Increasing Access to and Participation in the National Diabetes Prevention Program in Local and Tribal Health Department Settings

The Wisconsin Department of Health Services (DHS) Chronic Disease Prevention Program (CDPP) is a recipient of a cooperative agreement to prevent, reduce, and manage diabetes (CDC-RFA-DP-23-0020) from the Centers for Disease Control and Prevention (CDC). To implement the strategies of this cooperative agreement (known as 2320), CDPP partners with a variety of organizations across the state, offering funding, technical assistance, and connections to peer support.

CDPP is issuing this Grant Funding Opportunity (GFO) to provide interested parties with information on preparing and applying for the Increasing Access to and Participation in the National Diabetes Prevention Program in a Local and Tribal Health Department Settings grant.

The challenge and the opportunity

Diabetes is a serious and growing public health challenge in Wisconsin. About 1 in 11 Wisconsin adults have diabetes, increasing their risk for serious health complications such as heart disease, stroke, kidney disease, blindness, and nerve damage leading to lower limb amputation. Type 2 diabetes is a high-cost disease to treat. Many patients with type 2 diabetes pay more than twice as much for their health care. It is the seventh leading cause of death in America.

Before many people develop type 2 diabetes, there is a critical window for prevention: prediabetes.

Prediabetes occurs when a person’s blood sugar levels stay higher than normal, but not high enough for a diagnosis of type 2 diabetes. About one-third of adults in the U.S. have prediabetes, but most of them don’t know it. Without intervention prediabetes may progress to type 2 diabetes with debilitating lifelong consequences.

The good news is that prediabetes can be managed and type 2 diabetes can often be prevented or delayed. Small sustainable lifestyle changes, improving nutrition, increasing physical activity, and attaining modest weight loss, can make a meaningful difference.

The National DPP provides an evidence-based approach to help people with prediabetes build healthy habits and reduce their risk of developing type 2 diabetes. Guided by a trained lifestyle coach in a supportive group environment, participants make manageable changes that fit their life and help them feel motivated to improve their health. By expanding access to National DPP and connecting more people with proven prevention resources, people can take steps to prevent prediabetes or reverse prediabetes, and lower their risk for other conditions, and reduce the health and financial consequences associated with diabetes.

The National Diabetes Prevention Program (National DPP) provides an evidence-based approach to help people build healthy habits and reduce their risk for developing type 2 diabetes. Guided by a trained lifestyle coach in a supportive group environment, participants make manageable changes that fit their life and help them feel motivated to improve their health. The Diabetes Prevention Program research study used as a basis for the National DPP found that, over the 3-year study, improved nutrition and exercise (lifestyle intervention) reduced by 58% the chance that a person at risk for type 2 diabetes would develop diabetes; and, if the person was over age 60 the risk reduction increased to 71%. In comparison, the drug metformin also reduced risk, although less dramatically, by 31%. Even after 10 years, lifestyle change program participants had a 34% lower rate of type 2 diabetes. Other benefits of a lifestyle change program include reduced risk of heart attack and stroke, improved overall health, increased energy levels and reduced stress.

The trustworthiness for the National DPP is maintained through the Centers for Disease Control and Prevention’s (CDC) Diabetes Prevention Recognition Program (DPRP) and the DPRP Standards and Operating Procedures: June 2024. The CDC established the DPRP as part of the National DPP with the purpose to recognize organizations that have demonstrated their ability to effectively deliver the evidence-based National DPP lifestyle change program. The recognition program helps ensure that decisions about participant eligibility, program content, and data collection and reporting that could lead to health insurance benefits are based on accurate, reliable, and dependable information. The National DPP is further committed to ensuring health equity by increasing access to the lifestyle change program among populations of interest, including those living in geographically hard to reach or rural areas.

The Increasing Access to and Participation in the National Diabetes Prevention Program in a Local and Tribal Health Department Settings grant is structured to support aspects of the 2320 cooperative agreement where its strategies and performance measures are prescribed to standardize the assessment of how activities are leading towards the desired outcomes outlined in the following logic model:

Required strategy: Strategy 5

Increase enrollment and retention of populations at greatest risk for developing type 2 diabetes in the National Diabetes Prevention Program (National DPP) lifestyle intervention and the Medicare Diabetes Prevention Program (MDPP) by improving access, appropriateness, and feasibility of the programs.

Desired outcomes

Increase enrollment and retention of populations at greatest risk for developing type 2 diabetes in the National DPP lifestyle intervention and the Medicare Diabetes Prevention Program by improving awareness and appeal of the program, access to and appropriateness of classes, ease of enrollment, and relevant participant support.

Short-term performance measures

Number of participants (total # and # from focus populations) enrolled by CDC-recognized National DPP delivery organizations.

