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The Impact Brief is the official newsletter for the National Association of Chronic Disease Directors. It is distributed monthly to approximately 4,800 NACDD members, partners, and stakeholders. You can view NACDD's Impact Brief archive here:


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NACDD’s Partnership with the Association of State and Territorial Dental Directors Promotes Oral Health and Chronic Disease Integration Efforts

Posted By Barbara Park, Monday, June 18, 2018

Poor oral health can be a contributing factor to many chronic diseases, or a symptom and consequence of chronic disease. The National Association of Chronic Disease Directors (NACDD) has demonstrated its support of state oral health programs. In September 2016, this commitment strengthened when NACDD entered into a Memorandum of Understanding (MOU) with the Association of State and Territorial Dental Directors (ASTDD) to promote increased collaboration between chronic disease and oral health programs in states.

 As part of this project, a Chronic Disease Collaboration Workgroup came together to develop tools and resources for ASTDD members. In April, NACDD collaborated with ASTDD to host a member sharing session at the National Oral Health Conference, which focused on state examples of oral health and chronic disease integration. Using a “fireside chat” format, seven state oral health programs (Colorado, Georgia, Iowa, Maryland, Michigan, Minnesota, and Vermont) described the projects and approaches that are being implemented which align with four specific chronic disease prevention and health promotion priorities: 1) cardiovascular disease prevention; 2) diabetes prevention and management; 3) obesity prevention in children by limiting access to sugar-sweetened beverages; and 4) tobacco use prevention.

These types of collaborations not only enhance the ability of chronic disease programs to implement many of their evidence-based strategies, but they also can help to integrate oral health programs from “siloed” programs into more mainstream public health efforts. The session was well-timed as CDC had just announced the availability of additional funding for these types of collaborative efforts in a recent NOFO DP18-1810.

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California Prepares to Offer National Diabetes Prevention Program to 13 million Medicaid Members in Multiple Languages

Posted By Susan Lopez-Payan, Monday, June 18, 2018

California, rich with cultural and linguistic diversity, is home to 40 million people; more than 12 million of those individuals are Medicaid (Medi-Cal) members. Many Medi-Cal members will have the opportunity to prevent type 2 diabetes by enrolling and completing a one-year lifestyle change program as part of the National Diabetes Prevention Program (National DPP). This benefit will be available in 2019, and the agency overseeing Medi-Cal will provide services in English, Spanish, and 17 threshold languages.

A threshold language is a language identified on the Medi-Cal Eligibility Data System (MEDS) as the primary language of 3,000 beneficiaries, or five percent of the beneficiary population, whichever is lower, in an identified geographic area.[1]  In 2016, 38% (4,483,455 members) of Medi-Cal eligible persons reported a language, that met the criteria for a threshold language, other than English as their primary language. Seventeen distinct languages met the criteria for a threshold language: Arabic, Armenian, Cambodian, Chinese, English, Hindi, Farsi, Hmong, Japanese, Korean, Laotian, Punjabi, Russian, Spanish, Tagalog, Thai, and Vietnamese.[2] 

The legislature approved a request for a budget of $500,000 for translation services of the National DPP curriculum, and a separate budget request of $10 million to support marketing of the new benefit. Both are awaiting full approval by the Budget Conference Committee. The National Association of Chronic Disease Directors will continue to work with the State Health Department and their partners to expand the National DPP. One partner, Health Policy Advocates, mobilized independently to secure Medicaid coverage for the National DPP and leads a coalition to develop implementation details for successful roll-out and uptake of the program. The coalition gathered input and submitted the budget request. For more information, contact Susan Lopez-Payan.

[1] California Code of Regulations, Title 9, Rehabilitative and Developmental Services, Section 1810.410(f)(3) Cultural and Linguistic Requirements.

[2] Frequency of Threshold Language Speakers in the Medi-Cal Population by County for January 2015. Medi-Cal Statistical Brief. September 2016. Available at:

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New Mobile App Helps Cancer Patients Learn About Treatment Options

Posted By Margaret G. Ritchie, Monday, June 18, 2018
Updated: Monday, June 18, 2018

NACDD announces the availability of a brand new mobile app that helps newly diagnosed breast cancer patients learn about their treatment options. This state-of-the-art tool was developed using artificial intelligence engineering, to deliver a computer-animated conversational simulation tool. The app features an avatar character named Linda, who is a triple negative breast cancer survivor, and allows newly diagnosed patients to explore thousands of different conversational pathways.


Conversations include emotional concerns and treatment-related questions that allow for patient education to occur in a relational, non-threatening way. Cancer diagnosis often is overwhelming and confusing, and it can generate a flood of questions, concerns, and anxiety. This tool allows patients to spend time asking the computer the questions they may not have time to ask their own physician or caregiver. 


NACDD developed the app in partnership with CDC and technology leader, Kognito, a health simulation company. Kognito specializes in helping patients have candid, multi-directional conversations with animated subject matter experts, patients and instructors. 


The app is available on the Apple App Store.

