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There is growing interest in the factors that influence the tenure and early success of state and territorial health officials (STHOs) and the competencies new STHOs need to excel throughout their leadership journey. This is understandable, given the key role STHOs and their executive teams play in setting public health priorities and advancing programs, policies, and partnerships that promote health and ensure optimal health for all. While STHO tenure is similar to other appointed federal and state leaders and corporate “C-suite” executives (Matt Salo, National Association of Medicaid Directors, e-mail communication, 2018), its brevity (average 4.1 years and median of 2.9 years) illustrates the intensity of the job and potential for derailment and burnout in what are often very political and highly visible leadership positions. In addition, the brief tenure illustrates the need to ensure that new STHOs are quickly prepared to assume the mantle of leadership and accelerate efforts to improve health and well-being as soon as they are appointed to their positions. The literature on executive transitions and a leader’s first days is helpful to informing the essential elements of a new STHO’s onboarding. An executive’s first months on the job are important to setting the tone and pace of his or her leadership trajectory. Likewise, starting out “right” has significant impact on follower buy-in to a new STHO’s

Starting Out Right: What Are the Essential Elements of New State and Territorial Health Official Onboarding and Transition?