-BASED ORGANIZATION (CBO) THAT WAS FOUNDED BY A CLINICAL PHARMACIST TO CLOSE GAPS IN DISPROPORTIONATE HEALTH DISPARITIES FOR MINORITY AND UNDERSERVED POPULATIONS. IPDC HAS A LONG HISTORY OF WORKING WITH COMMUNITY HEALTH CENTERS (CHC) AND CHC COALITIONS IN PARTNERSHIPS TO STRATEGICALLY IMPROVE THE HEALTH OF THE COMMUNITY BY CLOSING GAPS IN DISPROPORTIONATE HEALTH DISPARITIES, WHILE UTILIZING A COMMUNITY HEALTH WORKER (CHW) MODEL. CHWS ASSESS LOW-INCOME PERSONS FOR THEIR SOCIAL NEEDS AND LINK THEM TO COMMUNITY RESOURCES. IPDC IS A CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) RECOGNIZED PROVIDER OF THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP) AND MEDICARE DIABETES PREVENTION PROGRAM (MDPP), AS WELL AS A NATIONALLY ACCREDITED PROVIDER OF THE DIABETES SELF- MANAGEMENT EDUCATION AND SUPPORT (DSMES) PROGRAM. ALTHOUGH IPDC AND ITS PARTNERS HAVE IMPLEMENTED THESE PROGRAMS AND REALIZED SUCCESS IN IMPROVED DIABETES OUTCOMES FOR UNDERSERVED COMMUNITIES, THERE REMAIN CERTAIN REGIONS OF LOS ANGELES (LA) COUNTY THAT HAVE AN EVER-INCREASING BURDEN OF DIABETES, LIMITED RESOURCES FOR HEALTH CARE, AND WORSENING HEALTH OUTCOMES. THE REGIONS ARE DENSELY POPULATED BY ETHNIC MINORITIES (HISPANICS AND AFRICAN AMERICAN), WHICH UNDERSCORES THE NEED FOR ACTION TO CLOSE THE GAPS IN DISPROPORTIONATE DISPARITIES. THIS PROPOSAL ADDRESSES BARRIERS TO HEALTH CARE, INCLUDING LIMITED ACCESS TO EVIDENCE BASED PROGRAMS SUCH AS DSMES, NDPP AND MDPP. LA COUNTY WITH A POPULATION OF MORE THAN 10 MILLION RESIDENTS IS DIVIDED INTO EIGHT (8) SERVICE PLANNING AREAS (SPA) AND COMPARISONS AMONG THE REGIONS PROVIDE DATA ON WHERE TO FOCUS RESOURCES. WE SELECTED OUR TARGET PRIORITY POPULATIONS UTILIZING DATA FROM THE COUNTY DEPARTMENT OF PUBLIC HEALTH, KEY HEALTH INDICATORS. THE DATA SHOWS WHERE THE HIGHEST DISPARITIES IN DIABETES OCCUR. SPA 1 AND SPA 6 HAVE THE HIGHEST PERCENTAGES FOR DIABETES DIAGNOSIS (14% AND 12%, RESPECTIVELY), WHICH ARE HIGHER THAN LA COUNTY (7.2%). SPAS 6 AND 7 RANKED 11% HIGHER (38.3 AND 33.2) THAN THE COUNTY (22.9) FOR AGE ADJUSTED DIABETES MORTALITY (PER 100,000 POPULATION). ADDITIONALLY, SPA 6 RANKED 20% HIGHER FOR STROKE MORTALITY (70.2%) COMPARED TO LA COUNTY'S 50.5%. SPAS 6 ALSO RANKED HIGH FOR AGE-ADJUSTED CORONARY HEART DISEASE, DEATH RATES THAT ARE 70% HIGHER THAN FOR LA COUNTY'S. ALL SPAS WERE OBSERVED TO HAVE OVERWEIGHT ADULTS WITH BMIS RANGING FROM 26.4 - 41.2. OVERWEIGHT IS DEFINED AS BMI > 25 AND < 30); THESE CONDITIONS POINT TO OPPORTUNITIES FOR ACTION TO STRATEGICALLY IMPROVE THE HEALTH OF HIGH-RISK COMMUNITIES. IPDC'S PARTNERSHIP WILL FOCUS ON CONTINUING EFFORTS WITHIN A COALITION OF HEALTH CENTERS WITH 350 CLINICS AND 1.7 MILLION PATIENTS. WE WILL TARGET SPAS 6 AND 7 (WITH DM PREVALENCE 9.7 AND 9.4 RESPECTIVELY) TO RECEIVE DSMES AND NDPP PROGRAMS (STRATEGIES 1 AND 5). ALL SPAS WITH A BMI RANGE OF FROM, 26.4 -TO 41.2 WILL RECEIVE NDPP (STRATEGY 5). THE TARGET REGIONS WILL BE SUPPORTED BY A NETWORK OF COMMUNITY OUTREACH NAVIGATORS (STRATEGIES 12 AND 13) TO ENSURE INCREASED ENROLLMENT, ENGAGEMENT AND RETENTION IN DSMES AND NDPP. UPON COMPLETION OF THE FIVE (5)-YEAR TERM, THE EXPECTED OUTCOMES ARE: (A) 50 CHCS BECOME CDC RECOGNIZED ORGANIZATIONS IMPLEMENTING NDPP (AND MDPP WHERE APPLICABLE); (B) 10 CHCS ACCREDITED BY ADA OR ADCES FOR DSMES; (C) 10 NEW QUALIFIED CERTIFIED DIABETES EDUCATORS; (D) 500,000 PATIENTS SCREENED FOR DIABETES/PRE-DIABETES (E) A 50 % INCREASE IN SCREENINGS FOR SDOH IN CHC CLINICAL SETTINGS; AND (F) A 50% INCREASE IN CHC PARTICIPATION IN DSMES AND MULTI-DIRECTIONAL COMMUNICATION BETWEEN HEALTH CARE TREATMENT TEAMS AND CHWS.