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Impact Briefs
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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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Top tags: Arthritis  Health Promotion  Walk with Ease 

NACDD Cancer Projects Portfolio 2018-19

Posted By Frank Bright, Monday, February 25, 2019

NACDD was successful in competing for thirteen cancer prevention and control projects funded by the Centers for Disease Control and Prevention Division of Cancer Prevention and Control.  All thirteen projects submitted were approved for funding. Following is a brief description of each project in the cancer project portfolio.

Increasing Colorectal Cancer Screening Rates: State-Specific Health Intelligence and Partner Collaboration - Using the State Engagement Model, NACDD, in partnership with CDC and Leavitt Partners, works with six state health departments (3 with Medicaid expansion and 3 without Medicaid expansion) to create state-specific health intelligence tools and resources and to engage key health system and health plan stakeholders to develop and implement targeted strategies to increase colorectal cancer screening rates. 

Cancer Prevention Across the Lifespan: Putting Scientific Evidence for Primary Prevention in Public Health Practice - This project uses information gained from previous work and applies it to the development of innovative resources to empower public health practitioners, including CDC funded Comprehensive Cancer Control grantees, to put evidence-based cancer prevention strategies into action in their communities using a lifespan approach.  During the first year of this five-year project the core focus areas include calculating and communicating cancer risk, reduction of unnecessary exposure to medical radiation, physical inactivity and caregiver stress. 

Cancer Leadership and Collaborative Technical Assistance –This project supports the NACDD Cancer Council activities including quarterly meetings of the entire Council, interaction with the CCC National Partnership and NCI, quarterly meetings of the CDC screening programs (NBCCEDP and CRCCP), regularly scheduled professional development offerings, special interest area discussions such as palliative care, cancer services in rural areas, impact of health insurance reform on programs and health communications, and peer-to-peer support.

Data Analysis and Support for Evaluation of the NBCCEDP and the CRCCP - NACDD has an ongoing partnership with the University of Washington (UW) who has been conducting annual surveys of screening projects for a few years.  NACDD has contracted with an Evaluation Specialist to work with CDC on evaluation capacity-building at the project level. NACDD will work with UW and CDC on the development of useful formats for evaluation training and program enhancement. The purpose of this project is to increase evaluation related technical assistance to NBCCEDP/CRCCP grantees and to increase the dissemination and utilization of survey data.

Capacity Building Training for Tribal and Territorial Cancer Prevention Programs - NACDD is collaborating with CDC and tribal/territorial cancer screening grantees to plan and provide a capacity-building workshop focusing on evidence-based strategies to increase breast, cervical and colorectal cancer screening.  The showcasing evidence-based strategies include: patient reminders, provider reminders, provider assessment and feedback and reducing structural barriers.  The training workshop provides knowledge and skill building workshop experiences to assist the attendee in having an enhanced ability to effectively implement health systems intervention strategies and leave with identified actions steps to implement through their programs.

Enhancing Cancer Program Grantee Capacity through Peer to Peer Learning - This project supports collaboration and communication across programs by facilitating peer‐to‐peer learning opportunities for NBCCEDP and CRCCP grantees and their partners. The project  develops and implements a training forum for grantees and select partners to:  discuss implementation of health systems change (and potentially, other FOA strategies) including successes, challenges, and lessons learned;  share promising practices and success stories in implementation, evaluation, and sustainability;  provide peer‐to‐peer skill-building and technical assistance (TA) training in critical implementation and evaluation areas;  share practical implementation and evaluation tools and tips; and  discuss data use and management to support program monitoring and improvement, and outcomes evaluation

Impact of the Changing Health Policy Environment on State Cancer Program - NACDD monitors the health policy environment at the national and state levels to assess how state cancer prevention and control programs are transforming to take advantage of opportunities to increase appropriate cancer screening and early detection, especially for CDC-funded cancer programs.  Briefs, reports and presentations of the impact of health policies on cancer screening programs are developed for use by CDC, state chronic disease directors and directors of CDC funded cancer programs. 

Providing Communication Technical Assistance to State Cancer Prevention Efforts - NACDD supports CDC cancer grantee communication efforts by offering on-going, proactive technical assistance.  NACDD supports and motivates grantees to act, ensuring implementation of communication plans and tools to the best of grantee capacity.  NACDD is committed to providing continued support and new messaging to grantees and CDC through an NACDD facilitated grantee to grantee mentoring program, new data-informed messages and talking points allowing for the enhancement of website, a national awareness push leveraging the state-of-the art resources, partnerships and talent of CBSHealthSolutions.

