NACDD and HALT Are Revolutionizing Chronic Disease Prevention

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/07/28

John W. Robitscher, CEO of the National Association of Chronic Disease Directors (NACDD), discusses the organization’s mission to prevent chronic disease through partnerships, community programs, and innovative tools like the HALT (Health And Lifestyle Training) app. Working closely with the CDC, NACDD helps implement evidence-based strategies nationwide, promoting healthy lifestyles and reducing risk factors such as poor diet and inactivity. Robitscher emphasizes the need for cross-sector collaboration, culturally tailored interventions, and empowering individuals through education and technology. Despite challenges, he believes widespread lifestyle change is possible with commitment, proper tools, and support from both public and private sectors.

Scott Douglas Jacobsen: Today, we are with John W. Robitscher. He serves as the Chief Executive Officer of the National Association of Chronic Disease Directors (NACDD), providing strategic leadership to advance its chronic disease prevention and health promotion mission.

Since joining NACDD in February 2005, he has overseen the acquisition of over $450 million in funding for chronic disease prevention and health programs across all 50 states and U.S. territories. With over thirty years of experience managing nonprofit organizations, Robitscher has expanded NACDD’s reach, supporting a network of over 7,000 public health professionals worldwide.

So, how is NACDD advancing early detection methods for chronic diseases like diabetes, and what emerging technologies are helping support these efforts?

John Robitscher: We’re proud to partner strongly with the Centers for Disease Control and Prevention (CDC), especially with the National Center for Chronic Disease Prevention and Health Promotion. The CDC has a long history of developing preventive medicine guidelines, going back fifty, sixty, even eighty years.

It works because the NIH (National Institutes of Health) does the medical research, and then the CDC implements that research through practical programming. They rely on national partners like NACDD to help bring those evidence-based programs into communities.

We support state and territorial health departments by directly interacting with local communities in every U.S. state and territory. Thus, we act as a bridge, helping push these proven programs to where they are needed.

Some programs include diabetes prevention, heart disease and stroke prevention, hypertension prevention, and more. One exciting innovation we’ve developed is a lifestyle management course called HALT, which stands for Health And Lifestyle Training. We can discuss it later, but it is a cutting-edge digital mobile application tool that helps people manage and treat their chronic conditions.

Jacobsen: What are some good examples of cross-sector partnerships? I was interviewing a medical professional recently, and we discussed how no single discipline can effectively tackle something as complex as cancer. Cross-disciplinary collaboration is key. Is it similar in chronic disease prevention?

Robitscher: Absolutely. What we know is that the significant risk factors for chronic diseases like heart disease, stroke, diabetes, cancer, early-onset arthritis, and even dementia—those risk factors are often the same.

They include physical inactivity, poor nutrition, unhealthy body weight, and tobacco use. So promoting physical activity, healthy eating, and smoking cessation addresses multiple chronic conditions simultaneously.

The CDC runs a program called Active People, Healthy Nation, which aims to get 27 million Americans to exercise at least 150 minutes weekly by 2027. That’s a realistic and vital goal.

We work across sectors—education, transportation, housing, private industry, and government—to support better access to physical activity, promote healthier diets (including fresh fruits and vegetables), and reduce tobacco use. All of these are essential components in reducing the leading causes of death and disability in the U.S.

Jacobsen: What are the biggest challenges in chronic disease prevention over the next year?

Robitscher: The biggest challenge is that people do not want to exercise. They do not want to eat healthily. People want to eat what they want, when they want, and we live in a society that celebrates individual choice. We support that independence, of course, but we must also be realistic.

You have to focus on it. Losing weight is hard in this country and anywhere. There is so much delicious food on the market that is not good for you.

Our Health and Lifestyle Training (HALT) program is so important. It is evidence-based and is currently being implemented in 17 states. I have used it myself for a year. I lost 30 pounds and have managed to keep most of the weight off. But it is a challenge. I have to work out regularly to maintain it.

Still, if we can give people the tools, resources, and education—if they can track their movement and food intake—then we can deliver real impact. It is about improving health outcomes and quality of life.

The goal is not just to live longer. Yes, longevity matters, but so does the quality of those years. People in their 70s and 80s who use wheelchairs or live in nursing homes because of preventable falls. That is not what most people want.

We want people to remain physically and mentally active as they age. Achieving that takes work from all of us. But it is possible, and we are committed to helping people lead longer, healthier, more balanced lives.

Jacobsen: How does NACDD utilize its data to inform programs and measure the impact of chronic disease prevention? And I do not necessarily mean something as coarse as “I weighed X. Hooray.”

Robitscher: The CDC—and we—use particular metrics. In the past, the CDC has developed stringent guidelines and deliverables for grantees to meet. These are not just about weight loss. They include measurable reductions in chronic disease rates, improved access to clean water and healthy food, and better medical services and devices.

There are many indicators: healthy weight, nutrition, physical activity, smoking cessation, and even broader community-level measures. When combined, these contribute to a healthier nation.

