Public Health in the Rockies 2026

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.

Background:

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.

Background/Purpose:

Since 2016, 715 Coloradans have had a Centers for Disease Control and Prevention-confirmed case of active tuberculosis. Many of these cases could have been prevented by treating patients’ latent tuberculosis infection (LTBI) before it progressed to contagious, active tuberculosis disease. The care cascade for LTBI includes 1) chest x-ray completion, 2) treatment initiation, and 3) treatment completion. Patient navigators assist patients throughout the care cascade by identifying barriers to care, connecting patients to resources, and providing education and helpful reminders. We sought to explore the association between receiving LTBI-focused navigation and failure to progress along the LTBI care cascade.




Methods:

This project took place at a safety-net health system in Denver, Colorado between October 1, 2023 and September 30, 2025. Among 1,136 primary care patients with positive interferon-gamma release assay, we randomized 50% (n=566) to receive LTBI-focused care navigation and 50% (n=570) to receive standard clinic care. We used multivariable log-binomial regression modeling that accounted for clinic-level clustering to compare chest x-ray noncompletion, treatment non-initiation, and treatment noncompletion among patients with LTBI receiving LTBI-focused care navigation and those receiving standard clinic care.



Results:

We found that patients receiving care navigation had a significantly decreased risk of chest x-ray noncompletion [adjusted risk ratio (aRR) = 0.90, 95% confidence interval (CI) 0.86-0.95, p

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.

Background: As Colorado expands dental scope of practice to include immunizations related to oral and respiratory health, understanding future oral health professionals’ preparedness for human papillomavirus (HPV)-associated oropharyngeal cancer prevention is essential. This study assessed HPV-related knowledge, attitudes, and willingness to vaccinate among Colorado dental and dental hygiene students. It was hypothesized that greater HPV knowledge and stronger perceptions of HPV prevention as a dental professional responsibility would be associated with willingness to vaccinate.

Methods: Colorado dental and dental hygiene students were recruited to complete an anonymous cross-sectional survey. The survey, adapted from prior dental student HPV research, included HPV knowledge questions and Likert-style items assessing communication comfort, barriers, professional role perceptions, curricular experiences, and vaccine training and administration interest. Descriptive statistics and regression analyses evaluated predictors of willingness to engage in vaccination training and administration.

Results: 88 students were surveyed. 88.6% and 80.7% believed discussing HPV-associated oropharyngeal cancer and recommending HPV vaccination are appropriate dental roles, respectively. 93.2% expressed at least some interest in administering HPV vaccines within dental settings. However, only 9.1% reported comfort discussing sexually transmitted infection-related topics with patients. Regression analysis showed willingness to vaccinate was significantly associated with perceiving HPV prevention as a dental professional role (p < 0.001), while HPV knowledge was not independently associated with willingness to vaccinate.

Implications: Oral health students generally support expanded HPV prevention efforts but may benefit from additional communication training and stronger curricular emphasis on HPV prevention. As Colorado implements dental immunization authority, strengthening HPV vaccination education within oral health programs may support interdisciplinary oral-public health collaboration, expand preventive care workforce capacity, and improve access to cancer prevention services. Future work will evaluate educational and systems-level implementation strategies to prepare oral health professionals for vaccine delivery.

Background/Purpose: Urban heat islands accelerate ground-level ozone formation through photochemical reactions, creating compound exposures that increase asthma emergency visits by 6–8% per 1°C temperature rise. This study examines how surface temperature, ozone, and built environment factors jointly drive asthma prevalence across New York City.

Methods: Asthma prevalence for 2,071 Census Tracts was obtained from the CDC 500 Cities database. Fifteen indicators were integrated — including spring and winter land surface temperature (Landsat), ozone concentration, building density, land use mix, employment accessibility, food environment access, income, car ownership, and race/ethnicity. Ordinary Least Squares (OLS) and Multiscale Geographically Weighted Regression (MGWR) captured spatial heterogeneity across scales. XGBoost-SHAP analysis identified non-linear predictor importance and interaction effects beyond the capacity of regression models.

