Public Health in the Rockies 2026

Public health professionals know that meaningful change starts with community. Yet building authentic, lasting community partnerships is often learned on the job, without the time, training, or infrastructure to do it well. When engagement is rushed or surface-level, interventions don't fit local realities, participation lags, and the trust we depend on erodes. Strengthening community engagement capacity across the public health workforce is essential to creating useful programs, improving health outcomes, and grounding public health efforts in the lived experiences of the populations we serve.

Since 2010, the Colorado Immersion Training in Community Engagement (CIT) has prepared public health and health care professionals to partner with communities through an immersive, community-led approach. Over six months, participants combine coursework with a week-long, community-based experience. This week-intensive is guided by trusted local partners with deep knowledge of place, and relevant health concerns.

Across 15 years, 167 participants from multiple disciplines have completed CIT, in partnership with eight Colorado communities serving as track sites. A recent review of CIT identified the partnerships, infrastructure, and practices required to support meaningful, sustainable training. This session shares those lessons and equips participants, including public health practitioners, program leaders, and researchers, to bring an immersive engagement training model to their own institutions.

In the first 30 minutes, participants will hear how CIT is structured and what it has produced, with a closer look at one community track. The next 40 minutes are hands-on: in small groups, participants will assess their own organizational and community readiness, map the partnerships and resources needed to launch an immersive training model, and outline concrete next steps. The final 20 minutes open into facilitated discussion to share insights, anticipate common barriers like funding, staffing, and capacity, and identify ways to sustain this work locally.

This session will help participants envision, plan, and advocate for engagement training that addresses public health challenges, strengthens partnerships, lifts up community leaders, and advances public health practice. Through hands-on activities, participants will build essential skills in stakeholder engagement, program planning, and implementation, while reinforcing the importance of community leadership. By centering community voices, the session models how strong partnerships produce more relevant programs, better uptake, and the kind of trust that builds trust in public health.

In an increasingly individualistic society, the prevailing narrative suggests that "self-care" is the primary antidote to burnout and trauma. We are told that if we only practice enough mindfulness or take enough bubble baths, we can endure any professional or systemic stressor. However, for a social mammal, the idea of regulating purely in isolation is a biological fable. Human beings have survived and evolved through the ongoing process of co-regulation—the process by which our nervous systems settle and find safety through the presence and support of others.

This interactive workshop challenges the "self-care" myth by introducing the framework of Co-Care. While individual wellbeing is foundational, the most impactful resilience occurs within our professional relationships and relational ecosystems. How we navigate emotions and interpersonal dynamics at work directly dictates the quality of our outcomes and the sustainability of our missions.

When we lack the tools to support one another through conflict, we often fall into maladaptive social patterns such as gossip, triangulation, or conflict avoidance. These behaviors don't just damage morale; they stifle curiosity and diversity of thought. Conversely, when a team learns to regulate through emotions and engage in healthy conflict, the collective capacity for growth expands. By staying regulated in the presence of conflict, we allow our biases and judgments to be challenged, leading to more innovative and equitable public health solutions.

Background:

Public health and quality improvement (QI) initiatives are increasingly expected to demonstrate measurable value alongside clinical outcomes. Practical applications of Social Return on Investment (SROI) methodology in maternal health QI remain limited. The Colorado Perinatal Care Quality Collaborative (CPCQC) partnered with the Center for Social Investment at Omni Institute to conduct an SROI study of Turning the Tide (TTT), a hospital-based QI initiative designed to reduce pregnancy-associated overdoses, a leading cause of pregnancy-associated death in Colorado, and improve engagement in substance use disorder (SUD) treatment.




Methods:

Using an SROI framework adapted from the New Economics Foundation, the study estimated the social and economic value generated through improved postpartum engagement in treatment. TTT data from 2022-2025 were analyzed to estimate outcomes associated with screening, referrals, social work consultation, and treatment engagement.




