University campuses are diverse ecosystems of students, faculty, and staff, many of whom are involved in the care of children and dependents. College student parents (CSPs) and other campus guardians struggle to find ways to integrate this identity with their campus roles. These challenges include standard access barriers and a sense of belonging to an environment where the focus is to develop and support incoming young adults. Protecting campus guardians and developing a family friendly campus benefits not only the guardians on campus, but all campus community members. A request-driven toy drive (TD) was developed and implemented by students at the University of Northern Colorado to provide support without requiring navigation of institutional barriers. To enhance accessibility, materials were offered in both English and Spanish. The TD was evaluated using a survey that included a sense of belonging (SOB) Likert scale and open-ended questions guided by the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The survey was distributed to TD participants, including volunteers who donated gifts and guardians who received them, all affiliated with the institution (students, staff, and faculty). Qualitative responses were coded using RE-AIM domains, while SOB data were analyzed using descriptive statistics, a one-way ANOVA, and independent samples t-tests. Results for SOB showed no difference between groups but did show that institutional SOB was high. Qualitative results communicated the TD overall was successful in adoption, implementation and maintenance, but had areas of improvement for effectiveness and reach. This study provides important insight into the effectiveness of student-led initiatives, like TDs, in addressing the needs of campus subcommunities who are often traditionally excluded from campus programs, while facilitating opportunities for meaningful campus engagement. This study also demonstrates that the RE-AIM framework can be a useful tool in evaluating low-barrier charity programs.
Madison is a Master of Public Health candidate in the Colorado School of Public Health Community Health Education concentration at the University of Northern Colorado (UNC). She has a BS in Biomedical Sciences from UNC, and is passionate about student research and authorship which... Read More →
Sarah C Jackson is a master's in public health graduate from the Colorado School of Public Health with a concentration in Community Health Education and a Maternal and Child Health certificate. Deeply passionate about empowering communities by integrating health education and community... Read More →
Background: Public health accreditation is positioned as a powerful driver of performance and quality improvement, accountability, and community impact. This presentation explores how accreditation through the Public Health Accreditation Board (PHAB) strengthens health departments by advancing key Foundational Capabilities, including Assessment & Planning, Communications, Policy Development & Support, and Organizational Competencies. Through real-world examples, attendees will gain insight into how accreditation fosters a culture of continuous quality improvement, enhances cross-sector partnerships, and supports data-driven decision-making.
In addition to accreditation, the presentation will introduce PHAB’s broader suite of services and resources that support agencies at all stages. From exploring resources to strengthen Foundational Capabilities, to assessing accreditation readiness, to maintaining accreditation status, to embedding continuous quality improvement efforts throughout daily operations, attendees will gain insight to the many benefits of being PHAB accredited.
methods: In alignment with Colorado’s Core Public Health Services, this session will highlight how departments aligned with PHAB’s standards are better equipped for Communicable Disease Control, Chronic Disease Prevention, and Emergency Preparedness. Particular emphasis will be placed on the role of accreditation in embedding health equity in public health programming.
implications: Aligned with the conference theme, Stronger Together: Public Health in the Heart of the Rockies, this session emphasizes benefit of collaboration between local health departments across the State of Colorado through Partnership and Resource Sharing and benefits of Accreditation.
Alcohol is a leading underlying cause of injury, illnesses, and premature death in Colorado. This session will focus on identifying ways to effectively communicate and intervene to decrease alcohol’s harms in areas outside of the Denver metro area. The session will begin with a review of quantitative epidemiologic data on the alcohol’s adverse health impacts on key health outcomes (injuries, hospitalizations, Emergency Department visits, deaths) and access to care for substance use disorders in areas outside the metro area. There will then be a panel discussion of the qualitative impacts of alcohol, including ways to communicate about these harms, and promising policy interventions. Alcohol has serious adverse health outcomes in areas outside the Denver metro area. Interventions will require statewide support, so we need effective methods for communicating about alcohol to rural areas. Ways to promote attendee interaction and discussion – We will assure that there will be at least 30 minutes for the panel discussion, including time for comments and questions from attendees.
Background: Public health policies, including tobacco regulations, are powerful tools for promoting health equity and behavior change. Since 2019, several Colorado communities have enacted policies to prohibit flavored nicotine sales to curb youth consumption. However, evaluating local impacts is challenging; standard behavioral surveys lack geographic granularity, and sales tax data is only available at the state level. Using data from a longitudinal panel of Colorado adults, we examined awareness of local flavor ordinances stratified by geographic region, nicotine use, and demographics.
Methods: The Colorado Health Survey is administered once every three years to a random sample of Colorado adults, with consenting participants joining a longitudinal panel that is surveyed annually. In 2026, 11,340 panelists were invited to complete a survey that includes questions about local flavor ordinances. Although recruitment is active through June 30, 2026, we have identified 896 current respondents residing in communities with post-2019 ordinances. Awareness estimates were stratified by current, former, or never nicotine use. Final descriptive statistics will be generated upon recruitment completion.
Results: Overall, 33% (293/896) of participants were aware of their local ordinance. Awareness was significantly higher among current nicotine users at 60% (56/94), compared to 30% (84/286) of former users and 30% (153/515) of never-users (p < 0.05).
Implications: Preliminary results indicate that current nicotine users—the primary target of these regulations—are most aware of local policies. Final analyses will demonstrate the degree to which Colorado adults are sensitive to local tobacco policies and illustrate how awareness varies across geographic and demographic strata to inform future municipal policy design.