Results: MGWR substantially outperformed OLS (R²≈0.90 vs. 0.47), confirming significant spatial non-stationarity in the built and social environmental drivers of asthma prevalence. correlation analysis indicating significant seasonal variation in the thermal environment's effect on asthma risk. MGWR assigns each predictor its own optimal bandwidth; smaller bandwidths indicate more localized effects. High-income proportion was the strongest factor (bandwidth=56, most localized), while car-free household proportion showed the strongest positive association with asthma (bandwidth=2,000, city-wide). Black/non-Hispanic population share significantly elevated asthma burden at a meso-scale (bandwidth = 500), reflecting persistent spatial inequities linked to historical residential segregation. Preliminary SHAP analysis further identified non-linear threshold effects, where asthma risk accelerates significantly above critical ozone concentration levels.

Implications: Heat and ozone co-exposure create spatially concentrated asthma disparities in low-income, minority neighborhoods. MGWR and SHAP together pinpoint where cooling infrastructure, street greening, and transit interventions can most effectively reduce asthma burden.

Long COVID is a complex and emerging chronic condition. Patients frequently encounter provider interactions in healthcare settings where symptoms are invalidated, downplayed, or dismissed, a phenomenon known as medical gaslighting. This research sought to analyze if having symptoms of Long COVID was associated with higher odds of experiencing medical gaslighting, hypothesizing that it would be. Perceived reasons for this medical gaslighting were further examined in those with Long COVID symptoms and those without. This addresses the need for continued exploration of the Long COVID patient experience through quantitative data analysis, providing information specific to the Colorado population and relevant to Colorado health practitioners.

This study utilized data from the 2025 Colorado Health Access Survey, a cross-sectional survey of Colorado that employed oversampling and population weighting to improve representation. This analysis included 3,782 individuals. Covariates evaluated include age, gender, race, and insurance type. The analysis utilized multivariate logistic regression models to estimate prevalence odds ratios. Additionally, secondary sub-analyses used logistic regression on a subset of participants (N=454) which examined perceived reasons for medical gaslighting.

This analysis found that those with Long COVID symptoms had 3.06 times the odds [95% CI: 2.42, 3.86] of experiencing medical gaslighting in comparison to those without. Further, these individuals had 2.40 times higher odds of feeling ignored, 1.94 times higher odds of feeling that they were not provided with a treatment plan or referral, and 1.67 times higher odds of feeling that their symptoms were attributed to mental health.

This analysis demonstrates that patients with Long COVID face significant challenges in receiving care, further examining the reasons that these patients felt that they were ignored, dismissed, or had their medical concerns go unaddressed. This work aims to be integrated into Colorado health practitioner training to shape the landscape of Long COVID diagnosis and treatment.

BACKGROUND: Recently-enacted cuts in government funding for Medicaid, public health, and social service programs threaten to increase uncompensated medical care and medical debt levels as more people lose insurance coverage, experience preventable health conditions and seek treatment in costly emergency department and hospital settings. Intentional efforts to align medical, social, and public health delivery systems can help communities share resources and mitigate these problems. We use novel data from the National Longitudinal Survey of Public Health Systems (NALSYS) to identify which communities have achieved strong alignment among these different systems, and to quantify the health end economic benefits of this alignment.

METHODS: We followed a national sample of 618 U.S. communities using NALSYS collected approximately every two years from 2014 through 2026, including 32 Colorado communities. Public health officials reported information about the implementation of 20 guideline-recommended public health practices, and the networks of organizations that collaborate to implement each practice, including medical, public health and social service organizations. We constructed network measures of systems alignment in each community, including shared financing, decision-making, and service delivery. We linked NALSYS with contemporaneous CMS data on uncompensated hospital costs and data on medical debt from consumer credit records. Generalized linear models with two-way fixed effects are estimated to assess how changes in system alignment influence uncompensated care and medical debt.

RESULTS: 28% of communities improved system alignment by at least 10 percentage-points (pp) over the 12-year period, while 37% experienced reduced alignment of at least 10 pp. Improved alignment was associated with a 5.9 pp decrease in hospital uncompensated care (p

Background

Emerging and re-emerging infections continue to challenge public health disease control programs. The United States’ measles elimination status is currently at risk of revocation. In 2025, the U.S. had 2,288 cases of measles, compared to 191 in 2015. Local public health must reexamine internal processes and employ more sustainable approaches to time-intensive communicable disease investigations.

