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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  capacity building  CNMI  CVH  Diabetes  Health Promotion  Healthy aging  heart disease  Louisiana  Medicaid  STAR  StEM  stroke  Walk with Ease 

A Combination of Healthy Lifestyle Traits May Substantially Reduce Alzheimer’s Disease Risk

Posted By Leslie Best, Wednesday, July 29, 2020

Data from two National Institutes of Health studies show that combining more healthy lifestyle behaviors is associated with a substantially lower risk for Alzheimer’s disease. The researchers scored each participant based on five healthy lifestyle factors: physical activity, not smoking, light-to-moderate alcohol consumption, a high-quality diet, and cognitive activities. Study participants who adhered to four or all of the five specified healthy behaviors were found to have a 60% lower risk of Alzheimer’s. The risk of Alzheimer’s was 37% lower in participants with two to three healthy lifestyle factors, compared to those with none or one.

Funded by the National Institute on Aging (NIA), part of the NIH, this research was published in the June 17, 2020, online issue of Neurology, the medical journal of the American Academy of Neurology. Read more about the study.

Reflecting this work that links healthy lifestyle to brain health, NACDD is collaborating with the CDC Alzheimer Disease and Healthy Aging Program to develop integrated messaging about brain health. The current grant, Integrating Alzheimer’s Messages into Chronic Disease Programs, seeks to adapt existing chronic disease risk reduction messages to include information about how behaviors related to these topics also can reduce the risk for cognitive decline. This purpose is consistent with the call to action in the Healthy Brain Initiative Roadmap, which is to integrate best available evidence about brain health and cognitive decline risk factors into existing health communications that promote health and chronic disease management for people across the lifespan.

This project focuses on integrating messages in five focus areas:

  • Heart health
  • Diabetes
  • Tobacco
  • Nutrition
  • Physical activity

For more information about NACDD work on Healthy Aging/Healthy Brain, visit For more information about the CDC Healthy Brain Initiative, visit

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Support for Public & Private Payer Coverage of the National Diabetes Prevention Program

Posted By Wendy Childers, Wednesday, July 29, 2020

NACDD’s Coverage 2.0 team is supporting efforts to expand Medicaid and Medicare coverage and uptake of the National Diabetes Prevention Program (National DPP).

NACDD’s Medicaid coverage work is supported by and conducted in collaboration with CDC’s Division of Diabetes Translation (DDT). NACDD provides individual and group-based technical assistance to twelve states through CDC’s 6|18 Initiative (Colorado, Illinois, Kentucky, Michigan, Virginia, and Wyoming), NACDD’s Intensive Technical Assistance opportunity (Minnesota, New Jersey, New York, and Pennsylvania), and continued support to the Medicaid Coverage for the National DPP Demonstration project states (Maryland and Oregon). Through this individualized work, NACDD works closely with states to support their ability to establish, operationalize, and sustain Medicaid coverage for the National DPP lifestyle change program through research compilation, resource development, and state partner facilitation.

The Coverage 2.0 team also has created opportunities for shared learning, problem solving, and communication among Medicaid and public health agencies across states though a multi-session virtual Learning Collaborative in 2020. An in-person Medicaid Coverage Summit is planned for Spring 2021.

NACDD’s Medicare Diabetes Prevention Program (MDPP) coverage work is conducted in collaboration with the Centers for Medicare and Medicaid Services (CMS) and CDC’s DDT. NACDD has co-facilitated a Community of Practice (MDPP CoP) series, which is an online peer-to-peer learning community where participants are given the opportunity to exchange ideas on a given MDPP topic, troubleshoot issues, share in collective resources, and provide education, tips, and advice to other MDPP suppliers. As part of this CoP, Medicare suppliers have shared insight and effective strategies related to such topics as claims submission, eligibility verification, working with hospital systems, and credentialing with Medicare Advantage plans.

The National DPP Coverage Toolkit helps payers and those making the case for coverage fully understand the program, navigate the steps needed to cover it, and access detailed information and resources. Since its launch by NACDD and CDC in 2017, the site has been visited by more than 36,000 unique users and continues to be expanded and updated on a regular basis.

Recent additions include:

·       Coverage in Practice: Describes how coverage for the National DPP lifestyle change program typically functions for commercial payers in real-world settings.