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Americans Have Disability Data at Their Fingertips with the Disability and Health Data System

Posted By Karma Harris, Tuesday, June 5, 2018

Use DHDS to help improve the health and the well-being of adults with disabilities.

Get started now!

Visit DHDS at

For the first time ever, data ondeafness or serious difficulty hearing is available through the Centers for Disease Control and Prevention’s (CDC) Disability and Health Data System (DHDS). State epidemiologists, researchers, and public health professionals need access to accurate and timely data to inform their state’s promotional activities and to improve the health of the population.

CDC’s DHDS has been updated with 2016 Behavioral Risk Factor Surveillance System to provide accurate data on adults with disabilities. The system is now easier for users to navigate and locate information on improving the health and well-being of those with disabilities.

CDC’s Disability and Health Branch and the National Association of Chronic Disease will be hosting two webinars in June on DHDS.  

Thursday, June 21, 2018

3-4 p.m. ET

Beginner’s Guide to DHDS: This course is for users who want to learn the basics of using DHDS to investigate health differences between adults with and without disabilities.

Register now!

Tuesday, June 26, 2018

3-4 p.m. ET

DHDS: Beyond the Basics: For users who want to explore more advanced features, learn tips about utilizing the data currently available in the system, and see examples of how the data can be used to plan for disability inclusive programs and services.

 Register now!

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New Chronic Disease Director Orientation to Take Place in June

Posted By Jeanne Alongi, Friday, May 18, 2018

The next offering of the National Association of Chronic Disease Directors’ (NACDD) New Chronic Disease Director Orientation course will take place at the end of June. This distance-based cohort experience will include six monthly virtual classroom sessions and will connect newer Chronic Disease Directors with their peers and others who have a wealth of experience and wisdom to share. The Chronic Disease Director Orientation is offered to Chronic Disease Directors with less than two years in their current position or those who have never taken the orientation and would like to attend. If you have questions about the orientation curriculum, would like more information about participation, or would like to receive a registration invitation, please contact Jeanne Alongi at

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CDC’s ScreenOutCancer Helps Advance Cancer Prevention Nationwide

Posted By Amy Greene and John Patton, Friday, May 18, 2018

The National Association of Chronic Disease Directors (NACDD) announces its work to develop the new brand identity, logo, and messaging architecture for the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program and Colorectal Cancer Control Program. The brand identity aims to increase awareness for, and the value of, state grantees' work among health systems and health agency leadership. The rebranding would not have been possible without the valuable partnership of CDC’s Division of Cancer Prevention and Control, and the input of state grantees across the nation. Extensive interviews with the target audiences and key stakeholders at the state and national level took place to help inform every element of the new brand. NACDD will provide a wide range of tools such as branding style guides, infographics, social media posts, and digital geofencing ads. There also is a state-of-the art promotional video ad featuring the new brand identity that addresses the evidence-based interventions that increase cancer screening rates. Materials will be available to public health agency leaders, health system administrators, and healthcare influencers to educate them and encourage them to learn more via a call-to-action message directing them to the CDC’s Cancer division website. NACDD will provide technical assistance and communications support through the launch of the initiative. To learn more, visit the brand-new landing page at

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State Health Departments Learn to Use GIS to Improve Blood Pressure Medication Adherence

Posted By MaryCatherine Jones, Thursday, April 19, 2018
In February 2018, Idaho, New York, South Dakota, and Wisconsin participated in the 2018 Advanced Thematic GIS Training for State Health Departments: Using Geographic Information Systems (GIS) to Address Blood Pressure Medication Adherence. Two representatives of each health department took part in a 10-day intensive GIS training, which included two days of in-person training at Rice University in Houston, Texas. Georgia, Maine, Michigan, and Vermont will participate in the second cohort in 2018. The training curriculum is tailored to meet the needs of state health departments working on blood pressure medication adherence as part of Domain 3: Healthcare system interventions. As a result of the project, participating states will use GIS to address the unique aspects of blood pressure medication adherence in their communities and follow an Identify-Assess-Act approach to using their maps to inform policies and programs, and to enhance partnerships. Products and lessons learned from the participating state health departments will be shared widely and posted to NACDD’s GIS webpage.

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Building an Evidence-Based Health Department

Posted By Margaret G. Ritchie, Thursday, April 19, 2018
Updated: Thursday, April 19, 2018

Experience has shown that evidence-based public health (EBPH) training gives chronic disease practitioners the tools they need to make decisions based on the best available evidence. Public health practitioners working within health systems studied and developed administrative evidence-based practices (A-EBPs) that can help facilitate the health departments’ roles in supporting the application of evidence-based decision making (i.e. how to become an evidence-based health department). A-EBPs consist of five major domains: workforce development, leadership, organizational culture and climate, relationships and partnerships, and financial processes.

In 2016, the National Association of Chronic Disease Directors (NACDD), and the Centers for Disease Control and Prevention (CDC), in collaboration with the Prevention Research Center at Washington University in St. Louis issued a national survey including a subset of questions on A-EBPs. There were four workforce development questions assessing perceptions of the respondent’s work unit as a whole; 11 leadership questions related to quality of leaders, evidence-based decision making, management, and unit capacity; 10 statements that assessed perceptions of organizational culture and climate; and four questions to assess perceptions of financial transparency, type and structure of funding sources, and economic evaluation.