Methods

The Denver Department of Public Health & Environment (DDPHE) Epidemiology and Disease Control team has 9 staff tasked with responding to communicable diseases, including measles. DDPHE’s nursing and emergency preparedness programs are also intimately involved in response efforts, as well as colleagues from jurisdictions across the region and The Colorado Department of Public Health & Environment (CDPHE).

Results

Two hundred and fifty contacts were identified in response to a single Denver County infant measles case in 2025. Three additional Denver cases were identified between April and August 2025, totaling 4 cases for the year. Additionally, DDPHE further responded to 520 measles contacts in 2025 and coordinated post-exposure prophylaxis for numerous residents. In response to out-of-jurisdiction cases identified in 2026, DDPHE has already investigated 35 contacts (as of May 2026).

To accommodate increased workloads while maintaining core services, DDPHE has had to thoughtfully adjust investigation methods.

Strategies have included:

* Use of current epidemiologic data to adjust measles testing and assessment criteria
* Use of mHealth surveys and press releases
* Partnership with The Public Health Institute at Denver Health
* Use of CDPHE’s Team EDIT for support
* Prioritization of moderate/high-risk contacts for direct follow-up
* Virtual delivery of quarantine and isolation orders
* Early coordination with neighboring jurisdictions

Implications

Strained budgets and the threat of new and re-emerging diseases continue to stress public health capacity. Methods to create sustainable and practical response strategies are imperative to balance staff burnout and disease prevention in our communities.

Background/Purpose: Following its establishment in 2023, the Adams County Health Department (ACHD) inherited fragmented systems, siloed workflows, and inconsistent data practices that limited coordination, efficiency, and timely decision-making. To build a more resilient and connected public health infrastructure, ACHD launched a Data and Technology Strategic Plan focused on modernizing how data are collected, managed, analyzed, and used across all six divisions of the department.

Methods: ACHD conducted a department-wide assessment to inventory systems, map workflows, and identify opportunities for integration. Through collaboration among internal program staff, community partners, and leadership, ACHD implemented an Integrated Data System, enterprise GIS, standardized governance, automated data pipelines, analytics solutions, and user-centered web applications and data collection tools designed to support diverse public health functions.

Results: Since implementation began, ACHD has developed and modernized more than 1,000 web-based applications and data collection tools supporting operations, epidemiology and data science, nursing, nutrition and family health, strategic health initiatives, and environmental health. Since 2024, the department has fulfilled more than 300 data requests and expanded systems that strengthen surveillance, service coordination, referral management, field operations, reporting, program evaluation, and community health assessment. These efforts have improved operational efficiency, increased access to timely information, strengthened cross-division collaboration, and supported equity-focused, data-driven decision-making.

Implications: ACHD's experience demonstrates how data modernization can strengthen public health by connecting people, programs, and information. Building shared infrastructure, governance, and workforce capacity creates a foundation for stronger collaboration, improved service delivery, and greater organizational resilience.

60-Minute Session Justification: Additional time will support demonstrations of modernization strategies and facilitated discussion on governance, change management, workforce development, and implementation lessons. Participants will identify practical approaches for advancing data modernization and cross-program collaboration within their own organizations.

Background/Purpose:
Local health departments are increasingly expected to make rapid, data-informed decisions, yet adoption of artificial intelligence (AI) tools remains limited due to workforce training gaps and technical barriers. This study examined whether structured AI education improves public health professionals’ confidence and readiness to use no-code forecasting tools. The research addressed two questions: (1) How does AI-focused training influence knowledge and attitudes toward AI in disease forecasting? and (2) Can a no-code platform (Akkio) generate feasible county-level influenza forecasts using weather variables?

Methods:
A quantitative pre–post design was implemented with public health professionals from Douglas and Jefferson Counties, Colorado (n=8). Participants completed a 20-item Likert-scale survey assessing AI literacy, readiness, and trust before and after two structured training sessions. During the sessions, attendees applied historical influenza and weather data within the Akkio no-code AI platform to generate 90-day forecasts. Paired t-tests were used to evaluate changes in survey responses, and forecasting outputs were reviewed for practical interpretability.