Results:

Across 25 participating hospitals, 87% of birthing people were screened for substance use and 94% of those who screened positive received a referral or treatment. The analysis estimated that 34 additional birthing people maintained engagement in SUD treatment due to program implementation, generating an estimated $681,990 in social and economic value through reduced healthcare and criminal justice costs. Overall, TTT generated an estimated return of $1.99 for every $1 invested, suggesting that hospital-based perinatal substance use QI initiatives can generate measurable economic benefits alongside improved treatment engagement.




Implications:

This presentation offers attendees a practical framework for applying SROI methodology to public health and QI initiatives using implementation-based data. Presenters will discuss methodological considerations, data limitations, strengths and challenges, and lessons learned. Finally, presenters will highlight how lessons learned are being applied to CPCQC’s community-facing program, IMPACT BH, for a future SROI analysis. Attendees will gain practical insight into how SROI can support evaluation, sustainability planning, and communication of program impact in maternal and behavioral health settings.

The Healthy Food for Denver’s Kids initiative (HFDK), established through a 2018 ballot measure, expands access to healthy food and food-based education for children and families. HFDK funds nonprofit organizations, local government entities, and public schools working across Denver’s food system. CAI serves as the external evaluator, developing shared process and outcome measures, tools, and resources to describe impact and promote sustainability.

CAI developed interactive geospatial maps and multi-level analyses to visualize where and how grantees delivered services across Denver. Using grantee reporting data on service delivery site locations, neighborhood-level indicators, and ArcGIS, CAI created customized maps to examine service reach for youth and families, potential gaps, and areas of overlap. CAI facilitated an interactive grantee convening where grantees reviewed maps, discussed patterns, and contributed community knowledge to contextualize the findings.

This participatory process generated insights that would not have emerged from CAI analyzing the maps alone. For example, grantees noted that two apparently underserved neighborhoods included a large golf course and cemetery, helping explain the absence of service sites and refine how potential gaps were interpreted. Grantees also recommended additional layers, including transit lines and food pantry locations, to help determine whether apparent gaps reflect limited access, transportation barriers, or existing resources not captured in the maps. Lastly, grantees identified opportunities to explore partnerships with school districts beyond Denver Public Schools in border neighborhoods where families may otherwise fall through the gaps.

This session will highlight how participatory data interpretation can support community health planning and policy development by helping to identify service gaps, strengthen partnerships, and translate data into actionable recommendations. Attendees will review the facilitation structure and mapping activities used with grantees, then participate in a small-group exercise replicating the grantee experience. A one-hour session is requested to allow sufficient time for both presentation and interactive application.

Youth substance use remains a critical public health concern, with prior Healthy Kids Colorado Survey (HKCS) data (2017–2019) in Denver Public Schools (DPS) indicating concerning trends and a clear need for targeted intervention. In response, DPS established an intentional partnership with the Colorado School of Public Health to strengthen the collection, analysis, and application of student health data. This collaboration was designed to ensure that prevention strategies were grounded in reliable data and aligned with identified student needs, advancing a shared goal of improving youth health outcomes.

Through this partnership, HKCS data were collected from middle and high school students and analyzed across multiple years, comparing baseline data from 2017–2019 with more recent data from 2023–2025. Analyses focused on identifying changes in substance use prevalence and patterns over time, as well as examining how data-informed strategies were implemented in response to earlier findings. These strategies included enhanced prevention education, early intervention efforts, and coordinated supports across school communities.

Results indicate a measurable decrease in reported student substance use in the 2023–2025 data compared to earlier years, suggesting positive impacts of targeted, data-driven interventions. These findings highlight the effectiveness of aligning public health and education efforts through intentional collaboration.

This session is highly relevant to public health professionals as it demonstrates how cross-sector partnerships can generate actionable data to inform programming and evaluate outcomes. Attendees will leave with practical approaches for analyzing state public health survey data to guide decision-making, implement effective prevention strategies, and measure impact.

