2022 Empowering Communities to Deliver and Sustain Evidence-Based Chronic Disease Self-Management Education Programs

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Title
2022 Empowering Communities to Deliver and Sustain Evidence-Based Chronic Disease Self-Management Education Programs
Opportunity ID
335066
Center
AOA
Primary CFDA Number
93.734
Funding Opportunity Number
HHS-2022-ACL-AOA-CSSG-0041
Funding Instrument Type
Cooperative Agreement
Expected Number of Awards Synopsis
9
Length of Project Periods
Other
Project Period Expected Duration in Months
36
Eligibility Category
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,Private institutions of higher education
Additional Information on Eligibility
Foreign entities are not eligible to compete for, or receive, awards made under this announcement. Faith-based and community organizations that meet the eligibility requirements are eligible to receive awards under this funding opportunity announcement.
Estimated Award Date
Funding Opportunity Description

In the United States, chronic diseases such as heart disease, cancer, stroke, and diabetes represent 7 of the top 10 causes of death, and are a leading cause of disability. [1][2] Among the rapidly increasing aging population, approximately three out of four older adults have multiple (two or more) chronic conditions which places them at greater risk for premature death, poor functional status, mental health conditions (such as depression and social isolation), unnecessary hospitalizations, adverse drug events, and nursing home placement. [3][4][5] Chronic diseases also significantly impact healthcare costs: 95% of healthcare costs for older adults in the United States can be attributed to chronic diseases. [6] [7] Additionally, adults with disabilities experience health disparities when compared with the general population. For example, adults with disabilities are more likely to have chronic health conditions such as high blood pressure, be overweight or obese, not engage in fitness activities, and receive less social-emotional support than adults without disabilities. [8]

Coping with multiple chronic diseases is a considerable challenge for older adults, their families and caregivers, which has been further complicated by ongoing COVID-19 related resource loss. Older adults, particularly those with chronic diseases, have been disproportionately impacted by the pandemic -- accounting for more than 75% of the COVID-19 related deaths. [9] Furthermore, since March 2020, nearly one in five older adults have reported worse sleep, worse depression or sadness, 28% have reported worse anxiety or worry, and more than six in ten have reported experiencing social isolation. [10] [11]

Empowering older adults to engage in evidence-based chronic disease self-management education (CDSME) programs to better manage their conditions can help mitigate the chronic disease burden. Now more than ever we see the critical need to promote, make widely available, sustain, and integrate CDSME and support programs across sectors as the COVID-19 pandemic has significantly exacerbated existing health inequities and further exposed underserved populations to suboptimal social determinants of health.

The acronym, CDSME, is being used in this announcement as an umbrella term for community-based education programs specifically designed to enhance self-management of chronic diseases. These programs focus on building multiple health behaviors and generalizable skills such as goal setting, decision making, problem solving, and self-monitoring, and are proven to maintain or improve health outcomes of older adults with chronic conditions. Similarly, a self-management support program is a community-based, behavioral change intervention that is proven to increase one or more skills or behaviors relevant to chronic disease self-management such as physical activity or medication management. [12]

The AoA has supported CDSME and other evidence-based health promotion programs for many years through grants, as well as collaborations on various federal initiatives. For example, Prevention and Public Health Fund initiatives in 2021 supported 8 CDSME grantees. Additionally, Older Americans Act Title III-D funding supports a broader portfolio of evidence-based disease prevention and health promotion activities. To date, more than 440,000 older adults and adults with disabilities have participated in an AoA-supported CDSME program. For more information about ACL’s CDSME Program, including grantee profiles, please visit: https://www.acl.gov/programs/health-wellness/chronic-disease-self-manag….

Purpose
This funding opportunity is designed for applicants to propose how they will develop capacity for, expand, deliver, and sustain evidence-based chronic disease self-management education and support programs that address the prevention and management of chronic conditions among older adults and adults with disabilities.

Goal 1: Develop or expand capacity to significantly increase the number of older adults and adults with disabilities, particularly those in underserved areas/populations, who participate in evidence-based chronic disease self-management education and self-management support programs to empower them to better manage their chronic conditions.

Goal 2: Enhance the sustainability of evidence-based chronic disease self-management education and self-management support programs through the implementation of robust sustainability strategies.

Please refer to Appendix A (Glossary of Terms) for definitions of CDSME and self- management support programs. Applicants for this funding opportunity must propose to deliver two or more CDSME programs AND at least one self-management support program. The programs proposed must be on the list of pre-approved interventions found in Appendices B and C of this funding opportunity.

All applicants must propose to implement at least one program that can be delivered in a remote format, i.e., by video conference, phone, mailed toolkit + phone, or some other format that does not have an in-person component. The National Council on Aging (NCOA) maintains a website that tracks remote program guidance (https://www.ncoa.org/news/ncoa-news/center-for-healthy-aging-news/track…). All applicants should contact the program administrator(s) for any program(s) they are interested in delivering remotely to confirm that: 1) the programs are allowed for remote delivery; and 2) training is readily available for applicants who need it. Note that the NCOA website includes programs on the pre-approved list in Appendix B and C, as well as other programs not on the list. For this funding opportunity, applicants may ONLY propose programs on the pre-approved lists in Appendix B and C.

All applicants who do not have adequate existing capacity for any in-person and/or remote program(s) they are proposing must include a letter from the program administrator(s) in their application indicating that they will be able to get training in the programs no later than three months after the start date of the grant (if selected for funding).

References
[1] Centers for Disease Control and Prevention, National Center for Health Statistics. Leading causes of death. Updated March 1, 2021. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed October 8, 2021.
[2] Buttorff C, Teague R, Bauman M. Multiple chronic conditions in the United States. Santa Monica (CA): RAND Corporation; 2017. https://www.rand.org/pubs/tools/TL221.html. Accessed October 5, 2021.
[3] Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions Chartbook. AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality. April 2014.
[4] Parekh, A.K., et al. 2011. Managing Multiple Chronic Conditions: A Strategic Framework for Improving Health Outcomes and Quality of Life. Public Health Rep. 126(4):460– 71.
[5] Kramarow E. et al. 2007. Trends in the Health of Older Americans,1970–2005. Health.
[6] Center for Medicare & Medicaid Services. National health expenditures 2019 highlights. https://www.cms.gov/files/document/highlights.pdf. Accessed October 5, 2021.
[7] Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013.
[8] Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. DATA 2010 [Internet database]. Hyattsville, MD: CDC; 2010
[9] Centers for Disease Control and Prevention. National Center for Health Statistics. COVID-19 Mortality Overview. Accessed October 5, 2021. https://www.cdc.gov/nchs/covid19/mortality-overview.htm
[10] Gerlach L, Solway E, Singer D, Kullgren J, Kirch M, Malani P. Mental Health Among Older Adults Before and During the COVID-19 Pandemic. University of Michigan National Poll on Healthy Aging. May 2021. Available at: http://dx.doi.org/10.7302/983
[11] NIHCM Foundation. Aging & COVID-19: Vaccination, Mental and Physical Health, and isolation. February 2021. https://nihcm.org/publications/aging-covid-19-vaccination-mental-and-ph…
[12] Brady, Teresa. “Strategies to Support Self-Management in Osteoarthritis.” AJN, American Journal of Nursing, vol. 112, no. 3, 2012, pp. 54–60., doi: 10.1097/01.naj.0000412653.56291.ab.

Award Ceiling
700000
Award Floor
600000
Due Date for Applications
Date for Informational Conference Call

Last modified on 11/24/2021


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