Designing competencies for chronic disease practice.

INTRODUCTION: Competencies are the cornerstone of effective public health practice, and practice specialties require competencies specific to their work. Although more than 30 specialty competency sets have been developed, a particular need remained to define competencies required of professionals who practice chronic disease prevention and control. To that end, the National Association of Chronic Disease Directors (NACDD) engaged a group of stakeholders in developing competencies for chronic disease practice. METHODS: Concept mapping was blended with document analysis of existing competencies in public health to develop a unique framework. Public health experts reviewed the results, providing extensive and richer understanding of the issues. RESULTS: The final product presents an integrated picture that highlights interrelationships among the specific skills and knowledge required for leading and managing state chronic disease programs. Those competencies fall into 7 clusters: 1) lead strategically, 2) manage people, 3) manage programs and resources, 4) design and evaluate programs, 5) use public health science, 6) influence policies and systems change, and 7) build support. CONCLUSION: The project yielded a framework with a categorization scheme and language that reflects how chronic disease practitioners view their work, including integrating communications and cultural competency skills into relevant job functions. Influencing policies and systems change has distinct relevance to chronic disease practice. We suggest uses of the competencies in the field.

The public health role in the primary prevention of diabetes: recommendations from the chronic disease directors' project.

AIM: The article reports on the recommendations from the Diabetes Primary Prevention Project that was initiated and funded by the Division of Diabetes Translation, Centers for Disease Control and Prevention, and developed by the National Association of Chronic Disease Directors. METHOD: Essential components of statewide programs are delineated for effective interventions for diabetes primary prevention. The recommendations were derived from a structured process that is detailed on the basis of a cross-comparison of state-level diabetes prevention initiatives in six states where such programs were most developed. RESULTS: The recommendations focus on state-level partnerships, statewide program planning, required resources, policies, benchmarks for progress, and data collection. CONCLUSION: Illustrations are provided regarding how the project influenced the six participating states in further developing their programs for the primary prevention of diabetes.

The role of state public health agencies in addressing less prevalent chronic conditions.

INTRODUCTION: State-based chronic disease programs typically focus on the most prevalent chronic conditions, such as cancer, diabetes, and cardiovascular disease, but interest in less prevalent chronic conditions (LPCCs), such as epilepsy, is growing. In our study, we examined the perceived roles of state health departments in addressing LPCCs and used this information to develop recommendations for state health departments that are considering developing LPCCs programs. We also compared the identified state health department roles for LPCCs with roles related to healthy aging, as well as to the essential elements of existing state-based chronic disease programs, to determine whether future LPCCs programs would have any unique requirements. METHODS: Participants used concept-mapping techniques to generate a set of 100 statements on steps that state health departments could take to address LPCCs. The participants sorted and rated each statement according to importance and feasibility. We used a sequence of multivariate statistical analyses to generate a series of maps, or clusters, and rating graphics. We reviewed the findings and produced recommendations for state health departments. We used a similar process to examine roles of state health departments in addressing healthy aging. RESULTS: The participants grouped the LPCCs statements into nine clusters, which they rated as moderately feasible and important. The healthy aging statements were grouped into eight clusters. Clusters for LPCCs and healthy aging were similar. We also compared LPCCs clusters and the essential elements of existing state-based chronic disease programs and found that they were similar. CONCLUSION: The similarities between LPCCs clusters and essential elements of existing state-based chronic disease programs highlight an important point. State health departments that are considering establishing LPCCs programs should use strategies that have already been used by other public health agencies to develop chronic disease prevention and control programs.