National Program of Cancer Registries: Identifying and Implementing Best Practices for Registry Operations - NACCD and the North American Association of Central Cancer Registries (NAACCR) work with the CDC Division of Cancer Prevention and Control to identify best practices among grantees funded by the National Program of Cancer Registries (NPCR) in an effort to improve compliance with the NPCR standards for 12-month and 24-month data quality and completeness.  Best practices are identified through a survey issued by the CDC Division of Cancer Prevention and Control, informal interviews, focus groups and in-person summit meetings.  To better understand differences in practice, project team will work with at least 8 registries that have difficulty meeting the NPCR standards and 8 registries that have demonstrated better compliance with the standard.  As a result of this project, cancer registries in the NPCR program will be better equipped to collect and process cancer incidence data in a timely manner and make data available for evidence-based/informed decision-making regarding public health priorities.

Strengthening National Program of Cancer Registries by Enhancing Educational and Training Capacity and Infrastructure - Working in partnership the CDC Division of Cancer Prevention and Control, NACDD, University of Miami School of Medicine's Fundamental Learning Collaborative for the Cancer Surveillance Community (FLccSC)  and the North American Association of Central Cancer Registries (NAACCR), will increase access and use of an existing online learning management system able to support the present, expected and forecasted educational needs of the National Program of Cancer Registries (NPCR) and CDC Division of Cancer Prevention and Control grantees.  The identified online educational portal will include functions to create sites specifically for cancer registries and cancer programs, a course management tool, a Help desk offering bi-directional communication and ability to offer pre- and post-tests to document changes in knowledge, attitude and practice.

Reducing Breast Cancer Disparities in States: Creating the Bridge from Data to Action The CDC Division of Cancer Prevention and Control, NACDD and the Association of State and Territorial Health Officials (ASTHO) work with five identified state health department cancer prevention and control programs to strengthen their capacity in implementing evidence-based interventions and actionable strategies for reducing breast cancer disparities.  NACDD and ASTHO will coordinate webinars, support calls, in-person technical assistance (TA) visits and a new community of practice

Increasing Healthy Behaviors Among Cancer Survivors in Rural Communities. - The purpose of this project is to expand the reach and sustainability of multiple-component survivorship wellness programs in rural communities by building capacity and fostering relationships with Community Based Organizations. NACDD is working with State Comprehensive Cancer programs and their partners to identify the needs of cancer survivors and address those need though local access to wellness and health education services.   Grant awards (4-6 awards) will support efforts to engage local community-based organizations in developing and implementing evidence informed wellness interventions for cancer survivors in rural communities.

Health and Wellness in Cancer Survivors: Developing new tools to talk about behavior change - NACDD partners with Kognito, a health simulation company to develop 4 simulation modules for cancer survivors.  Proposed modules will include nutrition, physical activity, tobacco and alcohol and anxiety. An additional fifth module will address health care providers. State, territorial and tribal health department professionals will be trained on the modular tools in order to deploy them throughout their survivor-communities. A strategic communication dissemination plan will be developed for state, territorial and tribal health departments as well as for traditional and social media, partner organizations and the larger clinical community.

For further information please contact Frank Bright – or the lead NACDD Consultant/Staff on each project (the first person listed).

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Diabetes Prevention is for Everyone

Posted By Stacey Evans, Sunday, February 24, 2019
Updated: Monday, February 25, 2019

According to the Centers for Disease Control and Prevention (CDC), the rate of diabetes cases in the United States has nearly tripled over the past twenty years, particularly as the population ages and more adults become overweight or obese. What is often not highlighted is the number of adults at the highest risk for having type II diabetes, a condition also known as pre-diabetes. Approximately 84 million Americans have pre-diabetes, and most are not aware they have it.

In the United States, people with disability make up approximately 25% of the total population. According to CDC, adults with disabilities experience a rate of diabetes more than double that of adults without disability (16.3% vs. 7.2%). Adults with disability also experience higher rates of obesity, hypertension and physical inactivity.

To raise awareness about diabetes, disability and healthy living, NACDD has partnered with the Lakeshore Foundation on committing to inclusion and to raising awareness that diabetes prevention is for everyone on Diabetes Alert Day, March 26.