Background: In 2024, the Colorado Department of Public Health and Environment (CDPHE) moved from collecting client-level data for all funded Syringe Access Program (SAP) interactions to an annual point-in-time survey (PiT). This change aligned with best practices for estimating demographic reach, client needs, and effectiveness of SAP services, while reducing data entry burden for SAP staff.

Methods: The PiT was administered to a sample of SAP participants in 2024 and 2025. Target sample sizes were calculated based on the estimated number of participants served annually at each SAP. Surveys were entered into REDCap, and analysis was completed using R. Infographics describing results were created and disseminated to funded SAPs and other stakeholders.

Results: 2,425 participants completed the PiT across 15 SAPs in 2024 and 2025. The average age of respondents was 43 years, most were White (48%) and/or Hispanic/Latine (32%). Men made up 66% of respondents, and 60% of respondents reported their housing status as homeless. The top SAP services included safer smoking/snorting supplies, syringe pickup, and Naloxone provision. The top SAP referrals were food/nutrition assistance, shelter/housing assistance and HIV Testing. 8% of participants reported sharing syringes/needles, and 25% reported reusing syringes or needles.

Implications: SAPs are a critical access point for prevention and supportive services. The proportion of respondents who reported syringe/needle sharing and reuse highlights the need for safer use education, increased access to sterile supplies, and expanded interventions that lower injection-related risks. Collecting this survey annually allows for monitoring of demographic shifts and changing needs over time. This data informs program improvement and planning, supports advocacy for continued funding, and guides expansion of services offered and referral networks.

Background

Falls are the leading cause of injury among older adults in Colorado, costing the state $739 million/year. Evidence-based fall prevention programs exist, but they’re underutilized and not systematically implemented statewide. The multi-year Scaling Trusted Evidence-based Fall Prevention (STEP) initiative scales evidence-based fall-prevention programs across Colorado and evaluates their real-world impact. We aimed to identify 10 fall-prevention program delivery sites across Colorado using a data-driven approach.

Methods

We mapped Colorado evidence-based fall prevention programs, then calculated county-level, age-specific, fall-associated ED visit incidence rates. Using 2019-2023 Census population estimates, SVI (Social Vulnerability Index), and CO Department of Public Health and Environment injury dashboard data, we created a series of choropleth maps showing Colorado counties with the highest density of older adults, highest frequency and rates of falls-associated ED visits, and highest SVI. Input from the STEP advisory board and the Colorado Falls Coalition informed the mapping tool and guided identification of high-priority regions for delivery site implementation. After candidates were identified, we conducted outreach to assess interest and distributed surveys to evaluate suitability.

Results

Areas (counties) identified as high-priority included the Denver Metro area (Adams, Jefferson, Arapahoe, and Denver), Front Range outside the Denver Metro area (Pueblo, El Paso, Weld, and Larimer), Western Slope (Mesa, La Plata, Montezuma, and Montrose), Central Mountains (Fremont, Summit), San Luis Valley, and Eastern Plains (Morgan, Las Animas). Thus far, we have identified 48 potential delivery sites. Final delivery site information will be finalized and available at time of conference.

Implications

Utilizing publicly available data sources can be a powerful way to aid public health program site exploration or research design. It allowed us to identify and target Colorado areas experiencing the highest need for fall prevention programs based on health care utilization data and falls risk factors.

Background: Rural populations experience a wide range of health disparities, including higher rates of cancer and heart disease death. Persistent inequities in the social determinants of health, such as lower access to quality public services, underlie many rural health disparities. Yet, rural contexts vary both across and within states, and the particular needs and resilience capacity of Colorado’s rural populations have been insufficiently characterized. This research showcase will report on a two-year project led by the Colorado Department of Public Health and Environment to assess rural health equity statewide and inform policy responses.