Intermediate performance measures

Number of participants (total # and # from focus populations) retained by CDC-recognized National DPP delivery organizations.

Long-term performance measures

Increase in number of program completers served by CDC-recognized National DPP delivery organizations who reduce their risk for type 2 diabetes.

Proportion of people with diabetes with an A1C > 9% (decrease desired in this measure).

DHS is seeking to partner with at least one local or Tribal health department (LTHD) that currently has a minimum of one National DPP Lifestyle Coach trained by an organization with a signed Memorandum of Understanding (MOU) with CDC but does not have CDC-recognition as a National DPP delivery organization.

The LTHD must be prepared to apply for CDC DPRP recognition and launch their first cohort prior to June 1, 2027. Eligible organizations may apply for up to $15,000 and will work to increase access to and participation in the National Diabetes Prevention Program serving geographically hard to reach or rural areas.

The anticipated scope of work includes, but is not limited to, the following activities:

• Write and complete a detailed work plan outlining grant work along with related budget.
• Establish as a National DPP delivery organization with the CDC DPRP.
• Work with local health care systems/clinics and community-based organizations to establish referral pathways.
• Promote National DPP at various community events, focusing on populations at greatest risk for developing type 2 diabetes.
• Conduct a Discovery Session (either in-person or distance learning delivery modes).
• Launch first National DPP cohort on or before June 1, 2027.
• Collect and report deidentified, aggregate data to CDC every six months following recognition application as required by CDC DPRP.
• Collaborate with CDPP to inform the evaluation and performance measurement plan (EPMP).
• Communicate and work closely with CDPP.

Eligible applicants must:

• Be a local or tribal health department in Wisconsin.
• Currently have a minimum of one National DPP Lifestyle Coach trained by an organization with a signed Memorandum of Understanding (MOU) with CDC but are not a CDC-recognized National DPP delivery organization.
• Complete the National DPP Organizational Capacity Assessment.
• Be capable of launching first National DPP cohort on or before June 1, 2027.
• Be capable of working with local health systems and community-based organizations.
• Be capable of recruiting and enrolling a sufficient number of eligible participants per cohort, typically 12-18 participants (i.e., via marketing and media outreach, partnership engagement, health fairs, referrals from health care professionals, etc.).
• Be capable of acquiring the knowledge, skills, and tools needed to collect, enter, monitor, and submit the required DPRP evaluation data elements to the CDC DPRP Data Portal every six months.
• Be capable of providing the appropriate space (in-person cohort) or equipment/technology platform (distance learning cohort) to allow participants to interact with the Lifestyle Coach(es) throughout the yearlong National DPP lifestyle change program.
• Be capable of developing a sustainability plan for the yearlong National DPP lifestyle change program long term without CDC-RFA-DP-23-0020 (2320).

Funding for the Increasing Access to and Participation in the National Diabetes Prevention Program in a Local and Tribal Health Department Settings grant comes from the CDC cooperative agreement to prevent, reduce, and manage diabetes, CDC-RFA-DP23-0020, known as 2320. Eligible organizations may apply for up to $15,000 and will work to increase access to and participation in the National Diabetes Prevention Program serving geographically hard to reach or rural areas.

This is a scored grant funding opportunity application survey. Submission does not guarantee funding within this opportunity. This allows DHS to assess capacity of interested parties to ultimately partner with to conduct the work outlined in the scope of work. DHS reserves the right not to award funding to any applicant, DHS reserves the right to award more than one applicant, and DHS may award additional funding if more funding becomes available. DHS also reserves the right to award grants for less than an applicant’s proposed amount. Should additional funding become available at any point during the grant period, DHS reserves the right to use the results of this application to increase funding to the selected applicants or fund additional applicants that were not selected.

Moreover, DHS reserves the right to negotiate with the successful applicant(s) separate cost reimbursement for additional work that is related to other state or federal initiatives.

Funding for this budget period and for subsequent years or budget periods may be awarded based on performance and availability of funding.

Funding may be used to pay for activities related to established and agreed upon work plan including staff time, fringe benefits, travel related to the project, data collection, analysis and reporting activities, and other project related costs.

Selected applicants will be required to use Grant Enrollment, Application and Reporting System (GEARS). Selected applicants will report costs incurred on expenditure reporting forms and submit the forms to the GEARS Unit monthly. Additional expenditure information will also be submitted to DHS staff. Awarded grantee(s) will need a STAR Supplier identification number and GEARS Agency number.

Applicants selected for award will need to agree to direct deposit payments and agree to the terms in the DHS’ grant agreement. A draft copy of a grant agreement can be provided upon request.

DHS uses a cost-based reimbursement model that limits reimbursement to actual allowable incurred costs. If funding is awarded, expenses can be submitted for reimbursement only after they have been incurred.

