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Domains and Competencies

NACDD Domains and Competencies


The competencies for Chronic Disease Practice defines the skills and knowledge identified as specific to leading and managing chronic disease programs that improve the health of the public. Developed by the National Association of Chronic Disease Directors (NACDD) through a comprehensive review of other competencies and an extensive review by context experts, the competencies are designed to assist practitioners in their professional growth. It is not expected that every individual working in chronic disease program will be proficient in each competency; rather, the competencies paint a picture of the "ideal” toward which individuals will strive as they grow in experience and excellence in their practice. Improvement in the capabilities of practitioners is expected to lead to improved outcomes in chronic disease programs and policy. The competencies are organized into seven major domains:

1) Build Support

2) Design and Evaluate Programs

3) Influence Policies and Systems Change

4) Lead strategically

5) Manage People

6) Manage Programs and Resources

7) Use Public Health Science

Each of these domains represents a grouping of related competency statements. Each domain consists of a different number of specific competency statements, based on the complexity of activities and functions included in that domain. In total, there are 104 competencies.

1) Build Support: Chronic disease practitioners establish strong working relationships with stakeholders, including other programs, government agencies and nongovernmental lay and professional groups to build support for chronic disease prevention and control.

  • Establish and maintain linkages and/or partnerships with key stakeholders (including traditional, nontraditional, and academic partners).
  • Interact effectively with other major sectors (including the healthcare industry, transportation, parks and recreation, education, private sector).
  • Communicate effectively in writing for professional and lay audiences.
  • Listen to other in an unbiased manner, respect points of view of others, and promote the expression of diverse opinions and perspectives.
  • Communicate effectively orally for professional and lay audiences.
  • Advocate for chronic disease programs and resources.
  • Facilitate integration between chronic disease programs and other state health-related programs (e.g., surveillance, oral health, maternal and child health, Medicaid, state employee health insurance, emergency service providers and planners).
  • Use effective collaboration strategies to build meaningful partnerships.
  • Lead and participate in groups to address emerging chronic disease issues.
  • Prepare and present the business case for chronic disease prevention effectively.
  • Facilitate use of coalitions as effective change agents for chronic disease prevention and control.
  • Develop enough social capital and political savvy to navigate the appropriate organizational systems quickly.
  • Facilitate group interactions and decision-making.
  • Work collaboratively with partners on data collection and interpretation.
  • Use the media, advanced technologies, and community networks to communicate information.
  • Identify and describe the roles of the key players on a national level.
  • Participate in national work groups to facilitate effective implementation of chronic disease programs.

2) Design and Evaluate Programs: Chronic disease practitioners develop and implement evidence-based interventions and conduct evaluation to ensure on-going feedback and program effectiveness.

  • Use program evaluation findings to improve program performance.
  • Select appropriate program and intervention activities.
  • Identify and use public health data as a tool to develop and prioritize community-based interventions or policies for chronic disease.
  • Apply principles of cultural appropriateness to program design.
  • Develop evaluation plans for chronic disease programs and activities.
  • Know program-specific content areas.
  • Apply cost-effectiveness, cost-benefit, and cost-utility analyses as appropriate.
  • Identify a data analysis agenda for state chronic disease programs.
  • Create and interpret logic models for chronic disease programs.
  • Guide the application of basic research methods and theories used in chronic disease prevention and control.

3) Influence Policies and Systems Change: Chronic disease practitioners implement strategies to change the health-related policies of private organizations or governmental entities capable of affecting the health of targeted populations.

  • Explain systems thinking and principles of systems change.
  • Use policy as a tool in advancing chronic disease and control.
  • Present accurate demographic, statistical, programmatic, and scientific information effectively for professional and lay audiences.
  • Assess the impact of public policies, laws, and regulations on chronic disease prevention and control.
  • Influence policy through accurate, persuasive communications with the public, partners, health agency leaders, and policy makers.
  • Articulate relative risks of disease effectively.
  • Describe the historical development, structure, and interaction of public health and health care systems.
  • Use health economics concepts and language to present chronic disease programs in a convincing manner to appropriate audiences.

4) Lead strategically: Chronic disease practitioners articulate health needs and strategic vision, serve as a catalyst for change and demonstrate program accomplishments to ensure continued funding and support within their scope of practice.

