A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes | CDC RFA DP 23 0020

Opportunity Information: Apply for CDC RFA DP 23 0020

The Centers for Disease Control and Prevention (CDC), through its National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), released this cooperative agreement funding opportunity (CDC-RFA-DP-23-0020) to take a more strategic, equity-driven approach to diabetes prevention and management. The overall aim is twofold: first, prevent or delay the onset of type 2 diabetes among adults with prediabetes or who are at high risk; second, improve outcomes for people already living with diabetes by strengthening self-care practices, raising the quality of care, and encouraging earlier detection of complications. A third, connected emphasis is reducing future risk by supporting evidence-based, family-centered childhood obesity interventions, recognizing childhood obesity as a major pathway into later type 2 diabetes.

A defining feature of the NOFO is that every funded activity must be designed to reduce disparities and advance health equity for "priority populations." The NOFO defines priority populations broadly as people who have systematically faced greater barriers to health because of factors such as race or ethnicity, religion, socioeconomic status, gender, age, mental health status, cognitive/sensory/physical disability, sexual orientation or gender identity, geographic location, or other characteristics linked to historical discrimination or exclusion. Applicants are expected to name which priority population(s) they will focus on, justify that choice using evidence of disproportionate diabetes burden and/or social vulnerability, and show credible ties to those communities through experience, partnership, and demonstrated community support. Across the program, the CDC is pushing applicants to tailor outreach, enrollment, and service delivery so that the selected strategies actually work for the populations experiencing the greatest barriers, rather than simply offering standard programming and hoping participation improves.

The NOFO is structured into three distinct components (A, B, and C), and an applicant may apply to only one. Components A and B both rely on a "menu" of 13 evidence-based strategies aimed at diabetes prevention, diabetes management, and childhood obesity interventions, and both require applicants to select a minimum number of strategies. In both components, applicants must include at least one, and may include both, of two core strategies: (1) strengthening diabetes self-management education and support (DSMES) by improving equitable access, appropriateness, and feasibility; and/or (2) increasing enrollment and retention of priority populations in the National Diabetes Prevention Program (National DPP) lifestyle change intervention, again by improving equitable access, appropriateness, and feasibility. The repeated focus on "access, appropriateness, and feasibility" signals that the CDC is looking for practical fixes to real barriers, such as cost, transportation, scheduling, language access, digital access, cultural fit, disability accommodations, and trust.

Component A, titled "Statewide Evidence-based Approaches to Diabetes Management and Type 2 Diabetes Prevention," is designed for statewide (or district-wide, for Washington, D.C.) implementation. The CDC intends to fund one organization in each of the 50 states and one in D.C., meaning 51 awards under this track. Applicants must have a physical location in the state (or in D.C. if serving D.C.), and the total body of work should be built for statewide reach, not just a single city or region. Under Component A, applicants must choose at least 6 of the 13 strategies from the menu, while ensuring they include DSMES and/or National DPP enrollment and retention improvements. Applicants are encouraged to concentrate effort in high-need counties that are disproportionately impacted by diabetes and social vulnerability (the NOFO indicates a list of such counties will be provided), but the overall intent remains broad reach across the state. A notable budget requirement in Component A is that 10 to 20 percent of the total requested funding (with 10 percent as a minimum) should be directed toward system-level or population-level work addressing social determinants of health (SDoH). The NOFO frames SDoH as the conditions in which people live, learn, work, and play, and gives examples such as improving greenspace and safe places to exercise, strengthening policies and supports that improve access to healthy food (particularly in food deserts), reducing intake of unhealthy foods, and collaborating with agencies responsible for urban planning, transportation, and housing to create healthier environments.

