Public Health in the Rockies 2026

Colorado’s evolving cannabis landscape has created significant challenges for public health surveillance, clinical assessment, and research translation. Despite increasing product potency and diversification, including concentrates, edibles, and vaporized products, many healthcare systems continue to rely on binary or frequency-only cannabis screening approaches that provide limited insight into real-world exposure patterns. This session presents the Pueblo Cannabis Use Measurement Initiative (PCUMI), a developing public health and clinical research framework designed to improve cannabis exposure characterization by integrating quantity, potency, and route of administration into standardized exposure classifications. The project directly aligns with the 2026 PHiR theme, Stronger Together, by highlighting collaborative partnerships among healthcare systems, public health agencies, academic researchers, and community stakeholders working to strengthen Colorado’s public health infrastructure.

Methods include a systematic review and adaptation of existing cannabis-use instruments, the development of structured exposure categories aligned with Colorado product-labeling norms, and pilot planning for implementation in emergency and behavioral health settings in Pueblo County. Planned procedures include clinician feedback, workflow assessment, and evaluation of feasibility indicators such as completion rates, participant comprehension, item-level missingness, and integration into electronic health record systems.

Preliminary development findings suggest substantial gaps in current cannabis-use documentation practices, particularly regarding potency and mode of administration. Early framework development demonstrates the feasibility of a scalable, clinically interpretable measurement approach capable of supporting more consistent data collection across healthcare environments.

Participants will compare traditional cannabis-use screening approaches with dose-centered frameworks, assess how standardized exposure classifications may improve clinical documentation and public health surveillance, and evaluate the broader implications of increasing cannabis potency and product diversification in Colorado. Attendees will leave with practical strategies for improving cannabis-related public health data collection, strengthening translational research capacity, and supporting more informed public health decision-making across Colorado health systems.

Background: Syphilis remains a public health priority nationally and in Colorado. Test Yourself Colorado (TYC) is an online, at-home STI testing program administered by the Denver Sexual Health Clinic that provides free mailed HIV tests and/or gonorrhea (GC) and chlamydia (CT) testing statewide. In 2026, TYC launched a pilot at-home syphilis self-testing program as an additional service for clients reporting never having syphilis.

Methods: The TYC at-home syphilis pilot utilizes the First to Know® Syphilis Test, the first FDA authorized over-the-counter self-administered test. The test utilizes fingerstick blood and results in 15 minutes. Clients are provided with resources for seeking further clinical evaluation in the event of reactive results. Syphilis test kits were offered as part of TYC first from 2/15/2026 -2/28/26 and then again starting 4/10/2026. We report initial programmatic results from the syphilis at-home testing pilot program as of 5/8/2026. Future evaluations will assess client satisfaction and barriers to use.

Results: During the pilot, 417 total orders were placed with TYC. Of these, 154 (37%) included a syphilis test. Of syphilis orders, 45 (29%) were among cis-men; 106 (69%) were among cis-women; 2 (1%) were among trans clients. Eighty-seven (56%) syphilis orders were among White, Non-Hispanic individuals; 7 (5%) were among Black non-Hispanic clients; and 31 (20%) were among Hispanic clients. The remaining orders (29; 19%) were among individuals who preferred not to answer the race/ethnicity question or who identified as a different race/ethnicity. Fifteen (10%) syphilis orders were among men who have sex with men.

Implications: Initial utilization of TYC’s at-home syphilis testing service indicated modest interest in the syphilis test. Ongoing efforts to promote the program in addition to the importance of syphilis screening among priority populations are merited. As efforts continue to address the syphilis epidemic, at-home testing services should be considered.

Over the past decade in the United States, there have been considerable shifts in policy around requirements of sexual education. A significant factor in this is the lack of policy at the federal level, allowing states to choose whether sexual education is a requirement at all. Currently, only 36 states and the District of Columbia have laws requiring a form of sexual education to be taught in schools. A notable consequence of states making their own individual laws around sexual education is the use of stigmatizing language within the policy itself. This can include use of language around abstinence-only education, how STIs are described and framed, pregnancy management and options, and provision of parental consent.

This qualitative study aims to begin to examine state-level K-12 sexual education policies, starting with Colorado and Alabama as comparative case studies. Using inductive analysis, the state’s policy documents will be systematically coded to identify key themes, allowing for the creation of a comparative thematic matrix. Based on noted patterns in the matrix, implications for public health research, policy, health equity, and marginalized populations can be identified. By analyzing how language functions within these policies, questions around participation, inclusion, accessibility, and relevance of content can begin to be answered.

Inside Out Youth Services (IOYS) believes that young people have an integral role in informing, shaping, and delivering programming responsive to health and wellness. By providing agency for young people to develop and facilitate educational programs, we recenter youth voice within their own care. IOYS serves LGBTQIA2+ young people ages 13-24 in a variety of modalities to best meet youth where they are at. One of the ways we sought to achieve this was the development of the Peer Program Internship in 2025, including a Substance Use Prevention Intern. These interns have the opportunity to learn leadership qualities, actively participate in civic engagement, and facilitate youth-led programming. To measure the impact of programs, data is collected through Program Feedback Forms, and twice-annual Outcome Assessments measure the broader impact IOYS has had on young people in areas like healthy relationships, support systems, and substance use. Since then, IOYS has seen the highest growth scores in Outcome Assessment data among responses related to understanding substance misuse and increased awareness of where to find support. Higher rates of attendance and engagement are also observed when programs are facilitated by other young people. To us, we implement the theme of ‘Stronger Together’ every day in our work with young people. We encourage other practitioners to consider how including youth voice within public health processes sets a foundation for greater agency for young people navigating healthcare settings, especially for young people who face increased barriers to service.