·       The Role of the State Legislature in Medicaid Coverage: Contains information on establishing coverage, how stakeholders may engage with the legislature, and National DPP state legislation examples.

·       State Stories of Medicaid Coverage: Profiles the coverage journeys undertaken by states, including Pennsylvania, New York, and Minnesota.

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How to the Share Talk to Someone Tool with Stakeholders

Posted By Administration, Wednesday, July 29, 2020

The Centers for Disease Control and Prevention (CDC) and the National Association of Chronic Disease Directors (NACDD) have launched a new, interactive tool to help cancer survivors and their healthcare providers understand how certain behaviors impact overall health and risks for recurring and secondary cancers. Called Talk to Someone, the tool offers simulated conversations with a virtual cancer survivor, Linda, covering evidence-based guidance for the long-term health needs of this growing population.

Talk to Someone allows cancer survivors to ask questions and engage in conversations on four of the most critical health concerns to prevent recurrence: alcohol use, tobacco use, nutrition and fitness, and anxiety and depression. Linda gives brief, informative, and emotionally supportive answers to help shape behavior change, while also citing her own experiences as a survivor.

Please share Talk to Someone with your stakeholders. You can download communication materials to help promote and disseminate this new exciting tool at the links below:

  • Communication Plan:This document is designed to introduce you to Talk to Someone. It provides an overview of communication goals, objectives, and the target audience.
  • Talk to Someone OverviewThis PowerPoint is designed to orient your internal and external stakeholders to the conversation simulations.
  • Q&A Fact Sheet: This fact sheet provides some basic key message points about the simulations and their effectiveness. 
  • Social Media Posts and Graphics: This series of English andSpanish Twitter and Facebook posts are designed to introduce your stakeholders to Talk to Someone simulations and drive utilization of the tools. 
  • Template Article: This short (under 200-words) write-up introduces Talk to Someone conversation simulation. It can be used as a newsletter article or posted as a blog on your organization’s website.

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Leveraging Partnerships to Develop a Sustainable Approach to Increasing Adoption of Arthritis Appropriate, Evidence-Based Interventions with Employers

Posted By Lisa Erck, Monday, June 29, 2020

The Leveraging Partnerships guide is intended to provide state or local health departments, or an identified partner or stakeholder, with a step-by-step approach to engage employers as payers of Walk With Ease, an evidence-based, low-cost, and easy-to-implement walking program for employees with musculoskeletal conditions.


 This “living” document provides the experiences, to date, of the National Association of Chronic Disease Directors (NACDD) in working with partners to increase the adoption of Walk With Ease as part of employer’s wellness efforts to reduce the burden of musculoskeletal conditions such as arthritis and back pain and increase physical activity levels.

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National Resource Center for Vision and Eye Health Launched

Posted By Carol McPhillips-Tangum, Monday, June 29, 2020

NACDD launched the National Resource Center for Vision and Eye Health to build the capacity of public health agencies and their partners. The online resource provides tools to help assess the level of vision impairment in communities, build effective partnerships, implement effective and sustainable interventions to improve vision and eye health, and evaluate the impact of vision and eye health interventions.


Because vision health represents a potentially modifiable risk factor for cognitive impairment and a potential contributor to the functional toll of cognitive impairment, attention to vision health is an important aspect of public health and cognitive health programs. Learn more and review the new Issue Brief containing toolkits, trainings, roadmaps, and data sets for health educators and public health agencies at

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CVH Team Hosts Two-Day Workshop with Public Health and Pharmacy Partners

Posted By Julia Schneider, Monday, June 29, 2020

NACDD’s Cardiovascular Health Team, in collaboration with the CDC Division for Heart Disease and Stroke Prevention, hosted a two-day virtual workshop with teams from Colorado, Georgia, Missouri, Texas, and Virginia as part of the Advancing Pharmacy-Related Interventions to Control Hypertension and Manage Cholesterol Learning Collaborative. The intent for this unique learning opportunity was to support the priorities of 1817 by focusing on innovative, team-based approaches to hypertension control and cholesterol management. Each team consists of health department staff working with 1817 pharmacy strategies and their pharmacy partners, including local colleges of pharmacy, state pharmacy associations, and quality improvement organizations.