Methods: The presentation will compare rural, rural resort, and urban geographies on 40 health and social determinant indicators, drawing on a novel dataset that combines vital statistics and survey data for all 64 counties in Colorado. The presentation will also report on a qualitative analysis of interviews and focus groups and a review of Colorado public policy.

Results: Rural populations fared worse than urban populations on 75% of health indicators, including premature mortality and deaths from chronic disease. Rural areas also fared worse on 55% of social determinant indicators tested, such as uninsured rates and food insecurity, but fared better on 30%, including the violent crime rate. Rural resort populations, by contrast, actually fared better than urban ones on 87% of health indicators. They also fared better on 50% of social determinant indicators, while faring worse on just 20%. Social connections are core strengths of both rural and rural resort communities, with participants routinely reporting a strong sense of belonging and interdependence.

Implications: Colorado’s rural populations face interlocking disadvantages across most health and social determinant indicators, but they also hold strengths that can be reinforced through strategic investments and expanded support. The presentation concludes with a discussion of promising approaches and lessons for advancing rural health equity.

The Colorado Alcohol Impacts Coalition (CAIC) is a newly formed statewide coalition dedicated to fostering a more healthful environment around alcohol use in Colorado. Excessive alcohol consumption remains a significant and often under-addressed public health concern, contributing to chronic disease, injury, mental health challenges, and health inequities across our state. CAIC brings together public health professionals, community organizations, researchers, and advocates to address these harms through a unified, evidence-based approach.

This presentation will introduce CAIC's founding mission, coalition structure, and strategic framework — centered on education, data, and policy — and outline priority areas for collective action in the months and years ahead. Attendees will learn how to engage with and contribute to this growing coalition as we shift Colorado's alcohol landscape toward one that better supports health and well-being for all.

We request 60 minutes because our presentation covers a wide variety of topics, from founding to current activities to funding. We hope this session will grow our coalition to include early public health professionals, rural stakeholders, and people affected by alcohol use. Therefore, we will include audience participation, coalition sign-ups, and material on funding for a new, advocacy-focused nonprofit. Audience members will be encouraged to share stories about alcohol impacts in their community to help us understand how the Coalition can better serve them.

To address local data needs, the Weld County Department of Public Health and Environment (WCDPHE) conducts a household-based Community Health Survey (CHS) using scientific random sampling to obtain population-level metrics for Weld County adults every three years. This survey's robust sample size along with weighting the results allow for disaggregation to highlight disparities.

In 2023 the then US Surgeon General released an advisory describing loneliness and social isolation as an epidemic. Between this report and coalition activities focused on reducing loneliness, many external and internal partners expressed a need to understand the impact of social isolation and loneliness in Weld residents.

While creating the 2025 Weld CHS, the WCDPHE data team added two new validated questions about social isolation and loneliness to meet partners’ data needs. The survey was sent out to around 20,000 randomly selected households in Weld County. A total of 2,802 residents completed the survey. The data was then weighted using Weld census data so that the results are representative of the county’s adult population.

Over 1 in 4 Weld residents reported being lonely, and over 1 in 10 never or rarely get the social and emotional support they need. Disparities in social isolation and loneliness were found when breaking the data down by income, gender, and race/ethnicity. Additionally, both loneliness and social isolation were much higher in residents with indicators of poor physical and mental health.

These results show how social connection can be quantitatively measured through survey data in large populations to produce useful metrics to guide and improve programs. Incorporating these metrics into Weld’s Community Health Assessment enables the county to better address the physical and mental health needs of residents through improved and targeted programming.

The rising cost of living, housing, and healthcare costs were the top three challenges facing the state, identified by residents in the 2025 Colorado PULSE poll. Weld County’s triennial Community Health Survey (CHS) captures several metrics relating residents’ affordability concerns to factors influencing their health. This presentation will share findings on food insecurity, rising housing cost burden, and cost as a barrier to healthcare from a random sample, mail-based survey sent to 20,000 Weld County households in 2025. Weighted results offer a representative picture of how these issues affect county residents.

