Public Health in the Rockies 2026

Background / Purpose: The Colorado Childhood Lead Poisoning Prevention Program conducts in-home environmental investigations for children and pregnant women with confirmed elevated blood lead levels at or above the CDC reference value of 3.5 µg/dL. All confirmed cases are contacted by a lead risk assessor and offered a free investigation. These investigations assess categories of potential lead exposure: paint, dust, food, water, soil, and consumer products. After the investigation, a report is generated that summarizes findings and provides recommendations to address any lead exposures.

Methods: Investigations conducted between July 2024 and December 2025 were included in this analysis. Data collected included demographic information, housing characteristics, and laboratory results for tested environmental samples and consumer products. Analyses examined the frequency and type of lead exposure sources identified, the presence of multiple exposure categories within a home, demographic patterns, and follow-up blood lead testing after the investigation.

Results: A total of 80 investigations were completed for 91 people. At least one lead exposure source was identified in 92.5% of homes. Consumer products were the most common source, with 62.5% of homes containing at least one product with elevated lead levels. Dust was the second most common source, with elevated dust levels found in 47.5% of investigations. In addition, 62.5% of homes had two or more lead exposure sources across multiple categories. After receiving recommendations, 56.6% of families obtained follow-up blood lead testing. Among those retested, 86.2% had lower blood lead levels, and approximately half fell below the CDC reference value.

Implications: These findings demonstrate the feasibility of the program for identifying sources of lead exposure in Colorado homes. Results can inform targeted prevention strategies, support exposure reduction efforts, and encourage follow-up blood lead testing.

Background
The ongoing substance use crisis continues to disproportionately impact rural communities with limited access to behavioral health services and high stigma surrounding substance use disorder (SUD). Las Animas and Huerfano rural Colorado counties show high rates of youth substance use, mental health concerns, and overdose risk compared to state averages. This project highlights the participatory co-design, implementation, and pilot evaluation of Change the Narrative, a community-informed multicomponent digital public health educational anti-stigma campaign developed to reduce substance use and mental health stigma and increase access to care.

Methods
Using participatory design and Boot Camp Translation-like methodology, a coalition of public health organizations, healthcare providers, and community members collaborated to develop culturally responsive evidence-based educational materials for stigma reduction. Mixed-methods evaluation, stakeholder feedback, and social media analytics help assess feasibility, acceptability, engagement, access, and preliminary impact.

Results
Over 15 community and health service organizations participated in campaign development and dissemination. More than 60 community members, including youth, adults, providers, and coalition members, participated in iterative testing and evaluation activities. Over 50 co-designed and iteratively enhanced materials focused on the impact of substance use, prevention and access, dismantling stereotypes and stigma, seeing the whole person, recovery, and hope. Components included: a) printed outreach materials distributed across hospitals, restaurants, park, schools, other community venues); b) prevention action-focused educational website; c) youth-centered social media (Instagram, Tiktok). Preliminary findings demonstrated acceptability of messaging and shifts in community perceptions.

Implications

This project supports the feasibility of community-engaged digital campaigns to reduce stigma and strengthen substance use prevention and mental health resources in rural communities. Youth-informed messaging, social media engagement, and culturally responsive resources may improve outreach, build community capacity, and advance health equity. Results highlight the importance of partnerships between local public health workforces and communities to develop evidence-based, community-driven prevention interventions.

BACKGROUND: Psychological birth trauma (BT) is a prevalent yet underrecognized complication of childbirth that can lead to short- and long-term impacts on maternal and family wellbeing. This study aimed to quantify the population-level burden of BT in Colorado and identify specific supportive interventions necessary for maternal recovery.

METHODS: This mixed-methods public health study utilized two sources of data. Quantitative estimates of BT prevalence and care utilization rates were calculated using novel maternal health surveillance data from new mothers in Colorado (2023-2024). This was complemented by a qualitative study involving in-depth semi-structured interviews with women who experienced traumatic births to explore their experiences and the supports that facilitated their recovery during and beyond the postpartum period.