Together, the Learning Collaborative teams participated in expert-led presentations, work plan development, and peer exchange. The workshop originally was intended to be held in-person but was modified due to COVID-19 travel and safety guidelines. State teams participated in lively discussions on partnerships and sustainability with presenters, including pharmacy experts Troy Trygstad and Marialice Bennett. Attendees also advanced their work plans in virtual team breakout sessions and participated in breakouts with public health and pharmacy partners. Questions centered around opportunities and barriers encountered in partnering with each other; how they foresee their partnerships with public health or pharmacy changing as a result of COVID-19 (either related to this project or beyond); and how both fields can help to reinforce the need for hypertension and cholesterol patients to continue to stay adherent to their medication.


Lessons learned from this project likely will apply to pharmacy and health department collaborations addressing other chronic diseases. A summary of the workshop will be available on the NACDD CVH webpage. The teams will continue to implement their work plans with support from NACDD, CDC, and pharmacy content experts. Plans for an in-person workshop are on hold until further notice.

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GIS Hallmarks Created for Sustainable Benefits

Posted By MaryCatherine Jones, Monday, June 29, 2020

The GIS Hallmarks for Building and Sustaining GIS Capacity in State and Local Health Departments provides a framework for health departments to implement policies and processes that maximize the benefits of GIS for chronic disease prevention and health promotion. They can be used to plan next steps and goals for moving capacity building beyond initial GIS training of a few staff to implementing GIS as a routine part of chronic disease surveillance, evaluation, decision-making, and communications. The GIS Hallmarks can be applied to health departments with any level of GIS capacity.


The GIS Hallmarks were developed by Members of NACDD’s Cardiovascular Health Council, the CDC Division for Heart Disease and Stroke Prevention, the Children’s Environmental Healht Initiative at RICE University, and health department staff, including four Chronic Disease Directors—Tomás Aguilar (Pa.), Nimisha Bhakta (Texas), Ryan Lester (Kan.), and Shamarial Roberson (Fla). The GIS Hallmarks are based on the NACDD Chronic Disease Competencies and the STAR (STate Activation and Response) framework.


Take a moment to explore the GIS Hallmarks with your epidemiologists, evaluators, and program staff to learn about ways you can bolster your health department’s GIS capacity. Visit NACDD’s GIS webpage for more information about the GIS Hallmarks and other GIS capacity building resources.

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June CEO Message: Advancing Health Equity and Anti-Racism Work

Posted By Administration, Monday, June 29, 2020

Racism is a public health crisis. Institutional and internalized white privilege and racism continue to hinder our ability to achieve critical progress in health, social, and economic equity. At NACDD, we are committed to action against racism to promote social justice.


Last week, we announced we are distributing nine mini-grants of $25,000 to select states to advance health equity and anti-racism work in the United States.

The grants are being offered to states that have participated in our Health Equity pilot project to address systemic racism in their State Health Departments. The grantees will receive the new funding for the application of either of NACDD’s nationally recognized tools,
Moving to Institutional Equity: A Tool to Address Racial Equity for Public Health Practitioners or the Health Equity at Work Assessment. NACDD will announce the grantees for this invitation-only opportunity in July 2020.

NACDD has worked for more than 15 years through its 
Health Equity Council, currently led by Council Chair Louise Square of the New York State Department of Health, to counter the root causes of unintentional bias and institutional racism as it exists in State Health Departments.


There is so much work to be done. Together, we must ensure that our efforts to promote health equity are not compromised by institutional racism or the lack of knowledge about how anti-racist activities can be leveraged to enhance our programs. We urge you to stand with us in solidarity to continue our work confronting racism.
Our Call to Action specifically for you, our Members, is to engage your State Health Departments’ Chronic Disease Units in listening sessions to foster open and transparent dialogue around issues of race and unintentional bias. I also encourage you to use our 
Health Equity Guide to help you consider ways you can dismantle racism within the institutions where you work.


Additional resources:

·      Our Health Equity Consultant, Robyn Taylor, wrote a blog “Thoughts on Racism as a Public Health Crisis from the Health Equity Perspective.” She also suggests reading "Maintaining Professionalism In The Age of Black Death Is….A Lot" and the Talking About Race Toolkit developed by the Center for Social Inclusion.


·      The Health Equity Council released a statement on racism.


