This is an open competition funding opportunity announcement (FOA) that builds on successful strategies tested in previous FOAs to scale and sustain the National Diabetes Prevention Program (National DPP) for general populations. In this FOA, those strategies will be adapted for both general populations, Medicare benificiaries and one or more priority populations in underserved areas.Through a five-year cooperative agreement, CDC will support national or regional organizations with multi-state networks to deliver a CDC-recognized lifestyle change program in underserved areas to adult populations with prediabetes or at high risk for type 2 diabetes. Applicants must identify affiliate delivery sites in at least three states and enroll at least 1000 priority population participants in the first year. Continued growth in sites and participants is expected in years 2-5. Applicants must demonstrate the organizational capacity and experience working with affiliate sites and other key partners to implement and deliver a CDC-recognized lifestyle change program or other evidence-based behavior change program, including documenting program outcomes.Applicants must have demonstrated specialized experience working with general populations, Medicare beneficiaries and one or more priority populations in underserved areas to deliver a CDC evidence based lifestyle change program or other behavioral change program. Priority populations include men, African-Americans, Asian Americans, Hispanics, American Indians, Alaska Natives, Pacific Islanders, and non-institutionalized people with visual impairments or physical disabilities. These populations are prioritized because they have been enrolled in lifestyle change program at lower rates despite relatively higher rates of type 2 diabetes.

Awardees must implement activities in all 5 strategies:

1. Increase the availability of CDC-recognized organizations in underserved areas;
2. Increase clinician screening, detection, and referral of adults with prediabetes or at high risk for type 2 diabetes to CDC-recognized organizations;
3. Increase awareness of prediabetes and enrollment in the lifestyle change program;
4. Increase retention rates for participants in the lifestyle change program;
5. Increase benefit coverage for participation in the lifestyle change program. By the end of the cooperative agreement, delivery infrastructure will be expanded, closing the enrollment gap so that more priority population participants with prediabetes successfully complete the CDC lifestyle change program, achieve 5-7% weight loss, and significantly reduce their risk for developing type 2 diabetes. The announcement is only for non-research activities supported by CDC; applications for research cannot be considered through this announcement.