Above view of group of people forming the shape of lungs

Learn More Breathe Better® Community Subcontract Program


NHLBI’s Learn More Breathe Better® 2021-2022 Community Subcontract Program

Through the Learn More Breathe Better® Community Subcontract Program, the National Heart, Lung, and Blood Institute provides funding to organizations around the country to implement innovative health education initiatives aimed at increasing awareness about chronic obstructive pulmonary disease (COPD). These efforts help meet the goals of the COPD National Action Plan, especially in building awareness among at-risk populations and supporting people living with COPD and the healthcare providers who treat them.
We are pleased to announce the following organizations have been selected to receive funding for the 2021-2022 program year to implement the projects described below.

ALA LogoRates of COPD in rural settings are nearly double those in urban areas of the United States, and unique barriers in these communities can stand in the way of patients’ ability to be diagnosed and treated early for the disease. The American Lung Association’s Reaching Rural Providers initiative aims to increase the early diagnosis of COPD in rural communities across the nation. The program will work to expand the reach of COPD education among rural healthcare providers, primarily nurse practitioners, physician assistants, and allied health professionals, such as pharmacists. With a special focus on six states in the Appalachian region, Reaching Rural Providers will support and promote a wide range of live and on-demand programs, trainings, and materials adapted specifically to support rural needs. These professional education opportunities will cover topics including strategies to help patients quit smoking, oxygen and medication therapies, and diagnostic approaches. The American Lung Association will draw on its robust partnership network to support the initiative, getting more COPD prevention, treatment, and management tools in the hands of rural healthcare providers.

BreatheCA logoIn California, about 1.4 million people are living with COPD.  Through its Better Breathing with COPD in the Bay Area program, Breathe California will use a wide range of approaches to deliver innovative programs to at-risk populations on the West Coast. Looking to reach vulnerable groups such as current and former smokers, non-English speakers, and senior citizens, Breathe California will collaborate with a broad range of community-serving partners including local senior centers; lung patient clubs; pulmonary physician groups, clinics, and hospitals; and media organizations across the Bay Area. Efforts will include developing Spanish-language COPD education materials and training and deploying community health workers (promotores) to disseminate them in low-resource communities. Other activities include leveraging local events, media coverage, and health observances as opportunities to educate new audiences about COPD, and identifying and engaging new partners to reach  communities most in need. 

EFA LogoThe Emphysema Foundation of America aims to increase understanding and reduce the burden of COPD in Southern California, especially in underserved communities. Their three-part strategy involves providing support to people diagnosed with COPD, raising awareness about COPD in populations who are at risk but may go undiagnosed, and increasing knowledge among healthcare professionals about the importance of early diagnosis. Through its StriveTM workshops, patients will learn how to manage medications, ways to prevent COPD flare-ups, the role of diet and exercise, mental health effects of COPD, and more. The public awareness efforts will reach about 20,000 at-risk adults, highlighting the importance of quitting smoking and other key messages. Engaging partners across Southern California, such as the California Smoker’s Helpline, will broaden the reach and provide more COPD patients with the support they need to manage their condition. 

Visit the COPD National Action Plan Community Action Tool to find more examples of projects being implemented by the COPD community. 

RFP Previously Funded

View Past Community Subcontract Awardee Projects
- Learn More Breathe Better® Community Subcontract Program

The Learn More Breathe Better's Community Subcontract Program provides funding to organizations for programs and activities focused on Goals 1 and 2 of the COPD National Action Plan—building awareness about COPD and improving care. Organizations awarded funding though this program help to reduce the burden of COPD in their communities through innovative strategies in areas of the country where COPD is the most prevalent.

To view previously funded projects, click on the funding cycle below. More information about activities that support the implementation of the COPD National Action Plan can be found in the Community Action Tool.

2020-2021 Cycle
- Learn More Breathe Better® Community Subcontract Program

During this funding cycle, three organizations received funding through the Learn More Breathe Better's Community Subcontract Program. Projects included the development of the first-ever program on pulmonary rehabilitation in an outpatient setting, promotion and increasing access to a mobile app for people in rural communities, and increasing the availability of COPD resources and information in diverse languages for underserved communities.