RESULTS: Preliminary surveillance estimates from 2023 indicate a BT prevalence rate of 9% among new mothers in Colorado (over 4800 mothers/year), with only 46% of those affected receiving helpful, timely care. Qualitative findings identified five critical areas where women and families lack adequate support: 1) Understanding the cognitive and behavioral impacts of BT; 2) Learning adaptive coping strategies for difficult emotions (anxiety, rage) and reactions (isolation, hypervigilance, overcontrol); 3) Addressing immediate and long-term physical health conditions resulting from pregnancy and childbirth; 4) Navigating mental health and medical care to determine the viability of subsequent, healthy pregnancies; 5) Accessing paid parental leave that reflects the actual time needed for postpartum recovery and caring for babies discharged from the NICU.

IMPLICATIONS: The high prevalence of BT coupled with low rates of care indicate a critical gap in the perinatal care continuum. Public health and clinical strategies must shift toward systemic, trauma-informed models. This includes educating providers, women, partners, and families; improving postpartum mental health screenings; integrating behavioral health within obstetric care; and enacting supportive labor policies like comprehensive paid parental leave to facilitate long-term maternal recovery.

Background:

Menstrual health can significantly impact physical, mental, and social well-being. Period poverty is defined as "The lack of access to safe and hygienic menstrual products, inaccessibility to basic sanitation services, facilities, and menstrual hygiene education" (Jaafar et al., 2023). It is estimated that 25% of menstruators in the United States will experience period poverty at some point during their life (Casola et al., 2022). This review examines how period poverty resources bridge gaps by addressing access to menstrual education, sanitation materials, and services.

Methods:

A literature review began with a PubMed search for “menstrual health”, identifying the Hennegan et al. (2021) framework. Hennegan’s framework defined multiple components of menstrual health; this review focused on the two components of the framework closely linked to period poverty: information and materials, facilities, and services. A subsequent search in PubMed and Google Scholar was completed, adding the keywords "health literacy”, “accessibility”, and “period poverty". Nine scholarly sources were mapped to explore if period poverty resources can bridge gaps in these two components of menstrual health.

Results:

This literature review found that period poverty resources could bridge gaps by improving access to menstrual education, products, facilities, and services necessary for optimal menstrual health. Yet, combating period poverty is complex, in part due to long-standing stigmatization and shaming that have made discussing the menstrual cycle difficult. Given the complexities, further research is needed to address additional gaps related to menstrual health.

Implications:

Action can take place at the individual level through conversations and involvement in local efforts. Through coordination efforts, academic institutions, medical facilities, governments, policymakers, and non-profit organizations such as Period Kits Colorado (PKC) can improve menstrual health equity by increasing menstrual education and expanding access to products and services, directly benefiting menstruators in Colorado.

Background: Approximately 400,000 Coloradans rely on private wells for drinking water, leaving a significant portion of the state’s population outside the purview of the federal Safe Drinking Water Act. While the Colorado Department of Public Health and Environment (CDPHE) offers subsidized private well testing for contaminants like per- and polyfluoroalkyl substances (PFAS), heavy metals in groundwater remain a critical, yet under-monitored, public health concern. CDPHE is launching a pilot program to test heavy metals in certain private wells, and this study aimed to map high-priority well locations to support testing resource prioritization.




Methods: We developed an evidence-based strategy to predict heavy metal occurrence in private wells. We integrated historical mining data, local geology, and environmental datasets, focusing on six key analytes: Arsenic, Cadmium, Manganese, Lead, Uranium, and Zinc. Using Empirical Bayesian Kriging (EBK) Regression Prediction, we merged sparse historical data with environmental predictors to create state-wide risk maps that bridge information gaps in unsampled regions.