That is the foundation on which we begin. We do not rely on just one metric. It is about understanding how these components work together to improve public health outcomes.

So a lot of what we do involves looking at all the data. We review scientific research, of course, but we also consider anecdotal data, like information from Google or Amazon about consumer behaviours, purchasing trends, and search patterns. We also evaluate environmental factors like air quality, food quality, and the location of recent natural disasters and how they impact specific populations.

We use all of that to develop a plan tailored to the community. There’s no point in launching a program that the target population will not follow. Programs must be culturally appropriate and aligned with the specific needs and values of the communities we serve.

We take this very seriously. We co-design programs with input from patients, community leaders, and public health professionals. One of our key roles at NACDD is being a convener—we bring together people from across sectors within a community, facilitate discussion, and collaboratively decide what will work locally.

There is no one-size-fits-all solution. Populations vary, with different cultures, dialects, and lived experiences. For example, our HALT program is available in English and Spanish and is culturally adapted for Native American communities in the Great Plains region.

We constantly strive to develop solutions that genuinely meet the needs of each community. That is not easy. You cannot just release a shiny new app or generic program and expect everyone to engage. You have to meet people where they are. That is our philosophy.

Jacobsen: What are the primary objectives of the Solving Health Care Challenges webinar? This will likely come out after the webinar, but could you repeat the key takeaways?

Robitscher: The webinar’s core message is to reject the idea that one program can fit everyone. That doesn’t work. We must meet people where they are.

We have to address populations at the macro and micro levels. On a population level, yes, we design programs to address broad needs. But ultimately, chronic disease prevention and management come down to individual decisions. A person must choose the life they want to live and commit to making meaningful changes. That is how we help them live longer, better lives.

Jacobsen: Are you engaged with policymakers or legislators through NACDD to support these types of chronic disease prevention and management programs?

Robitscher: We do not lobby, per se.

We meet with policymakers primarily to educate them on the opportunities available within their states. Often, legislators do not know what programs are working well in their jurisdiction, or even what initiatives are currently active.

At NACDD, we maintain a database called State Success Stories, where we showcase programs nationwide that effectively prevent chronic diseases and promote population health. Much of our work is leveraged. The federal government often provides seed funding, but private industry and businesses frequently match or exceed that investment.

One great example is our Walkability Action Institute. I just returned from Anchorage, Alaska, where we conducted a walk audit with the community to assess and improve walkability. These efforts aim to make communities more livable, ensure access to healthy food, and create safe environments for walking and biking.

That program is a strong public-private collaboration. For every federal dollar invested in the walkability program, the private sector contributes approximately $177. Through this initiative, we have brought millions of dollars to local communities. Private businesses have built walking paths, biking trails, and community fitness infrastructure. They have brought people together around the goal of healthier living.

That is what NACDD does—we serve as a conduit, bringing diverse stakeholders together.

Jacobsen: How do you transform engagement into chronic disease management? You can deliver excellent resources, run webinars, build programs, and raise $450 million—but at scale, the population-level impact depends on people becoming invested enough to take action. How do you get them actually to make that change?

Robitscher: I am glad you asked that. It is a great question, and it ties directly into our HALT application. This is a digital tool that can be found on every American’s smartphone.

We are currently proposing it to the MAHA Group because lifestyle management is something this administration is ready to prioritize. Secretary Kennedy and President Trump—regardless of party lines—are among the first national leaders in recent memory to talk openly about chronic disease prevention. We are excited to support them.

We would love to see HALT in the hands of every American. With this app, people can track their food intake, physical activity, and weight and even sync up with a blood pressure monitor. These are critical indicators of a healthy lifestyle.

We have to control our health. Again, the only way to do that is hard work. But if we give people the right tools, we can help them succeed.

It is physical. It is about being physically active daily and watching and tracking what you eat. But all of that depends on education.

We expect people to make significant lifestyle changes, but often, we do not explain why. In reality, physicians only spend about five to seven minutes with each patient. That is not enough time for meaningful behaviour change education.

So, we need a tool that empowers the person, not just the patient. You may not be a patient yet, but you can still take action to improve your life.

We believe lifestyle change management is critical—it may be the most vital initiative this country has ever embarked on. Can we help people manage their lifestyles effectively enough to live longer, happier, more fulfilling lives?

We believe we can. But it will take hard work.

People think they can download an app and just have it on their phone, which will make them healthier. It will not. The app must be paired with education, and you must commit. You have to put in the effort.

But the good news is—it is doable. I am a living example of that. I lost 30 pounds using the HALT app. I believe we can change the lives of millions of Americans and make them much better than they are today.

Jacobsen: Excellent. John, thank you for your time and expertise. It was nice to meet you.

Robitscher: Yes. You had good questions. I enjoyed it too.

Jacobsen: Thank you again. Take care.

Robitscher: You too. Bye-bye.

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