Breathe California logoBreathe California seeks to bridge the gaps within the COPD population by developing programs which aim to increase education among the most at-risk patient populations such as current and former smokers, seniors with low-socioeconomic status, and non-English speakers. Breathe California Bay Area will empower people with COPD, their families, and caregivers to recognize and reduce the burden of the disease by increasing the availability of educational resources in diverse languages for these communities. Additionally, their colleagues with Breathe California Golden Gate and Central Coast will work to establish tobacco-free communities, enhance patient support programs, and promote lung disease prevention and interventions in vulnerable populations with health disparities and inequities reaching children to seniors. They will also partner with media agencies to coordinate and conduct campaigns for health education purposes and grassroots advocacy.

COPD Foundation logoAn important part of the COPD National Action Plan is for every person living with the disease to have the knowledge, tools, and skills that will support their efforts in COPD self-management and take control of their health. Today, rural COPD care is limited, which leaves people living with COPD in these areas without the proper resources to manage their health. The COPD Foundation’s CIRCLES (Clinicians Improving the Rural COPD Landscape through Education in Self-care goals) project will support rural COPD communities in New Mexico and Colorado and will promote and increase accessibility of their COPD Pocket Consultant Guide mobile application - an app designed to support the treatment and management of COPD among patients, caregivers, and their healthcare providers.

Respiratory Health Association Pulmonary rehabilitation continues to be one of the top recommended health practices for people living with COPD as it provides a safe and supervised environment for patients to be educated on their COPD care. The benefits of pulmonary rehabilitation include decreased fatigue, improved physical activity and reduction of hospitalizations. With rehabilitation programs not active and COPD patients staying home for long periods of time as a result of COVID-19, the Respiratory Health Association will develop Project STRENGTH (Support for Transitioning Rehabilitation and Exercise Now Going To Home). STRENGTH will be the first-ever program of its kind to serve as a resource for people living with COPD who participate in pulmonary rehabilitation and wish to continue outside of the outpatient setting. This program will fulfill the need for simple understandable support resources for people transitioning from outpatient pulmonary rehabilitation to home while increasing the utilization and accessibility of the program in the COPD community.

2018-2019 Cycle
- Learn More Breathe Better® Community Subcontract Program

Through the Learn More Breathe Better's Community Subcontract Program, six organizations received funding in July 2018. These organizations focused on a variety of aspects of prevention and intervention. Activities ranged from COPD education; empowerment of those living with COPD, their family members, and caregivers; trainings for health care providers focused on early detection, diagnosis, and treatment; and improved resources for those at higher risk for the disease. Combined, the efforts reached communities in Illinois, Indiana, Michigan, New Hampshire, North Carolina, Ohio, South Carolina, and Tennessee.


Starting in July 2018, Atrium Health set out to learn more about kids’ awareness of COPD and the role they play in talking about the disease with their parents and grandparents, who may be at risk. To engage children, Atrium Health hosted events at their local family science museum, located in the Greater Charlotte area in North Carolina, where families and their children could learn about COPD and its risk factors. Student ambassadors at the museum also helped facilitate interactions with a lung display and a spirometer to show kids how COPD can be diagnosed.

In addition to onsite education, Atrium Health invited families to participate in the KIDS4COPD social media challenge by asking them to learn about COPD, post a photo with the hashtag #KIDS4COPD, and talk to their family about the disease. These posts aimed to generate COPD conversations on social media, and over the course of a few months, KIDS4COPD received over 690,000 impressions.

Atrium Health also conducted surveys and focus groups to further understand youth preferences for social media advocacy regarding COPD. These findings inspired the development of a social media toolkit.

Social media card encouraging kids to to talk about COPD with family


Smoking is the number one risk factor for COPD. In New Hampshire, the smoking rate is well above the national average, which is why Breathe New Hampshire focuses their efforts on increasing awareness and education about smoking-related COPD. The organization worked with partners across Greater Manchester to disseminate their Tobacco-Use Disorder toolkit that includes resources to help primary care physicians and nurse care coordinators increase conversations about smoking and lead referrals to the NH Quitline. In addition, Breathe New Hampshire hosted trainings for over 35 health care professionals to share best practices and approaches to help more people stop smoking, ultimately helping them reduce their risk for COPD.