Results: The analysis created a series of comprehensive risk maps for each metal, alongside a generalized index map. These tools do not predict specific outcomes for individual wells, but rather identify areas of elevated concern where environmental and historical factors suggest a higher probability of naturally occurring or introduced heavy metals. By comparing these areas with permitted well locations, we can better visualize which regions may benefit most from increased community outreach and subsidized testing resources.




Implications: Colorado’s diverse mineral geology and mining legacy present ongoing concerns for groundwater contamination. By integrating these factors into spatial risk maps, CDPHE can effectively prioritize sampling and resource allocation. As funding becomes available, this data-driven framework will enable targeted outreach, testing, and health education, empowering private well users to make informed decisions about their water quality.

As AI-assisted research tools continue rapidly expanding, public health researchers are increasingly faced with questions surrounding which tools are useful, how they can be integrated into evidence synthesis workflows, and what methodological and ethical considerations should guide their use. These challenges are especially relevant in interdisciplinary public health research, where fragmented terminology, inconsistent indexing, and evidence dispersed across multiple disciplines can make comprehensive literature searching particularly difficult.

This session presents a practical hybrid evidence synthesis workflow that combines traditional review methods with selectively integrated AI-assisted tools to strengthen search development, terminology refinement, citation mapping, and supplemental evidence discovery while maintaining transparency, reproducibility, and methodological rigor.

Using a scoping review on tobacco cessation interventions as a case study, the session will walk participants through each stage of the workflow. The presentation will include:

* How traditional database search strategies are initially developed and refined.
* How AI-assisted tools such as Elicit and Research Rabbit can be used to identify related terminology, map citation networks, and uncover supplemental literature that may have been missed through traditional keyword searching alone.
* Examples of how search terms and concepts may evolve throughout the review process in response to interdisciplinary terminology differences.
* Demonstrations of practical workflow integration across stages including evidence discovery, screening support, citation organization, and documentation practices.
* Discussion surrounding methodological tradeoffs, reproducibility concerns, ethical considerations, and limitations associated with integrating AI-assisted tools into evidence synthesis.

Participants will engage with example workflows and practical demonstrations and apply them to their own research question to demonstrate how hybrid approaches can support evidence synthesis across a variety of public health topic areas. The session will emphasize that AI-assisted tools are intended to complement, not replace, researchers' expertise, predefined inclusion criteria, manual screening processes, and transparent reporting practices.

Attendees will also discuss practical considerations for selecting appropriate AI-assisted tools depending on project goals, research questions, and stages of evidence synthesis. By focusing on adaptable workflows and critical evaluation rather than automation alone, the session aims to provide participants with transferable skills they can apply to their own interdisciplinary public health research environments.

This session is particularly relevant for public health researchers, graduate students, practitioners, and interdisciplinary teams conducting evidence synthesis in emerging or under-indexed topic areas where traditional search strategies alone may not fully capture the available literature.

The Toxicology and Risk Assessment Program (TARA) at the Colorado Department of Public Health and Environment (CDPHE) continues to grow the PFAS Testing and Assistance Program (PFAS TAP) following its successful statewide expansion in 2025. PFAS TAP provides Colorado residents using private wells with free PFAS testing and supplies eligible participants with free filters that meet NSF standards for contaminant reduction. In addition, the program conducts targeted outreach in priority areas to focus resources where they are most needed. We’re partnering with Boulder County and the San Luis Valley Public Health Partnership this year.

This presentation compares outreach strategies and lessons learned from engaging with regions across Colorado. We will also share high-level results of our program efforts and the impact of providing free water filters to eligible households.

Key takeaways from this session include:

* How evaluation findings were applied to improve communication and build trust with underrepresented populations.

* Insights into regional differences in outreach effectiveness and how to better serve diverse communities across the state.

* The impact of PFAS TAP across Colorado to date and plans for moving forward.

We will highlight how PFAS TAP has evolved into a sustainable, statewide framework, and we offer a scalable model for other agencies or organizations seeking to improve outreach and engage private well users.