“We are an association that believes in broad and equitable access to evidence-based programs and services,” said NACCD CEO John Robitscher. “To be inclusive is in our nature and our disability work helps ensure that our programs are proactive and culturally relevant. We encourage all our partners to celebrate Diabetes Alert Day on March 26 by raising awareness that diabetes prevention is for everyone.”

Disability and diabetes do not discriminate. Spread the word and learn more at and via social media #Push4YourHealth.

To learn more about prediabetes and diabetes prevention programs, visit

For more information, contact Alice Jaglowski at

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Expanding the Reach of AAEBIs Through a Partnership with the Illinois Physical Therapy Foundation

Posted By Heather Murphy, Friday, February 22, 2019
NACDD began a partnership with the Illinois Physical Therapy Foundation (IPTF) in the fall of 2017 to deliver the arthritis appropriate evidence-based intervention (AAEBI) Walk With Ease (WWE) through clinic and community partners. WWE is a physical activity program that reduces arthritis pain and improves overall health. WWE appealed to IPTF’s clinic partners because it is evidence-based and easy to implement. A year into the project, IPTF and its 22 partner clinics had informed more than 5,500 people about WWE, distributed 600 WWE guide books, and enrolled nearly 300 people in the program—about 88% of whom completed it. As IPTF looks to continue its efforts, their initial experience suggests ways that organizations like theirs can act as “hubs” for sustainability—such as fostering a learning community among their peers and growing a library of tips, tools, and lessons learned. For more information on this project, contact Heather Murphy at

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Cancer Prevention Across the Lifespan: What's Happening in State Health Departments

Posted By Leslie Best, Friday, January 25, 2019

NACDD is partnering with CDC’s Division of Cancer Prevention and Control to: 1) identify and discuss cancer risk factors; 2) identify gaps in existing resources, by type of resource, behavior or interest or sociodemographic group and address these risk factors at the community level; 3) determine the types of information and resources that would be most useful to community leaders and public health practitioners when addressing these risk factors at the community level; and 4) develop an innovative yet practical resource to fill the identified gaps and further the implementation of evidence-based community-level strategies for cancer prevention.

As part of that work, NACDD will be sending a brief survey to Chronic Disease Directors to ascertain how they learn of innovative cancer prevention strategies, barriers faced to program implementation, and what additional, potentially cross-cutting risk factors they would be interested in learning about. We anticipate this survey will be issued to Chronic Disease Directors in February 2019, and your participation will be very helpful as we plan for the remaining years in this project.

Background: The Cancer Prevention Across the Lifespan (CPAL) workgroup was formed to address cancer risk and protective factors at each phase of life. In previous years, the CPAL workgroup collaborated with NACDD to conduct reviews of the literature and convene expert meetings to identify factors that influence cancer risk and promoting strategies to address these factors during every phase of life. This project will use the information gained from this previous work and apply it to the development of innovative resources to empower public health practitioners, including CDC funded Comprehensive Cancer Control grantees, to put evidence-based cancer prevention strategies into action in their communities using a lifespan approach. This year the CPAL/NACDD partnership will explore four topics:

•        Calculating and communicating cancer risk

•        Reduction of unnecessary exposure to medical radiation

•        Physical Inactivity

•        Caregiver stress

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MENDS Pilot Sites Selected

Posted By Stacey Evans, Thursday, January 24, 2019
Updated: Thursday, January 24, 2019

In 2018, CDC funded NACDD to pilot a surveillance project in two states that is successful in Massachusetts. Called MENDS (Multi-state EHR-based Network for Disease Surveillance), the pilot will use electronic health record (EHR) data collected in clinical settings in two State Health Departments in the first year.

The MENDS pilot seeks to test an automated chronic disease surveillance system using data routinely stored in health records to provide clinically detailed, efficient, and timely information from large, diverse populations with minimal added work and cost for health departments or clinicians.

The development of MENDS will be guided by the University of Massachusetts Medical School, Commonwealth Informatics, Harvard Medical School’s Department of Population Medicine, the Public Health Informatics Institute, and the Council of State and Territorial Epidemiologists. A guidance group made up of national surveillance experts will provide feedback on the expansion of MENDS so that it enhances its suitability as a viable component of a national chronic disease surveillance system.

