Colorado is facing a critical moment, both for immunizations and trust in healthcare as a whole. As of April 30, 2026, the U.S. is dealing with myriad challenges in the immunization landscape, from infectious disease outbreaks to erosion of evidence-based policy. So far this year, there have been 1,803 confirmed measles cases in 37 states, with 17 cases in Colorado. Motivational Interviewing (MI) is an evidence-based tool that providers, health educators, and public health professionals at all levels can utilize to help increase trust in the healthcare system and to more effectively communicate with the public.
This 1.5 hour interactive session will summarize the history of anti-vaccine rhetoric in the United States, the current immunization landscape in Colorado, and common misconceptions about individuals who question vaccines; attendees will spend the majority of the session learning how to utilize MI in a variety of vaccine-related contexts. Presenters will discuss the use of presumptive language in vaccine recommendations and the core steps of MI: Open-ended questions, Affirmations, Reflective listening, and Summary (OARS). Participants will have the opportunity to learn MI utilizing group discussion, one-on-one role play, and practice scenarios. Skills built during this session will be measured through a pre- and post-test that will measure knowledge of basic MI concepts and individuals’ self-efficacy in utilizing the skills they learned in their role.
This session is relevant to public health professionals, regardless of whether they deal with immunizations on a daily basis. The concepts and communication tactics taught in this session will be applicable to many areas of health behavior change, and participants will be encouraged to apply what they learn to their area of work. MI is an exceptionally powerful interpersonal communication strategy that perfectly embodies the conference theme of “Stronger Together” because it works to bring health educators and the public closer together, one conversation at a time. With vaccination rates declining and confidence waning, this tool is critical for protecting Colorado communities. MI fundamentally centers empathy, increases trust, and focuses conversations on what unites us, rather than what divides us.
Public health professionals are being asked to advance equity and anti-racist practices while working within systems shaped by funding requirements, tight timelines, staffing shortages, and competing priorities. Equity is often named as a value, yet many practitioners wrestle with what it looks like in everyday decisions—program planning, community partnerships, internal governance, and resource allocation. This session focuses on that gap: how equity shows up in the daily structures and choices that shape public health work.
The purpose of this training is to help participants identify where community voices may be unintentionally constrained and determine practical shifts that increase authentic community influence without adding burden to already stretched communities. Rather than staying theoretical, we will work through public health scenarios grounded in Colorado contexts—rural, urban, and frontier—and examine how decision-making hierarchies, grant expectations, timelines, and performance measures influence whose knowledge is centered.
The session opens with a brief framing of anti-racist public health practice and systems-level decision-making. Most of our time will be spent in guided, case-based discussions where participants analyze real challenges, assess where equity may be limited, and identify structural adjustments—such as revisiting decision points, clarifying roles, or strengthening feedback and accountability loops. Participants will also reflect on one of their current initiatives and outline one equity-centered action they can take immediately.
This training strengthens core public health skills in systems thinking, ethical practice, community engagement, and shared accountability. It reinforces that equity is not an add-on—it is reflected in how decisions are made, how power is shared, and how success is defined. Participants leave with practical strategies to adjust processes, lead stronger equity-centered conversations, and align their work with community voice.
As Colorado communities face widening disparities and capacity gaps, public health professionals need structured approaches that keep equity central—even under pressure. This session supports the conference theme by turning equity commitments into actionable skill development and strengthening leadership in community-informed public health practice.
Participants will leave with clear next steps, practical tools, and peer connections to sustain this work in their daily roles
Background: FOCUS is a novel HIV, HCV, Syphilis screening program which launched on 1/1/2025 at St. Anthony North, 84th Ave, and St. Anthony Hospital emergency departments. This grant funded program with support from CDPHE and Gilead, is one of the first of its kind for the region and has served as a pilot program to provide evidence for efficacy in the state of Colorado. This showcase aims to provide a template for future programs and explore challenges and successes to improve learning.
Methods: A structured approach, starting with clear goals and a SWOT analysis, informed strategic planning and decision-making for this program. Clinical staff (Registered Nurses, Critical Care Technicians, Physician Assistants, and Medical Doctors) were instrumental in guiding workflow integration and program implementation. Key partnerships enabled the creation of a 'Patient Navigator' role, complete with standard operating procedures (SOPs), to facilitate efficient access to care and prevention services. Additional SOPs were developed to effectively identify reactive test results and patients at elevated risk for Syphilis, HIV, or HCV. The program then leveraged a continuous quality improvement (CQI) process to monitor and ensure its success, improve patient satisfaction, and achieve positive population health outcomes.
Results: As a result of effective program planning and implementation there were significant increases in screening across all 3 disease types (2253.9% increase in HIV tests, 1466.7% increase in HCV tests, 349.51% increase in Syphilis tests. 2024 v 2025). Additionally, there was a 5133% increase in patients successfully linked to prevention services, and a 86.7% successful linkage to care rate for patients with active syphilis infections.
Implications: Integrated and standardized opt-out screening of STIs in Denver area Emergency Departments is an effective strategy to address rising STI rates among Colorado communities and improve prevention and general health education related to STIs.