Recommended indirect rate, if applicable, should be ≤ 15%.

All costs must comply with the DHS Allowable Cost Policy Manual. The tables below include the common allowable and unallowable costs.

Allowable costs

• Staff time to coordinate and implement the project
• Meeting expenses related to the project
• Public health evaluation
• Office supplies, postage, copying, etc. related to the project
• Consultant and contract services needed to implement the project

Unallowable costs

• Direct or indirect lobbying activities, including:
  • Preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body.
  • The salary or expenses of any grant or contract recipient or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before any legislative body
• Clinical care such as health screening, patient care, personal health services, medications, patient rehabilitation, and other costs associated with treatment and direct care
• Costs of promotional items and memorabilia, including models, gifts, and souvenirs
• Costs or activities not directly related to the overall project description and scope of work
• Research
• Construction
• Capital expenditures and capital equipment. Capital equipment costs are defined as all costs associated with the acquisition of assets having a value in excess of $5,000, and a useful life in excess of one year
• Food for programs (for example, food for taste testing activities and fruit and vegetable incentive programs, produce prescription programs)

See the unallowable costs included in 2 CFR 200 Subpart E – Cost Principles and a comprehensive list of funding allowances from the CDC General Terms and Conditions for Non-Research Grants and Cooperative Agreements (PDF).

Applicants must have, or obtain prior to grant agreement execution, an UEI and must not be disbarred, suspended, or ineligible. The UEI is a 12-character alphanumeric identifier (ID) that is issued through SAM.gov. You can go to SAM.gov and search to see if your organization already has a UEI. If it does not have one, you can request one by following the prompts at SAM.gov. It is free and usually takes a day or two to receive the number. Please note that you do not have to go through the full registration process, which takes longer. If you do need to obtain an UEI, please review Before You Get Started for more information. If additional help is needed, visit the Federal Service Desk at FSD.gov.

• Complete the grant application by 11:59 p.m. CDT on September 22, 2026.
• Access the grant application link via Alchemer: Apply for National DPP funding. Only applications submitted through this link will be considered.
• Work plan: Develop activities to increase access to and participation in complementary diabetes support programs and services. Include activities to support sustainment of these programs. See application question #13 for work plan template and further details.
• Budget and justification: Provide a detailed outline of how the funds will be used per budget category. See application question #14 for budget template and further details.
• If the applicant does not provide the information necessary to meet the application requirements, DHS reserves the right to remove the application from further consideration.

• Depending on your experience and interest, the time it takes to complete the application will vary. Therefore, we recommend you work "offline" until you are ready to complete the application in Alchemer in full. You may use the application questions section below to work “offline” and prepare your application.
• Use the navigation buttons at the bottom of the page instead of your internet browser’s navigation.
• You will not be able to navigate to any previous responses once “Submit” is selected on the last page.
• Complete this application in one sitting. You will not be able to return to your earlier responses.
• All questions are mandatory for completion.
• You must complete all required questions in order to submit your responses and to be considered for this funding opportunity. Required questions are indicated by a red asterisk (*).
• Some questions have set word limits. The maximum number of words set are indicated after the question in brackets as well as under the text box field where applicable.

Note: These are the application questions you will complete in Alchemer. You may use this section to work “offline” and prepare before submitting your application in full using Alchemer.
Name of lead organization applying.

1. Name of the lead organization applying
2. Contact information for who will serve as the primary point of contact for communication regarding this application.
   1. First Name
   2. Last Name
   3. Title
   4. Street Address
   5. City, State, ZIP code
   6. Email
   7. Phone
3. Organization website (if applicable)
4. Name and email of trained National Diabetes Prevention Program (National DPP) Lifestyle Coach
5. Date of Lifestyle Coach training and name of training entity
6. Please insert your answer totals from the answer totals box on the right-hand side of page 5 in the National DPP Capacity Assessment.
   1. Total yes:
   2. Total no/unsure:
7. Description and approach to scaling the National DPP in your county or Tribal Nation. (Maximum word count: 1000)
8. Description and approach to ways in which your organization can work with local health systems/clinics and/or community-based organizations to build referral pathways. (Maximum word count: 750).
9. Description and approach to ways in which your organization can work to market and promote the National and enroll and retain participants, especially those from populations at greatest risk for developing type 2 diabetes. (Maximum word count: 750)
10. Description and approach to ways in which your organization can work to identify and address barriers to participation. (Maximum word count: 750)
11. Description and approach to ways in which you envision your organization can sustain the National DPP. (Maximum word count: 750)
12. Attach a copy of your Lifestyle Coach’s certificate of completion for National DPP Lifestyle Coach training.
13. Work plan: Using the template provided, develop activities for the period January 1, 2027 – June 29, 2027, to increase access to and participation in the National Diabetes Prevention Program. Include activities to support sustainment of these programs. You can automatically download the Work Plan Template (Word) in its ready-to-use Word format. Please click your internet browser's computer downloads. You will attach your completed work plan template in Alchemer. Follow the file naming convention: Applicant name_Work Plan_DPP LTHD GFO.
14. Budget and justification: Complete the budget template for the period January 1, 2027 – June 29, 2027. You can automatically download the Budget Template (Excel) in its ready-to-use Excel format. Please check your internet browser's or computer's downloads. You will attach your completed budget template in Alchemer. Follow the file naming convention: Applicant Name_Budget_DPP LTHD GFO.

