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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 

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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Pilot States Use the Institutional Equity Tool to Examine Organizational Policies

Posted By Robyn Taylor, Friday, September 21, 2018

The Moving to Institutional Equity: A Tool to Address Racial Equity for Public Health Practitioners was developed by NACDD’s Health Equity Council to identify policies that have resulted in unintended or negative socio-economic and health outcomes for women and minorities. The tool takes users through four worksheets designed to guide user in:

·      assessing if the policy or procedure is written and implemented in a way that is inclusive and allows for diversity;

 ·      determining if and where there are opportunities/decision points to ensure the policy or procedure is inclusive and promotes diversity, thereby avoiding structural inequalities;

·      identifying action steps to modify the policy or procedure and to implement new steps to ensure diversity and inclusion; and

·      vetting the plan/policy with an Equity Crosscheck.


A recent pilot of the institutional equity tool among participating states resulted in states analyzing organizational health equity policies, developing organizational health equity training modules, revising hiring and promotion policies, and applying the tool to program planning and assessment procedures. For more information about the Moving to Institutional Equity tool, please contact Louise Square or Robyn Taylor.

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