NACDD invited all Chronic Disease Directors to apply to conduct the initial pilot. Eighteen State Health Departments expressed interest and were interviewed to assess their clinical relationships and readiness to begin implementing the pilot in January 2019. The Maryland Department of Health and the Washington State Department of Health were selected. NACDD will continue working with all interested State Health Departments to prepare them to participate in MENDS as funds become available.

To receive information about MENDS including newsletters, notification of webinars, and publications, contact Kathy Foell at

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NACDD’s Cardiovascular and Diabetes Peer to Peer Program Thrives after more than 10

Posted By Trina Thompson/April Reese on behalf of 233, Wednesday, January 23, 2019

The Cardiovascular Network and Diabetes Council are proud to share that a record-high 58 learners, representing 33 states and DC, applied for the Peg Adams Peer to Peer Program running from January-December 2019. NACDD matched these learners with 12 volunteer guides from State Health Departments (SHD) who have at least two years of experience in either cardiovascular disease or diabetes. Guides are leading 12 teams (four cardiovascular, four diabetes and four epidemiology/evaluation) on specific topics for discussion and troubleshooting. Guides frequently report that they get at least as much out of the program as learners do. This year, two new guides are previous learners and one guide, Stephanie Poulin (Conn.), is returning for her third consecutive year. Guides and learners say that they establish lasting relationships from participating.

Peg Adams (1940-2009), the namesake for the program, was a veteran chronic disease manager from the West Virginia Department of Health and Human Resources and was a strong proponent of peer learning. She valued and practiced mentoring of new staff through individual outreach and conference calls. During national conferences, Peg frequently arranged breakfast, lunch, and dinner meetings to get to know new SHD staff and help them feel a sense of community. It was easy to attach her name to the program and carry on the tradition of mentoring and providing a community environment for new SHD staff. The Diabetes Council’s Mentoring Workgroup leads the administration of the program.

If you would like to learn more, contact April Reese at

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State Health Departments Selected to Participate in 2019 State GIS Training for the Surveillance of Heart Disease, Stroke and Other Chronic Conditions

Posted By MaryCatherine Jones , Wednesday, January 23, 2019

NACDD congratulates staff from the health departments of Florida, Kansas, Pennsylvania, and Texas for their selection as participants in Phase XI of the NACDD Geographic Information Systems (GIS) Training for Surveillance of Heart Disease, Stroke, and Other Chronic Diseases in State Health Departments. These health departments will participate in one virtual and two in-person GIS trainings at Rice University in Houston. The training curriculum is tailored to meet the needs of chronic disease prevention programs in State Health Departments. The Chronic Disease Directors from these states will also participate in a peer group meeting at Rice University and four monthly calls focused on enhancing and sustaining GIS capacity for heart disease, stroke, and other chronic diseases.

GIS are computer-based systems that allow users to analyze and display geographically referenced data. The use of GIS-based technologies is common in the fields of infectious disease and environmental epidemiology, but many chronic disease prevention units are working to build or expand their GIS capacity and infrastructure. Participating health departments will make use of GIS and maps to address four impact areas: 1) document geographic disparities; 2) inform policy and program decisions; 3) enhance partnerships with external agencies; and 4) facilitate collaboration within agencies. With the use of GIS, State Health Departments can produce maps and data reports that are accessible, clear, and effective in communicating the needs for the prevention and management of heart disease, stroke and other chronic diseases.

NACDD will also be issuing a Request for Applications for a GIS and Translation/Dissemination opportunity for State Health Departments. This opportunity will include a one-day on-site workshop for each selected State Health Department, along with other activities.

For more information, contact MaryCatherine Jones at

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NACDD Supports the Health of our Military

Posted By Catherine McCann, Friday, November 30, 2018

A recent report to Congress by the Community Preventive Services Task Force (CPSTF) on military readiness and resilience estimated that seven in 10 young people would not qualify for military service due to unhealthy weight and other factors. Additionally, obesity, tobacco use, and alcohol abuse pose a significant challenge to the health of current service members. While there is considerable investment in healthcare, programs, and services for active duty service members residing on military bases, the Department of Defense (DoD) recognizes the need for increased support for service members who do not reside on military installations and for those in the Reserve forces and National Guard. Many of these service members rely on community supports and programs to help meet their health and economic needs.

Earlier this year, DoD launched a pilot project to help them better understand the resource challenges affecting the health, readiness, and resiliency of its population. The pilot, Building Healthy Military Communities (BHMC) is taking place in seven states: Florida, Indiana, Oklahoma, Maryland, Minnesota, Mississippi, and New Mexico. DoD has conducted rapid needs assessments in these states and are in the process of finalizing action plans to meet the top needs identified by the assessments.