The 2025 Weld CHS revealed that roughly 4 in 10 residents are worried or stressed about affording medical care, health insurance, and healthy meals. Additionally, cost remains the most frequently cited barrier to accessing healthcare, behavioral healthcare, and insurance. The percent of residents who are housing cost burdened (spending 30% or more of household income on rent or mortgage and utilities) rose significantly from the previous survey cycle in 2022 (43% versus 33%, respectively). While affordability concerns affect a broad swath of Weld’s population, young adults and those living in low-income households bear a disproportionate burden.

These findings support Weld County’s efforts to expand access to care and adequate nutrition, addressing cost barriers through free health screenings, a public health mobile unit, and free, high-quality chronic disease prevention/nutrition programming. The impact of the Weld CHS does not end with the health department; these findings are disseminated to a multitude of community partners leading to continued improvements to service delivery addressing financial barriers to health care, behavioral healthcare, housing, and food access. Continued inclusion of affordability measures as part of the CHS strengthens this collaborative effort across a broad coalition of community organizations and healthcare partners.

Background: Roadway safety remains a critical public health challenge across Colorado, where factors such as population density and roadway type vary significantly in different regions of the state. Effective prevention strategies rely on the timely identification of high-risk locations and a nuanced understanding of contributing factors to motor vehicle crashes. Existing tools for crash data analysis are currently aggregated to the county level, but there is limited information available statewide about the factors of individual crashes. The purpose of this presentation will be to describe the development of a new Crash Map Dashboard, and provide a demonstration of the map.

Methods: The Crash Map Dashboard was developed to address input of stakeholders from local public health agencies, the Colorado Department of Transportation (CDOT), and injury and built environment specialists at the Colorado Department of Public Health and Environment. Geocoded crash data collected by the Department of Revenue and managed by CDOT were obtained for 2024. The data were cleaned and locations were validated against a street network database to map precise locations of crashes. The maps were integrated into an online interactive ArcGIS Dashboard.

Results: Preliminary results from beta testing indicate that the Crash Map Dashboard can provide key insights into contributing factors for individual crashes. Crash-level data are now accessible for all 64 counties in Colorado. Some of the functionality requested by partners that has been incorporated into the dashboard include selection tools for identifying crashes that occur near schools and symbology for differentiating crashes that involve vulnerable road users.

Implications: The Crash Map Dashboard offers an accessible and user-friendly tool that allows public health professionals to access data that can be incorporated into injury prevention programs. The next phase of the project seeks to provide additional levels of analysis and years of data to improve upon the dashboard.

In 2025, the Weld County Department of Public Health and Environment conducted its triennial Community Health Survey (CHS) to identify local health trends and inform public health programming. A random, mail-based survey was distributed across Weld County, and 2,802 completed responses were weighted to represent the county population.

Findings revealed an increase in smokeless tobacco/nicotine use and highlighted disparities in tobacco/nicotine use across Weld County. In 2025, 7.5% of residents reported using smokeless tobacco/nicotine products (chew, pouches), double the rate reported in the 2022 CHS. Higher rates of smokeless tobacco/nicotine use were reported among residents aged 18–34 (12.4%) compared to residents aged 35–54 (7.9%) and residents aged 55 and older (3.1%). Additionally, smokeless tobacco/nicotine use among young adults aged 18–34 nearly quadrupled from 3.4% in the 2022 CHS to 12.4% in 2025. Smokeless tobacco/nicotine use among men in Weld County was double the statewide rate reported in the 2024 BRFSS. The survey further identified significantly higher cigarette and e-cigarette use among Hispanic/Latino residents and residents living at or below 138% of the FPL.