Award

Financial assistance that provides support or stimulation to accomplish a public purpose. Awards include grants and other agreements (e.g., cooperative agreements) in the form of money, or property in lieu of money, by the federal government to an eligible applicant.

Budget period or budget year

The duration of each individual funding period within the period of performance.

Contracts

An award instrument used to acquire (by purchase, lease, or barter) property or services for the direct benefit or use of the Federal Government.

Cooperative Agreement

A financial assistance award with the same kind of interagency relationship as a grant except that it provides for substantial involvement by the federal agency funding the award. Substantial involvement means that the recipient can expect federal programmatic collaboration or participation in carrying out the effort under the award.

Evaluation (program evaluation)

The systematic collection of information about the activities, characteristics, and outcomes of programs (which may include interventions, policies, and specific projects) to make judgments about that program, improve program effectiveness, and/or inform decisions about future program development.

Evaluation and Performance Measurement Plan (EPMP)

A written document describing the overall approach that will be used to guide an evaluation, including why the evaluation is being conducted, how the findings will likely be used, and the design and data collection sources and methods. The plan specifies what will be done, how it will be done, who will do it, and when it will be done. The evaluation plan is used to describe how DHS CDPP and/or CDC will determine whether activities are implemented appropriately, and outcomes are achieved.

Grant

A legal instrument used by the federal government to transfer anything of value to a recipient for public support or stimulation authorized by statute. Financial assistance may be money or property. The definition does not include a federal procurement subject to the Federal Acquisition Regulation; technical assistance (which provides services instead of money); or assistance in the form of revenue sharing, loans, loan guarantees, interest subsidies, insurance, or direct payments of any kind to a person or persons. The main difference between a grant and a cooperative agreement is that in a grant there is no anticipated substantial programmatic involvement by the federal government under the award.

Lifestyle Change Program

A structured, long-term health initiative designed to help individuals prevent chronic conditions like type 2 diabetes through healthier eating, increased physical activity, and behavioral coaching.

Logic Model

A visual representation showing the sequence of related events connecting the activities of a program with the programs’ desired outcomes and results.

Outcome

The results of program operations or activities; the effects triggered by the program. For example, increased knowledge, changed attitudes or beliefs, reduced tobacco use, reduced morbidity and mortality.

Performance Measurement

The ongoing monitoring and reporting of program accomplishments, particularly progress toward pre-established goals, typically conducted by program or agency management. Performance measurement may address the type or level of program activities conducted (process), the direct products and services delivered by a program (outputs), or the results of those products and services (outcomes). A “program” may be any activity, project, function, or policy that has an identifiable purpose or set of objectives.

Technical Assistance

Advice, assistance, or training pertaining to program development, implementation, maintenance, or evaluation provided by the funding agency.

Work Plan

The summary of period of performance outcomes, strategies and activities, personnel and/or partners who will complete the activities, and the timeline for completion. The work plan will outline the details of all necessary activities that will be supported through the approved budget.

• A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes Component A–Recipients, CDC-RFA-DP-23-0020 (or 2320)
• Diabetes Action Plan
• CDC National Diabetes Prevention Program (National DPP)
• Resources on CDC’s National DPP Customer Service Center:
  • Diabetes Prevention Recognition Program (DPRP) Standards and Operating Procedures: June 2024
  • National DPP Organizational Capacity Assessment
  • National DPP Delivery Modes
  • Organizations with a signed National DPP Lifestyle Coach training Memorandum of
  • Understanding (MOU) with CDC
  • Resources for Recruiting Participants
  • Resources for Health Care Professionals
  • Resources for Pharmacists
  • Resources to Encourage Participant Retention (Personal Success Tool) and Promotional Materials
  • Prevent T2 Marketing Resources for Recruiting and Retaining Participants
  • Program Champion Strategy Toolkit and Promotional Materials (English & Spanish)
  • Recruitment and Retention: Keys to Success
  • Lifestyle Coach, Program Coordinator, and Program Provider Journey Road Maps
• National DPP Coverage Toolkit

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512.
Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4. Epub 2009 Oct 29. Erratum in: Lancet. 2009 Dec 19;374(9707):2054.