A Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions | CDC RFA EH19 1902

Opportunity Information: Apply for CDC RFA EH19 1902

The grant opportunity titled "A Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions" (CDC-RFA-EH19-1902) is a CDC cooperative agreement designed to help communities reduce asthma illness, deaths, and long-standing inequities by scaling up proven, coordinated asthma control strategies. The focus is not on small, isolated programs, but on improving the overall reach, quality, effectiveness, and staying power of asthma services across multiple settings where people live, learn, work, and receive health care. The work is aligned with the CDC initiative Controlling Childhood Asthma Reducing Emergencies (CCARE), which emphasizes practical, high-impact levers that can meaningfully improve childhood asthma outcomes and prevent avoidable emergency department visits and hospitalizations.

At the center of the funding announcement is implementation of the EXHALE technical package, a set of six evidence-based strategies that are meant to be deployed together as a coordinated bundle. The idea behind EXHALE is that asthma control improves most when health care, public health, housing, schools, and community partners work in sync rather than addressing problems one at a time. Funded recipients are expected to strengthen their organizational infrastructure and then expand services in a way that makes these interventions easier to deliver at scale, more consistent in quality, and more sustainable over time. A major expectation is that all six EXHALE strategies be implemented in the same high-burden geographic area or within the same high-burden population so the components reinforce each other and produce larger combined effects than any single intervention could achieve alone.

The six EXHALE strategies are: Education on asthma self-management, which includes asthma self-management education (AS-ME) to help patients and caregivers recognize symptoms early, use medications correctly, follow action plans, and reduce preventable flare-ups; eXtinguishing smoking and exposure to second-hand smoke, recognizing tobacco smoke as a major trigger and a driver of severe outcomes; Home visits for trigger reduction and asthma self-management education, which pairs clinical guidance with practical, in-home steps to reduce exposure to triggers such as dust mites, mold, pests, smoke, and other irritants; Achievement of guidelines-based medical management, meaning care that aligns with established clinical guidelines so patients receive appropriate assessments, controller medications when needed, and consistent follow-up; Linkages and coordination of care, which aims to connect clinics, schools, community health workers, home visiting programs, payers, and other partners so patients do not fall through gaps between systems; and Environmental policies or best practices to reduce indoor and outdoor asthma triggers, emphasizing changes that can reduce exposures at the building, community, or policy level rather than relying solely on individual behavior change.

The outcomes CDC highlights are practical and measurable improvements in how asthma services are delivered and who benefits from them. These include increased capacity to deliver asthma self-management education, expanded services targeted to people and places carrying the highest asthma burden, improved asthma control, better insurance coverage or reimbursement support for key services, stronger care coordination, and measurable reductions in disparities. Over the longer term, the work is intended to contribute to the broader CCARE goal of preventing 500,000 hospitalizations and emergency department visits among children with asthma within five years, reflecting the program's emphasis on avoiding severe exacerbations through preventive care, trigger reduction, and coordinated support systems.

The announcement frames the need for this investment by emphasizing that asthma is both widespread and expensive in the United States. It cites estimates that more than 26.5 million Americans have asthma, including 6.1 million children and 20.4 million adults, and that asthma leads to heavy health care utilization, including emergency department visits, physician office visits, and hospitalizations. It also notes the day-to-day societal impact of asthma through missed school and work days, and the fact that deaths still occur despite the existence of effective medications and management approaches. Economically, the notice points to national estimates showing tens of billions of dollars spent annually on asthma treatment, with even higher total costs when absenteeism and mortality are included.

A major theme throughout the opportunity is reducing inequities. The CDC notes that asthma prevalence and severity are not evenly distributed, with higher burden among groups such as children, women, low-income and inner-city residents, and certain racial and ethnic communities including African American and Puerto Rican populations, who experience higher rates of emergency department visits, hospitalizations, and deaths. The notice also mentions that American Indian/Alaska Native children are substantially more likely to have asthma than non-Hispanic White children. The funding announcement underscores that these disparities are driven by complex, intertwined factors beyond genetics, including access to quality care, differences in patient-provider communication and health beliefs, and environmental conditions in housing and workplaces that increase exposure to allergens and irritants. That context is used to justify multi-sector interventions that address both clinical management and upstream environmental and social drivers.

In terms of program structure, this is a discretionary cooperative agreement, which typically means CDC expects substantial involvement and partnership during implementation rather than simply issuing funds and stepping back. The opportunity was issued by the Department of Health and Human Services, Centers for Disease Control and Prevention, within the National Center for Environmental Health (NCEH). The eligibility field is listed as unrestricted (open broadly to entity types, with any limits clarified in the full notice), and the program builds on prior CDC-supported asthma efforts, including earlier funding announcements (CDC-RFA-EH14-1404 and CDC-RFA-EH16-1606). For FY 2019, the notice lists an award ceiling of $800,000 and anticipates up to 25 awards. The original application closing date was May 31, 2019, with electronic submissions due by 11:59 p.m. Eastern Time on the due date.

Overall, this opportunity is best understood as a large-scale, coordinated asthma control effort that prioritizes evidence-based interventions delivered together, concentrated in high-burden communities, and implemented through partnerships that connect health care with home, school, and environmental change. The program aims to move beyond short-term education or isolated clinical improvements by building sustainable infrastructure, aligning incentives and coverage, improving guideline-based care, and reducing environmental triggers, all while making measurable progress on preventable emergencies and persistent disparities.

• The Department of Health and Human Services, Centers for Disease Control - NCEH in the health sector is offering a public funding opportunity titled "A Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.070.
• This funding opportunity was created on Mar 28, 2019.
• Applicants must submit their applications by May 31, 2019 Electronically submitted applications must be submitted no later than 1159 p.m., 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 $800,000.00 in funding.
• The number of recipients for this funding is limited to 25 candidate(s).
• Eligible applicants include: 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 EH19 1902

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