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South Dakota Department of Health
South Dakota Department of Health

Chronic Disease Lifestyle Coach Application

Online Delivery Platform for National Diabetes Prevention Program (NDPP) or Chronic Disease Prevention & Health Management Programs

healthylifestyle.sd.gov    Download Paper Form

Applicant Information

(If multiple coaches are applying with the same organization, each coach will need to complete a separate application form.)

Training and Experience

(Online programs cannot use in-person NPI number. If Online NPI has not been applied for, please do so and share number once you receive it.)

Interest in Online Chronic Disease Prevention & Health Management Programs
Interest in Online Chronic Disease Prevention & Health Management Program Delivery

(age, race, ethnicity, employees, community, etc)

Resources

  1. CDC’s National Diabetes Prevention Program homepage https://www.cdc.gov/diabetes-prevention/index.html 
  2. National DPP Customer Service Center https://nationaldppcsc.cdc.gov/s/
  3. CDC and Prevention Diabetes Prevention Recognition Program Standards and Operating Procedures: https://www.cdc.gov/diabetes-prevention/php/program-provider/program-requirements.html 
  4. Organizational Capacity Assessment for Applicant Organizations to the CDC's DPRP https://www.cdc.gov/diabetes-prevention/media/pdfs/legacy/capacity-assessment.pdf 
  5. National Diabetes Prevention Program Coverage Toolkit https://coveragetoolkit.org/
  6. National DPP Infographic https://www.cdc.gov/diabetes/communication-resources/ndpp-prevent-type-2-diabetes.html 
  7. “So…Do I have Prediabetes” website for patients https://doihaveprediabetes.org/
  8. “So…Do I have Prediabetes” Awareness Campaign Toolkit http://prediabetes.adcouncilkit.org/
  9. South Dakota Department of Health’s Undo the Risk website: www.undotherisk.com
  10. South Dakota Diabetes Coalition’s “What is Prediabetes” website pages http://www.sddiabetescoalition.org/prediabetes-awareness.html
  11. American College of Preventive Medicine DPP Resource Center https://www.acpm.org/initiatives/diabetes-prevention/diabetes-prevention-resources-(1)/ 
  12. “Successfully Delivering an Online DPP Program” webinar provided by CDC https://www.youtube.com/watch?v=xvE-6IouSXg