571 chronic disease practitioners responded to a national survey.

What did we learn?

 • In the leadership category, the highest percentage of respondents agreed with the presence of quality leadership (63%). The items with the lowest percentage of agreement were related to the future workforce in public health. Only 12.4% agreed that their department had a replacement plan for those who retire or move to another job.

• Within the culture and climate construct, 68% of respondents reported working in a department that encourages communication and collaboration. Respondents used a likert scale (from strongly disagree to strongly agree) as to whether their department "adequately represents the cultural needs of the communities in my state." 34% agreed or strongly agreed with the statement. Of all the questions in the climate and culture category, this had the fewest number/ lowest percent who agreed or strongly agreed.

• Within relationships and partners, only two items had agreement percentages less than 50%. Only 30% agreed that their health department collaborates with health plans, and 42% agreed that they collaborate with sectors outside of public health. The vast majority (87%) agreed that partnership development with both health and other sectors is needed to address health issues within their state.

• In the financial practices group of questions, less than one-third agreed that economic evaluation is included in decision making about programs and policies, and only 28% reported that their organization had a variety of stable and flexible funding sources. In addition to the use of evidence-based interventions, administrative best practices can help ensure the quality and sustainability of initiatives within state health departments.

The data from this study can be used to target training and to inform practice in a number of ways. They suggest a need for: 1) succession planning, particularly in light of the aging workforce; 2) continued development of leadership capacity; and 3) stronger collaborations, i,e. more integration of primary care and public health, and more partnering with other sectors outside of health. Enhancing awareness of A-EBPs within public health leadership and highlighting their importance to practice may lead to increased use of these practices.

For more on the findings, read the full article: Eyler, A. A., Valko, C., Ramadas, R., Macchi, M., Fershteyn, Z., & Brownson, R. C. (2017). Administrative Evidence-Based Practices in State Chronic Disease Practitioners. American Journal of Preventive Medicine, 54(2), 275–283. 

 View the assessment tool online.

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NACDD Health Equity Council Continues to Develop Strategies to Address Health Disparities

Posted By Robyn Taylor, Thursday, April 19, 2018

Through the active participation of representatives from state chronic disease programs, NACDD’s Health Equity Council (HEC) has developed tools, resources, and technical assistance for members. The Council continues to host opportunities for public health leaders to discuss, explore, and develop additional resources for state chronic disease directors to effectively address chronic disease disparities and the multi-dimensional issues contributing to disparities experienced by ethnic and racial minorities, people with disabilities, the LGBTQ, rural communities and the poor. Nine statesLouisiana, MassachusettsGeorgiaArkansas, Virginia, MississippiNew HampshireMinnesotaFloridaare working with the NACDD HEC to pilot the recently released, “Moving to Institutional Equity” tool. The objective of the tool is to help users recognize institutional racism by moving through a process to identify potentially racist policies and/or procedures, and then to explore opportunities to facilitate new outcomes. The nine states are analyzing hiring practices and developing health equity policies that will sustain health equity efforts in state chronic disease programs. Additionally, HEC recently was awarded a grant to implement the 2018 Health Equity Virtual conference, which is scheduled for fall 2018. Members are invited to join the Council as it works on these and other projects to develop tools, resources, and training for state chronic disease programs. The HEC meets the second Tuesday of each month at 2:00 p.m. ET. For call details, contact Robyn Taylor at

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CDC DNPAO and NACDD Announce Final Two Webinars on Childhood Obesity

Posted By Leslie Best, Friday, April 13, 2018

The Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity and the National Association of Chronic Disease Directors announces the last two webinars in a series on effective strategies to increase utilization of evidence-based healthy weight management programs for children with obesity.


The webinar, “Four Stages of Obesity Care: Translating Expert Committee Guidelines on Childhood Obesity into Practice,” presented by staff from Nationwide Children’s Hospital Center for Healthy Weight and Nutrition, is scheduled for Tuesday, May 1, 2018, at 11 a.m. ET. Registration instructions will be issued in April.


In addition, Denise Wilfley, PhD, the Scott Rudolph University Professor of Psychiatry, Medicine, Pediatrics and Psychology at the Washington University School of Medicine in St. Louis and Samar Muzaffar, MD, MPH, Medical Director for the Missouri HealthNet Program, will present on “Family Based Behavioral Treatment for Obesity: Lessons Learned from Translating 30 Years of Research to Practice,” at 2 p.m. ET on May 16, 2018. Registration instructions will be issued in April.


This webinar series has created peer-to-peer learning opportunities to facilitate information sharing among state health departments, public health practitioners, healthcare providers, clinician researchers, community organizations, and others seeking to develop sustainability plans, monitor success, share lessons learned, and explore the role of nontraditional partners in this emerging issue in pediatric public health.  View the rest of the series’ archived webinars online.

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