Results:
Post-training scores increased across all survey domains. Familiarity with AI-driven forecasting tools increased from a mean of 1.25 (strongly disagree) to 3.75 (agree). Participants reported greater confidence in interpreting AI-generated forecasts and stronger agreement that public health professionals should receive AI training. Forecasting outputs demonstrated feasible short-term influenza projections using temperature-based variables, with higher predicted case trends observed in the 65+ population.

Implications:
No-code AI platforms can reduce technical barriers while enhancing workforce readiness for predictive surveillance. Structured AI education improves confidence and supports responsible integration of forecasting tools into routine public health practice. Expanding AI literacy initiatives may strengthen local preparedness and data-driven decision-making nationwide.

Background/Purpose: Colorado’s newborn hearing screening program works with birthing facilities, audiologists, and other providers to collect data on infant hearing screening and follow-up. The Colorado Department of Public Health and Environment (CDPHE) sends follow-up letters for infants who missed screening or did not pass and require rescreening or additional evaluation. Before this dashboard was completed, quarterly reporting required manual calculation of facility-level and statewide measures, making it time-intensive to present screening performance, follow-up outcomes, timeliness and benchmarking results to both birth facility staff and the Colorado Infant Hearing Advisory Committee (CIHAC). This project aimed to create a more user-friendly system for monitoring newborn hearing screening performance across Colorado.

Methods: As part of CDPHE’s Informatics work, we began the dashboard by writing a stored procedure, designing dashboard tabs, and improving how measures were organized and displayed. Although CIHAC initially requested detailed numeric tables, we recognized that tables alone would not provide a complete picture of statewide performance. The final reporting structure combined tables with visualizations to better communicate trends, outcomes, timeliness, and facility comparisons. This enables users to access the detailed numbers they needed while also observing clearer trends and outcomes. A map-based tool is also being developed to help families identify local hearing screening sites.

Results: The dashboard reduced reliance on manual quarterly preparation, enabled secure access to state and facility-level reports, and improved transparency around facility categorization and comparison to statewide coverages. Denver Health highlighted the dashboard’s accuracy and its value for real-time monitoring. It generated productive conversations with professionals from other states at the 2026 EHDI conference.

Implications: This work shows that user-centered dashboards can reduce reporting burden while making data more actionable. Key takeaways are that combining required tables with visualizations strengthens oversight, supports quality improvement, and improves communication with facilities, program leaders, and advisory stakeholders.

Background: Cytomegalovirus (CMV) is a ubiquitous virus that generally causes minor disease. Congenital CMV (cCMV) causes birth defects in about 20% of infected infants & is the leading non-genetic cause of pediatric hearing loss. Colorado added cCMV as a reportable condition in January 2025.




Methods: Retrospective review of cCMV cases reported to Colorado public health between January 2025-January 2026. We collected data through electronic lab reporting & provider reports, then matched records to vital statistics. We excluded out-of-state records.


Results: 60 reported cases met definition for either confirmed cCMV infection (n=54) or disease (n=6). Females were overrepresented (61.7%). The ethnic distribution of cases mirrored the Colorado population (23% Hispanic, 73% not Hispanic, and 3% unknown). Case racial distribution was 61.7% White, 20% other, 13.3% Black, 3% unknown, & 1.7% Asian.



Discussion: Ten percent of cases presented with signs visible at birth, aligning with reported U.S. rates. While race and ethnicity largely reflected DOLA 2024 population data, we observed a slight under-representation of non-Hispanic White (61.7% vs. 65%) & Asian (1.7% vs. 3.9%) infants, alongside over-representation of Black infants (13.3% vs. 4.3%). Surveillance case rates were 0.94 per 100,000 in the five-county Denver metro area, & 1.08 per 100,000 outside the metro; both figures remain significantly below the national estimate of 4.5 per 1,000 live births, in screening data.




Implications: Colorado’s early cCMV epidemiology for race, ethnicity, & rate of disease at birth is similar to national trends. Our rates overall and female preponderance are different from national estimates.These findings likely indicate a combination of variable testing practices, variation related to the first year of a newly reportable condition, & variation due to a small sample size. Regional epidemiologic differences or changing epidemiology over time may also be factors.