Breathe New Hampshire also organized and led first discussions through the COPD Communication Collaborative, a national platform offering organizations the opportunity to share best practices and key learnings on activities being pursued to achieve the goals of the COPD National Action Plan. To date, the organization has held two webinars focusing on goals one and two of the Action Plan. To learn more, visit the Breathe New Hampshire website.


Smoking rates are highest among those living in rural areas, and considering it is the main risk factor for COPD, it should come as no surprise that prevalence of COPD is also higher in rural area compared to urban. With this knowledge, the South Carolina Tobacco-Free Collaborative (SCTFC) worked closely with health care providers from rural health clinics across the state to develop and distribute their custom change package. The package supplied health care providers with tobacco intervention materials and tools to help empower their patients to quit smoking and refer them to the state’s tobacco quitline.

In partnership with South Carolina’s Office of Rural Health, the SCTFC also hosted a training attended by 30 health care providers representing 17 rural health clinics. Attendees learned how to use the CDC’s brief tobacco intervention tool and were provided with more information on how the custom change package can ultimately improve COPD outcomes.


COPD is a leading cause of death in Michigan. Over 634,200 people have been diagnosed, and it is likely that more people live with the disease but remain unaware. Because of this, the Western Michigan University Homer Stryker M.D. School of Medicine (WMed) wanted to increase awareness about COPD in their community. During this subcontract, the medical school launched a community education program involving an interdisciplinary team of medical students, respiratory therapists, primary care physicians, and nurses to conduct outreach events throughout Kalamazoo. During the events, the team educated members of the community about a variety of aspects of COPD, including risk factors, diagnosis, treatment, and management of the disease. WMed was also able to purchase a portable spirometer so they could demonstrate and conduct spirometry tests and encourage those at risk for COPD to talk to their health care provider.

WMed reached over 300 people with their events, conducted over 50 spirometry tests and 25 inhaler-use assessments over the course of the subcontract. The organization further amplified the reach of their program by developing and launching an eight-week long billboard campaign highlighting the common signs and symptoms of COPD.

Image of a billboard with symptoms of COPD: short of breath, coughing and wheezing


While the greatest focus in COPD education and care is on those at risk for or living with the disease, fewer resources exist to address the needs of informal caregivers. A study found that 35 percent of informal COPD caregivers report having health-related problems due to their caregiving role. To better help this often overlooked audience, the Respiratory Health Association developed a COPD Caregiver’s Toolkit, a resource designed to provide informal caregivers a comprehensive overview of what they need to know to care for themselves in addition to their loved ones with COPD. This subcontract helped to disseminate their toolkit to over 200 informal caregivers in the Midwest and to assess its contents and impact.

Findings from their research on usability and usefulness of the toolkit are being used to further refine the resource to address the evolving needs of those impacted by COPD. This is an important step to make sure these individuals have access to information and strategies that can be used at every stage of the caregivers’ journey.


Physician assistants and nurse practitioners play a vital role in providing care for those living with COPD – particularly in rural areas. The COPD Foundation’s subcontractor program set out to equip health professionals, who may not be specialized in respiratory health, in rural Tennessee, with the knowledge and resources to diagnose and treat people living with the disease. Their pilot initiative, Teaching and Outreach in Underserved Communities and Health Improvement (or TOUCH COPD), provided training opportunities, webinars and workshops to professionals in the state. Through various events, TOUCH COPD offered practical skills to help effectively treat patients. In addition, professionals trained by the TOUCH COPD initiative continued to share their knowledge by training others at their rural health care facilities.

After the pilot program, 67 percent of participants said that the information shared through the TOUCH COPD initiative improved their level of care for COPD patients. About 83 percent said the knowledge improved the level of care in their rural health care facilities. The COPD Foundation plans to continue their discussions with facilities throughout the state to schedule additional trainings and to ultimately increase their reach in rural communities.