Background: Congenital heart defects (CHDs) are the most common birth defects, affecting approximately 1% of births annually in the United States. Critical congenital heart defects (CCHDs), comprising approximately 25% of CHDs, are associated with substantial morbidity and mortality. Elevated risk of CCHDs has been suggested among pregnancies occurring at moderately high altitude (4,921–8,202 feet). Colorado, the highest elevation state in the US, has an average elevation of 6,800 feet. We sought to determine whether Colorado has a higher prevalence of CCHDs at birth compared with national estimates.
Methods: Data from the statewide birth defects surveillance system, Colorado Responds to Children with Special Healthcare Needs (CRCSN), were analyzed for the years 2016–2021 to identify CCHD cases using International Classification of Diseases, Ninth and Tenth Revision (ICD-9 and ICD-10) diagnostic codes recommended by the National Birth Defects Prevention Network (NBDPN). National comparison data were obtained from population-based estimates derived from 13 U.S. surveillance programs for 2016–2020. Prevalence estimates of CCHDs, overall and by defect category, were calculated as cases per 100,000 live births.
Results: Case-level data were available for 381,168 live births in Colorado between 2016 and 2021. A total of 1,025 CCHD cases were identified, corresponding to a prevalence of 26.9 per 100,000 live births. Colorado has higher prevalence estimates for several CCHD subtypes compared with national estimates, including coarctation of the aorta (10.4 vs. 5.8 per 100,000), hypoplastic left heart syndrome (5.2 vs. 2.6 per 100,000), interrupted aortic arch (4.0 vs. 1.0 per 100,000), pulmonary valve atresia (2.8 vs. 1.5 per 100,000), and single ventricle defects (2.5 vs. 0.7 per 100,000).
Implications: These findings raise concern that Colorado’s high-altitude environment may contribute to increased prevalence of selected CCHDs. We will discuss strategies to strengthen surveillance infrastructure to improve prevalence estimation and support early detection and prevention efforts.
Stigma surrounding substance use remains a major barrier for people seeking overdose prevention services, treatment, and recovery support. First responders interact daily with individuals who use drugs and play a critical role in overdose response, care, and support. As overdose prevention increasingly relies on cross-sector collaboration, reliable assessment tools are needed to measure knowledge, perceptions, attitudes, and experiences related to substance use and overdose prevention. High-quality assessment data help identify gaps, guide evidence-based interventions, and strengthen collaboration across public health partners. However, many assessment tools have not been adequately validated for specialized workforce populations such as first responders.
This session shares the use of factor analysis, a statistical method used to identify underlying patterns or groupings among related variables, to assess perceptions related to substance use stigma among Denver first responders and to strengthen assessment design and interpretation in public health work. Methods: factor analysis was used to identify underlying dimensions within survey responses (n=120) and examine how perception items clustered into meaningful constructs. Results: five constructs were generated from the instrument through identification of coherent stigma-related perception domains, reduced redundant items, and improved interpretability. Implications: factor analysis provided advantages for public health evaluation practice. It supports construct validity and internal reliability. It improves interpretability of complex survey results, thus strengthening the practical use of findings for program planning and implementation. Also, grouping related survey items into meaningful domains facilitates communication to stakeholders and decision-makers.
This session highlights the importance of using validated instruments in public health assessment and demonstrates how factor analytic methods can improve assessment quality, strengthen measurement practices, and support data-informed approaches to overdose prevention related public health initiatives. Moreover, this session emphasizes how rigorous assessment approaches can enhance cross-sector partnerships and provide the evidence needed to jointly develop, implement, and sustain public health workplans.
Jessy is an analyst in the division of community and behavioral health at the Denver department of public health and environment, where she has worked for 3.5 years. Jessy has over a decade of experience in research, mixed-methods analytical work, and public health practice. She supports... Read More →
Measles outbreaks among unvaccinated communities are becoming increasingly common. Two outbreaks have been reported in Colorado within the last year, including an ongoing outbreak in Broomfield County. In response, Denver Health has implemented a clinical decision support tool, an Epic OurPractice Advisory (OPA), to identify gaps in measles immunity among adult patients.
Methods:
Between May and October 2025, approximately 62,444 adults visited Denver Health outpatient clinics. The OPA flags patients with no record of either a measles antibody results or prior measles vaccination. Patients are excluded from further testing if a provider accepts a verbal report of prior vaccination or infection. Providers then order a measles antibody titer and administer vaccination if the titer is low or undetectable. A descriptive analysis was performed to evaluate the effectiveness of the OPA in identifying patients in need of follow-up.
Results:
The OPA flagged 28,383 unique patients lacking documented measles immunity. Of these, 24,145 (85%) were eligible for serologic testing after clinical assessment, but only 5,447 (22.6%) of those eligible had titers ordered. Of those with orders, 3,540 patients (65%) completed testing. Among those with orders, there were 1,097 (31%) without evidence of immunity. Of those with no evidence of immunity, a total of 348 (32%) patients returned for follow-up after testing, and 160 (46%) received the MMR vaccination.
Implications:
The OPA effectively identified patients lacking protective measles antibodies, with approximately 45% of the patient population lacking documentation. This clinical decision support tool proves valuable in prompting conversations about measles immunity and strengthening surveillance within a safety-net hospital setting. While the tool demonstrated strong identification capabilities, subsequent follow-up and vaccination rates were low. These findings show that a screening tool is an important first step, but future studies are needed to find best practices to bridge the gap between screening and care.