Component B, titled "Local Evidence-based Approaches to Diabetes Management and Type 2 Diabetes Prevention," focuses resources more intensively in "very high need" counties identified as having both high diabetes burden and high social vulnerability (again, the NOFO notes that a list of eligible counties and their populations will be provided). The CDC expects to fund up to 22 organizations under this component. Unlike Component A's statewide emphasis, Component B is about deep, targeted work in the hardest-hit places at a scale large enough to matter: applicants must propose work reaching a total population of at least 350,000 across one or more of the designated high-need counties. Component B applicants must choose at least 4 of the 13 menu strategies and, as with Component A, must include at least one of the two core strategies related to DSMES and/or National DPP enrollment and retention. Applicants must specify which communities or localities within the selected counties they will serve, describe the size and demographics of those communities, identify priority population(s), and explain why those communities and groups were selected based on burden and vulnerability. A major operational requirement in Component B is partnership with community-based organizations (CBOs) that have real experience reaching and engaging the priority populations. This is reinforced by a firm funding rule: Component B applicants must sub-award at least 30 percent of total funding to their CBO partners. Those sub-awards are meant to support on-the-ground implementation of DSMES and/or National DPP strategies and to reduce SDoH-related barriers that prevent recruitment, enrollment, and retention. In practice, the NOFO is signaling that local trust, culturally grounded engagement, and practical barrier reduction are not optional add-ons but central to performance.

Component C, titled "Using Multisectoral Partner Networks to Scale and Sustain the National Diabetes Prevention Program (National DPP) to Reach Priority Populations," is different from A and B in that it centers on building durable regional infrastructure to grow and sustain the National DPP at scale, with explicit attention to priority populations. The CDC expects to fund 3 to 4 multisectoral partnership networks in different parts of the country. Under this component, the applicant serves as the hub or backbone organization that convenes, coordinates, and funds partners across multiple sectors. The network is expected to work collaboratively on four areas that the NOFO describes as proven necessities for National DPP growth and sustainability: (1) administrative infrastructure, (2) participant referrals and enrollment, (3) program delivery and participant support, and (4) payment/coverage. Enrollment should primarily focus on priority populations, while also serving the general eligible population in the service area. Applicants must define their geographic area(s) and priority populations, describe how the network will address social needs and SDoH barriers that reduce enrollment and retention, and demonstrate a payer-ready approach to sustainability. A key performance and documentation requirement is that Component C applicants must submit signed memorandums of understanding (MOUs) with enough partners to support enrollment of at least 10,000 participants in year 1 and to show the ability to submit claims to payers. Required partners include payers, health care organizations, CDC-recognized National DPP delivery organizations (both in-person and virtual), CBOs, organizations experienced in engaging the priority populations of focus, and partners that address SDoH needs. The MOUs must spell out enrollment targets and the share of award funding that will go to each partner. Priority consideration is given to applicants who plan for at least 50 percent of the 10,000 year-1 enrollment target to come from eligible priority populations, which makes equity performance a clear competitive advantage rather than a general aspiration.

Across all three components, the NOFO reflects an expectation that applicants will not only implement evidence-based interventions, but also evaluate and adapt them to ensure they truly reach the people most affected by diabetes disparities. The opportunity is categorized as a discretionary cooperative agreement under CFDA 93.988, with an award ceiling listed at $3.3 million and an anticipated 77 total awards. Eligibility is broad and includes various levels of government, tribal governments and organizations, public and private higher education institutions, nonprofits (including 501(c)(3) and non-501(c)(3)), for-profit organizations (including small businesses), and other eligible entities as clarified in the NOFO. The original posting indicates a creation date of January 6, 2023, and an original application deadline of March 7, 2023 (with electronic submissions due by 11:59 pm ET).

• The Department of Health and Human Services, Centers for Disease Control - NCCDPHP in the health sector is offering a public funding opportunity titled "A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.988.
• This funding opportunity was created on Jan 06, 2023.
• Applicants must submit their applications by Mar 07, 2023 Electronically submitted applications must be submitted no later than 1159 pm ET on the listed application due date.. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $3,300,000.00 in funding.
• The number of recipients for this funding is limited to 77 candidate(s).
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For profit organizations other than small businesses, Small businesses, Others (see text field entitled Additional Information on Eligibility for clarification), Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.

Apply for CDC RFA DP 23 0020

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