Core Competencies for Chronic Disease Prevention Practice

Mary Kane, MSLIS; Jennifer Royer-Barnett, MPA; Jeanne Alongi, DrPH


Prev Chronic Dis. 2019;16(10):e144 

In This Article


Chronic disease prevention practice is an important specialization within public health and health care. It intersects and connects the causes and prevention strategies associated with chronic conditions and the population-based health promotion modalities that affect the health and well-being of the population. Competencies for chronic disease prevention and health promotion encompass leadership, epidemiology, program practice, and evaluation, among others.[1] Competencies are described here as the combination of observable and measurable knowledge, skills, abilities, and personal attributes that contribute to enhanced employee performance and support organizational success.[2]

Many professions have an agreed-on set of knowledge, skills, aptitudes, and traits that are expected in their professions but not codified in a standard set of competencies and guidelines. This was the case for chronic disease prevention practice until the Core Chronic Disease Prevention Competencies (Competencies) were formalized in 2007 by the National Association of Chronic Disease Directors (NACDD).[1] NACDD established these Competencies through an iterative, member-driven process bounded by practice standards and peer-reviewed literature.[1,3] NACDD's mission is to improve the health of the public by strengthening state-based leadership and expertise for chronic disease prevention and control. The association's initiatives support the work of state chronic disease units and their partners and build prevention and health promotion practice capacity at both the staff and organizational levels. NACDD's membership includes over 6,500 professionals in 59 state and territorial health departments. NACDD used the Competencies to identify training and professional development needs for state chronic disease prevention and health promotion practice and to develop tools to support human resources decisions (eg, job description planner, interview guide, competency assessment tool). Additionally, NACDD created learning opportunities to build workforce capacity in the identified competencies areas including chronic disease academies, webinars, and chronic disease prevention leadership meetings. Data from the NACDD Survey of States indicated that 17 states conducted employee assessments by using this tool in 2017. No data are available about the overall ratings or applications of the results of use.

Rapid changes in environments, technology, practices, and science relevant to chronic disease prevention during the last decade required that state health departments develop flexible, responsible, and effective means and innovative approaches to chronic disease prevention and health promotion. At the same time, growth in evidence-based practice and organizational effectiveness science have resulted in an evolution of the skills, knowledge, and attributes used in chronic disease prevention practice. In 2015 in response to these contextual factors, NACDD leadership reviewed and revised the 2007 Competencies to make them more relevant and usable for learning, professional development, and agency needs. The objectives of this endeavor were to review and revise as necessary the 2007 Competencies for relevance to current and forecasted practice requirements; to identify and understand how these competencies and any revision may relate to relevant practice frameworks; and to begin the implementation and dissemination activities that would increase use of the Competencies. The resulting report and recommendations, entitled NACDD Core Chronic Disease Competencies: Updated June 2016 was finalized in 2017.[4]