These findings directly informed Weld County Tobacco Education and Prevention Program (WCTEPP) strategies and program planning. In response, WCTEPP expanded culturally responsive cessation outreach, increased in-school education efforts focused on emerging nicotine products for ages 9 and older, and developed new initiatives to address alternative-to-suspension needs in school and community settings in partnership with law enforcement, parents/trusted adults, and youth.

This presentation will explore how local survey data was translated into tobacco prevention and cessation programming in Weld County, a community that includes both rural and urban municipalities. Participants will have the opportunity to model an alternative-to-suspension approach in response to local county data trends.

Nicotine use is still the leading preventable contributor to disease and death in the United States. States in the Mountain West share many, but not all, patterns and trends in nicotine use.

This session presents findings from surveys on adult nicotine use conducted by WYSAC in the region, highlighting Colorado's neighbors to the north and south. WYSAC has conducted similar surveys in seven states. We will share how we develop survey instruments tailored to each state's needs, how we field surveys, and how we weight and analyze data to obtain accurate estimates of nicotine-related behaviors and opinions.

Our findings show broadly that:

* Smoking rates have declined while vaping rates have increased, so that vaping now matches or exceeds smoking among adults.
* Young adults, people experiencing poverty, and people with behavioral health challenges are disproportionately likely to vape.
* Poverty and behavioral health are significant predictors of cigarette smoking.
* In New Mexico, most smokers and vapers intend to quit within the next six months. In Wyoming, roughly a third of smokers tried to quit in the last year
* In New Mexico, people living in multi-unit housing are significantly more likely to be exposed to secondhand smoke in their homes.
* Substantial majorities of adults support cigarette tax increases and tax increases on other nicotine products.

We will present maps showing state- and county-level variations and graphs detailing variations across demographics and other population characteristics.

States in the Mountain West share in national trends in nicotine use and behaviors, but also differ in important ways. There are strong associations between social determinants of health and nicotine use and behaviors, but these determinants vary across our region. Placing local data in a regional context enables public health professionals to see both what we share and how we differ.

Background/Purpose: Tobacco use remains a leading preventable cause of disease and death, with persistent disparities among Black/African American individuals, LGBTQ+ individuals, individuals with behavioral or mental health conditions, and individuals receiving healthcare assistance. As Colorado's largest safety-net system, Denver Health serves nearly one in four Denver residents annually. With funding from the Colorado Department of Public Health and Environment's Amendment 35 program, Denver Health partnered with patients and providers to identify barriers and co-design strategies to reduce tobacco treatment disparities among these priority populations.

Methods: We used a participatory mixed-methods design across 12 clinical sites. Data included dot-voting with 275 clinical staff, surveys of 59 patients and 27 providers, four focus groups (n=28), and nine provider interviews. Qualitative data were thematically coded; quantitative data summarized descriptively. Findings were synthesized into candidate interventions, prioritized through clinic engagement, then piloted and integrated into workflows. Evaluation included website analytics, QR-code tracking, EHR-based outreach, and pre/post cessation indicators.

Results: Patients identified stress, withdrawal symptoms, social environments, and low motivation as primary barriers; providers added co-occurring mental health conditions, visit time constraints, and cost. Both groups identified nicotine replacement therapy, pharmacotherapy, and one-on-one counseling as most effective. Qualitative themes emphasized non-judgmental communication, follow-up, and clearer cost information. Over 20 interventions were implemented across five domains: provider and patient education (department lectures, patient stories, formulary tip sheet); patient-facing digital outreach (redesigned Tobacco Cessation website, MyChart campaign, banner, resource link, After-Visit Summary education); reducing stigmatizing language (Words Matter preference list, free-text tracking); clinic-based materials (bilingual posters, Gemba boards); and follow-up workflows (STC and TCC call lists). Monthly website views rose, scheduled cessation appointments increased, and smoking prevalence among priority populations declined.

Implications: Patient-centered, non-judgmental engagement supports cessation. Workflow integration determines uptake. Addressing the structural barriers of cost, access, navigation is essential for equitable outcomes.