·       NACDD closed offices on Juneteenth in solidarity with the Black community. As part of our observances, NACDD’s Culture Club wrote a statement on Juneteenth, and suggested viewing the official Juneteenth Worldwide Celebration's history page and the PBS webpage What is Juneteenth? 


·       NACDD also offers a compilation of resources for State and Territorial Health Department staff interested in broadening their scope and consideration of how minority health can be improved through chronic disease programming and during COVID-19.


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Health Equity Council Statement on Racism

Posted By Administration, Monday, June 29, 2020
Updated: Tuesday, June 30, 2020

The National Association of Chronic Disease Directors is committed to the principles of health equity and to creating just and fair opportunities for people to live longer, healthier lives free from disease. NACDD reinforced that commitment 15 years ago by creating the Health Equity Council (HEC). The council’s primary function and purpose is to work with states to identify needs and create tools and resources to help them move toward health equity. Over the years, the council has worked with states to come up with several comprehensive approaches to help us all move toward health equity, but it didn’t take long to realize that no matter which social determinant we focused on, race and racism are the greatest predictors of health in our country. Therefore, we have worked steadily to counter the root causes of bias and institutional racism.  

Now is the time to have the uncomfortable conversations. Poor health outcomes for people of color are the result of powerful economic, educational, financial, and political policies and systems that were designed to create disadvantage for non-white members of society. We cannot ignore the fact that these forces also give license to some to commit violent acts against people of color under the pretense law of enforcement.

Until we begin to value human life equally and collectively, and to develop ways to change these policies, we will continue to discuss the need for foundational change without action to follow. The members of the Health Equity Council are committed to action. We will continue to work to reduce and eliminate the inequities that negatively impact our health and our lives, but we need your help. Write to us or join us for our monthly general meeting so that we can create the action steps needed to effect real change for people of color and all the communities we serve.

We also would like it if you reviewed “Moving to Institutional Equity” a HEC tool designed to help states review, identify, and dismantle when needed, policies and procedures that may perpetuate institutional racism.

We can succeed when we work together to make change at the national, state, and local levels.

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May Impact Brief CEO Message

Posted By Administration, Thursday, May 28, 2020

Connecting Body and Mind During Covid-19


Before COVID-19, many of you shared with us that some of the primary challenges you face in your work were providing clear and impactful communication, building trust, and developing effective collaboration models. Today, these skills are even more critical, yet developing them may be harder while also managing the many new stressors that the pandemic brings.


Yet, our world still is looking to public health for leadership during this time – and as a result, we are more attentive than ever to our work building and cultivating strong and innovative leaders.


For example, NACDD’s Public Health Leadership and Practice Team facilitates peer-to-peer learning and collective problem-solving through dialogue between Chronic Disease Directors and CDC.


In two leadership courses aligned with NACDD competencies, Foundations of Public Health Leadership and Strategic Leadership in State Public Health Agencies, participants say these trainings helped them to think critically about leadership issues. Since 2018, 78 emerging leaders have participated in the eight courses offered.


The six-month Chronic Disease Director & Emerging Leader Coaching Program pairs new Chronic Disease Directors / emerging leaders with experienced Chronic Disease Directors to receive practical advice, guidance, and support for further development of their leadership competencies.

Being a public health leader under any circumstances demands self-sacrifice. In recent weeks, we have heard from Members how it also can be isolating and emotionally exhausting. Healthcare in the U.S. is fragmented and often hard to navigate from the consumer and provider side, and mental health and addiction are often treated as separate conditions from physical health, making it challenging for people to get timely access to services. I believe when healthy community conditions, equitable coverage, and inclusive policies are in place, we will achieve the outcomes that improve mental health in this country. 


However, we want to hear from you, our Members, on how you are committed to staying the course, being there for your teams, and how NACDD can help you with aligning mental health with your chronic disease prevention and control programs.


We know what you are doing asks so much of you – and we hope you will ask us to help you when you need it personally or professionally. Until then, we remain immensely proud to be a part of your response to our changing environment.



I’d like to pass along what I have adopted as four things every leader should do:

(1) Facilitate connections between the organization and the outside world;

(2) Hold yourself and your teams accountable for deciding, "What business are we in? What is the deep community need we are uniquely positioned to fulfill?";

(3) Articulate and model a positive, inclusive, and healthy set of behaviors; and

(4) Reinforce the processes you are using to meet goals and deliverables.

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