When the contract with the external evaluator for Colorado's Electronic Healthy Incentive Program (eHIP) pilot was canceled in early 2025, it left a gap: no evaluation funding and no clear path to capturing what the state was learning. What stepped in to fill it was a cross-agency workgroup that had been meeting informally for months with no fixed agenda, just an intention to share work and think out loud together.

Colorado was one of three states awarded the eHIP grant to pilot an EBT-integrated SNAP nutrition incentive program. Colorado SNAP Produce Bonus (CSPB), launched in July 2024, instantly reimburses SNAP households on their EBT cards for purchases of eligible fruits and vegetables. When federal evaluation support disappeared, staff from the Colorado Department of Human Services (CDHS), Nourish Colorado, and the Colorado Department of Public Health and Environment (CDPHE) drew on their different organizational strengths to piece together a collaborative evaluation plan. CDPHE leveraged funding through its CDC SPAN grant and the expertise of its internal evaluators; Nourish Colorado brought on-the-ground relationships with farmers and customers; CDHS provided program infrastructure and data access.

Together, the partners conducted customer and farmer surveys, focus groups, and farmer interviews. Results show 97% of customers say the program helps them eat more fruits and vegetables and 80% of farmers report it helps them sell more produce. Nourish Colorado has used the findings to advocate at the state and federal levels for continued investment beyond the pilot.

This session explores how three organizations — a state human services agency, a public health department, and a nonprofit — used an open-ended, generative partnership to respond to evolving priorities. Attendees will leave able to identify the strengths different organization types bring to community health planning work, and explain why diverse partnerships matter, especially when funding becomes uncertain.

Skin cancer remains the most common cancer in the United States, yet prevention efforts continue to focus primarily on individual behavior change, with limited integration of environmental strategies that shape exposure. Public health agencies are increasingly recognizing the need to incorporate structural approaches into prevention programming. This session presents a collaboration between the Colorado Department of Public Health and Environment (CDPHE) and an academic partner to integrate built environment interventions, specifically shade infrastructure, into a broader skin cancer prevention framework.

CDPHE identified gaps in addressing environmental exposure to ultraviolet (UV) radiation in public spaces. In response, a multi-phase, mixed-methods shade assessment was conducted across diverse site typologies including parks, schools, and community spaces. Methods combined field-based audits, spatial analysis, and stakeholder engagement to evaluate shade availability, distribution, and equity. Findings revealed consistent disparities in shade access, particularly in high-use areas, and identified priority sites for intervention.

Results from this collaboration informed the development of practical tools, including shade design guidelines and site prioritization strategies, which are now being integrated into CDPHE programming. The session will highlight how research findings were translated into actionable resources and discuss the opportunities and challenges of embedding built environment approaches within existing public health systems.

Presenters will also discuss emerging policy pathways to support implementation, including funding mechanisms, cross-sector partnerships, and regulatory considerations. A 1-hour session is requested to allow both presentation and interactive engagement: the first 30 minutes will present the program and findings, followed by a 15-minute small-group activity applying site prioritization strategies to a sample scenario, and a 10-minute facilitated discussion on implementation barriers and policy adoption.

By situating built environment strategies within a statewide prevention program, this session demonstrates how cross-sector collaboration can expand the scope of public health practice and support more equitable, sustainable approaches to cancer prevention.

Background:
Access to timely, culturally responsive lactation support remains a significant barrier in underresourced communities. In Colorado, data from the Colorado WIC Program (2024) indicate that breastfeeding prevalence declines from 53% during the first postpartum week to 32% at six months postpartum, while only 3.5% of individuals report receiving breastfeeding information via telephone, according to the Baby & You Survey (2024). These gaps highlight the need for accessible, community-based breastfeeding support strategies and continuity of care.

Objective:
To evaluate the development and early implementation of a training program preparing community members to provide telephone-based breastfeeding support.

Methods:
Surveys and interviews will assess the feasibility and early outcomes of the program. Feasibility measures include recruitment, retention, and training completion rates among lactation counselor participants. Participants are recruited through a community leadership initiative and complete an accredited online training program covering lactation fundamentals, counseling skills, common breastfeeding challenges, referral pathways, and culturally responsive peer support. Weekly study sessions facilitated by a lactation consultant reinforce learning and practical application.

Post-training surveys will assess changes in perceived competence, self-efficacy, and preparedness to provide breastfeeding support. Trained participants will deliver telephone-based support to postpartum individuals experiencing early breastfeeding challenges, caregiver confidence, and access to timely, evidence-based guidance. Breastfeeding participants will be recruited through maternal and child health referrals. Outcomes, including breastfeeding confidence and access to lactation information, will be evaluated through pre- and post-intervention surveys. Open-ended responses will explore program acceptability and opportunities for improvement.

Results:
LactiConnect is currently implementing a structured training program for community members to become breastfeeding support specialists.

Implications:
Training community members as breastfeeding support specialists may strengthen the lactation workforce and improve access to culturally responsive care. Telephone-based peer support offers a scalable model to reduce barriers and improve breastfeeding outcomes.