The Centers for Disease Control and Prevention (CDC) and the National Association of Chronic Disease Directors (NACDD) understand the importance of this work and have partnered together with DoD to help them connect their work to chronic disease programs in the pilot states. Through this partnership, CDC and the Association have been able educate high-level military personnel on upstream, evidence-based interventions for physical activity, nutrition, and tobacco cessation and prevention. This pilot represents the first time that DoD has invested in a coordinated public health approach across the uniformed branches. If successful, it could pave the way to increased funding for more upstream policy, systems, and environmental approaches to health and wellbeing in military communities across the nation.

For more information, contact Catherine McCann.

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Cancer Prevention Across the Lifespan

Posted By Leslie Best, Friday, November 30, 2018

The Cancer Prevention Across the Lifespan project will develop innovative resources to empower public health practitioners and community leaders to implement evidence-based strategies to reduce cancer risk in their communities by making it easier for people to reduce exposure to carcinogens and adopt healthy behaviors where they live, work, learn, and play.

This project builds upon past work of the CDC Cancer Prevention and Control’s Cancer Prevention Across the Lifespan Workgroup (CPAL), which included collaboration with NACDD to conduct literature reviews and convene meetings of experts to identify factors that influence cancer risk and promising strategies to address these risks throughout the lifespan.

The first year of this project is focused on four key focus areas: calculating and communicating cancer risk; avoiding unnecessary exposure to radiation in cases of pediatric mild traumatic brain injury; physical inactivity; and caregiver stress. NACDD is collaborating with CPAL to identify experts in each of these fields and convene small, in-person meetings on each of the four focus areas to discuss the risk factor, identify gaps in existing resources, and develop innovative yet practical resources to fill the identified gaps. Plans to disseminate and evaluate these new resources are also key deliverables this first year. The evaluation plan will be continuously modified throughout the five-year grant period.

NACDD members should expect a series of webinars in 2019 that will share promising practices to address the risks in each focus area, which will be archived on the NACDD website, along with resources and information related to lifetime cancer risk reduction.

For more information, contact Leslie Best.

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NACDD Supports Efforts to Increase Awareness and Participation in the Arthritis Foundation’s Walk With Ease Self-Directed and Group Interventions

Posted By Paige Rohe, Tuesday, October 16, 2018

As one of the national awardees for the CDC Arthritis Program’s “National Advancing Arthritis Public Health Approaches through National Organizations” cooperative agreement, NACDD continues to work with partners and subcontractors to increase awareness and participation in arthritis-appropriate, evidence-based interventions. Main components include working to increase access to arthritis self-management interventions in worksites and physical activity interventions through the Walk With Ease Self-Directed Funding Support Opportunity. As of September 29, 2018, NACDD has provided mini grants to the following recipients: 

 American Physical Therapy Association Affiliate Chapters

 Hospitals (Wellness Center)

 Physical Therapy Clinics

 During NACDD’s last five-year cooperative agreement with the CDC Arthritis Program and working in partnership with Westat, Inc., the CDC Arthritis Program and NACDD surveyed 841 physical therapists and learned physical therapists are willing to recommend arthritis-appropriate, evidence-based programs in the community either during therapy and at discharge. CDC, NACDD and the American Physical Therapy Association, American Chronic Pain Association and Westat, Inc. used responses to creation of a toolkit of informational flyers and decision aids now available online at and

The Toolkit includes an overview fact sheet presenting the value for arthritis-appropriate, evidence-based programs, six program fact sheets designed to provide information of importance to physical therapists, six program fact sheets PTs can distribute to patients, and a decision aid PTs can use to find an appropriate intervention to refer to patients. The toolkit is free for use by anyone interested in increasing awareness and participation in the identified interventions.

 According to CDC, arthritis remains as one of the nation’s most common causes of disability. As a significant public health issue, NACDD continues efforts to provide technical support, funding and connections enabling parties interested in working to connect adults to arthritis-appropriate interventions and help improve the quality of life for people living with arthritis or limited mobility.    

 For more information about the NACDD Arthritis programs, contact Heather Murphy NACDD Arthritis Lead. 





Tags:  Arthritis  Health Promotion  Walk with Ease 

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