  • Demonstrate critical thinking.
  • Respond with flexibility to change needs.
  • Leverage resources.
  • Provide leadership to create key values and shared vision.
  • Generate, share, and accept new ideas and incorporate them.
  • Apply effective problem-solving processes and methods.
  • Facilitate integration among chronic disease programs.
  • Create a culture of ethical standards within organizations and communities.
  • Develop budget initiatives based on priorities to sell to decision-makers.
  • Oversee the development and implementation of a statewide chronic disease plan.
  • Translate policy into organizational plans, structures, and programs.
  • Identify policy agenda for state chronic disease programs.
  • Identify individual and organization's responsibilities within the context of the Essential Public Health Services and core functions.

5) Manage People: Chronic disease practitioners oversee and support the optimal performance and growth of program staff as well as themselves.

  • Manage a team of professional staff effectively.
  • Balance multiple tasks.
  • Prioritize work responsibilities of self and staff.
  • Practice effective time management.
  • Recruit and retain a diverse chronic disease workforce.
  • Implement processes so that staff from multiple programs can identify underlying common goals and outcomes.
  • Match staff skills to tasks.
  • Recruit, mentor, and support a diverse interdisciplinary team.
  • Mediate and resolve conflicts effectively.
  • Conduct performance appraisals and give guidance/feedback to staff regularly.
  • Promote team and organizational learning.
  • Support professional and personal development for chronic disease program staff.
  • Negotiate budgets and contract requirements/objectives with both funders and contractors.
  • Navigate relevant fiscal systems effectively.
  • Manage meetings and conferences.
  • Employ effective interviewing and questioning strategies.
  • Motivate individuals and teams to achieve goals.

6) Manage Programs and Resources: Chronic disease practitioners ensure the consistent administrative, financial, and staff support necessary to sustain successful implementation of planned activities and build opportunities.

  • Manage chronic disease programs within budget constraints.
  • Navigate cooperative agreements with the CDC.
  • Set program goals and objectives of chronic disease programs.
  • Monitor chronic disease program performance.
  • Identify and assess potential funding opportunities.
  • Balance needs, requirements, partnerships, work load, etc. for multiple projects/programs.
  • Adhere to public health laws, regulations, and policies related to chronic disease prevention and control.
  • Prepare proposals for funding from a variety of sources.
  • Implement strategies for transition from planning to implementation.
  • Provide technical assistance to partners, subcontractors and others as needed.
  • Develop and justify a line-item budget.
  • Assess an organization's implementation readiness, capacity, and effectiveness.
  • Conduct internal and external needs and assets assessments to inform program planning.
  • Develop and justify an activity-based budget.
  • Apply current techniques in decision analysis and planning for chronic disease.
  • Conduct regular and purposeful site visits with grantees.
  • Apply organizational theory to professional practice.
  • Develop a plan for chronic disease information systems.

7) Use Public Health Science: Chronic disease practitioners gather, analyze, interpret and disseminate data and research findings to define needs, identify priorities, and measure change.

  • Articulate evidence-based approaches to chronic disease prevention and control.
  • Discuss the underlying causes and management of chronic diseases, including behavioral, medical, genetic, environmental and social factors.
  • Articulate key chronic disease issues.
  • Recognize and apply current relevant scientific evidence.
  • Describe socioeconomic and behavioral determinant of health disparities.
  • Develop and adapt approaches to problems that take into account differences among populations.
  • Explain relevant inferences from quantitative and qualitative data.
  • Apply ethical principles to the collection, maintenance, use, and dissemination of data and information.
  • Discuss quantitative evaluation.
  • Identify relevant and appropriate data and information sources for chronic disease.
  • Monitor and analyze chronic disease epidemiology and surveillance data to identify burden, trends, and outcomes.
  • Identify the factors that influence the delivery and use of public health programs and services.
  • Guide to translation of research into chronic disease programs and activities.
  • Know and apply the Chronic Disease Indicators.
  • Select and use appropriate data collection methods.
  • Discuss issues of data integrity and comparability.
  • Explain basic clinical terms and etiology for chronic diseases.
  • Discus qualitative evaluation.
  • Define and interpret non-traditional data to address chronic disease prevention and control. (e.g. transportation data, cigarette sales).
  • Implement social marketing strategies.
  • Maintain up-to-date knowledge on the development of genetic advances and technologies relevant to chronic disease.

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National Association of Chronic Disease Directors
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Decatur, GA 30030
Phone (770) 458-7400
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