MSW, Colorado Department of Public Health and Environment
Jill Benarek is the Tobacco Policy Initiatives Supervisor at the Colorado Department of Public Health and Environment. She directs youth tobacco prevention and secondhand smoke initiatives for the State Tobacco Education and Prevention Partnership. Jill has worked in tobacco control... Read More →
Sara Cooper is the Director of the Community Epidemiology and Program Evaluation Group (CEPEG) and a Senior Clinical Instructor in the Department of Community and Behavioral Health in the Colorado School of Public Health. With over 25 years of experience in Survey Research, and both... Read More →
Community health assessments and community health improvement plans (CHA/CHIPs) are essential tools for public health accreditation, community benefit, funding alignment, and shared action. Yet many agencies and partners experience these processes as time-intensive compliance exercises that result in reports but do not always translate into feasible, measurable improvement strategies. This session will showcase a practical approach for streamlining CHA/CHIP work while strengthening equity, data use, cross-sector partnership, and implementation readiness.
HMA and Metopio have developed and refined a set of CHA/CHIP tools and methods, including engagement instruments, survey approaches, qualitative and quantitative analysis processes, dashboard and reporting products, governance structures, and CHIP implementation and performance measurement templates. These methods draw from MAPP 2.0 principles and experience supporting local public health agencies, hospitals, regional collaboratives, and community partners. The session will present examples of how teams can integrate secondary data, community voice, facilitation, priority setting, and action planning into a more coherent and lower-burden process.
Participants will leave with practical takeaways about how to select data for specific decisions, align assessment findings with community priorities, move from findings to measurable strategies, and design processes that support both accountability and shared ownership. We are requesting a 1-hour session because the topic requires both presentation of examples and meaningful peer discussion. The additional time will be used for an interactive scenario-based exercise in which participants discuss what data they would choose, for what purpose, and how those choices shape priority setting and implementation. At least 15 minutes will be reserved for facilitated discussion and audience exchange.
Robyn Odendahl is a Principal at Health Management Associates (HMA) with expertise in community health assessment and improvement planning, stakeholder engagement, research and evaluation, facilitation, and strategic planning. She partners with public health agencies, healthcare organizations... Read More →
Jodi L. Radke is the Regional Director for the Rocky Mountain/Great Plains Region with the Campaign for Tobacco-Free Kids. Jodi manages tobacco control policy for nine states, promoting and supporting legislation that prevents kids from starting tobacco use and assisting adults that... Read More →
The Marshall Fire Resilience Work Group was formed in early 2022 in response to Colorado’s most destructive wildfire to date, which destroyed over 1,000 homes in Boulder County at the end of December, 2021. Since its formation, the group has conducted a multi-wave household survey, interviews with community members and local-decision makers, policy analyses, and focus groups. Core values of the group are producing collaborative research based on these data, collecting data in a community-engaged and trauma-informed manner, and disseminating results back to community, government agencies, and other researchers on a regular basis.
As the 5 year anniversary of the Marshall Fire draws near, this poster will serve as a look back at the practical successes and challenges to managing such a work group. In particular, this session will focus on the following:
1. The reasoning behind the work group’s design, how it supports community needs and rigorous science, and why this model could serve other natural disaster research contexts.
2. When and how different sectors have been engaged throughout the work group’s history.
3. An overview of research products the group has produced and feedback the work group has received over time
4. Strategies to keeping team members engaged over time as well as the practical needs for managing and sharing diverse and complex data within the team.
Background: Access to maternal healthcare is essential for strong maternal and infant health, yet rural communities often face barriers to adequate care. This study investigates how maternal healthcare accessibility varies by rurality across Colorado counties and its impact on birth outcomes. We hypothesize that greater distance traveled to access maternal healthcare is associated with poorer birth outcomes, proving a need for addressing this lack in health equity.
Methods: Using county-level data from the Colorado Department of Public Health and Environment (CDPHE) and the Colorado Hospital Association (CHA), we analyzed distance traveled to maternal healthcare facilities, rurality classifications, and infant health outcomes during the period between 2015 and 2024. We assessed the relationship between distance traveled and annual birth defects and preterm birth counts by county using Quasi-Poisson regression models, adjusting for county-level percentage of Women, Infants, and Children (WIC) participation, percentage of births on Medicaid, and an offset for all annual births in each county.
Results: Distance traveled to access maternal healthcare is higher among rural counties (median = 40 miles) compared to urban counties (median = 5 miles). Quasi-Poisson models indicated that an interquartile range (IQR) increase in distance traveled (32 miles) was associated with a 24% increase (95% confidence interval (CI): 0.5%, 53%) in birth defects and a 5.5% increase (95% CI: 0.8%, 10%) in preterm births in rural counties. Corresponding results for urban counterparts were attenuated.
Implications: Our findings indicate that limited access to maternal healthcare independently predicts poorer birth outcomes. Maternal care deserts are predominantly located in rural areas, and our research underscores geographic disparities as a key driver of health inequities affecting rural Colorado families. These findings demonstrate the need for public health efforts toward fostering equitable maternal and infant health outcomes across Colorado.
Tatum is a Master of Public Health candidate in the Colorado School of Public Health at Colorado State University, concentrating in Health Communication. Her research interests are in healthcare accessibility, rural health, maternal health, and health equity.
Background/Purpose: Carbapenem-resistant Enterobacterales (CRE) infections are a major healthcare concern. We compared risk factors, comorbidities, and outcomes of invasive and noninvasive CRE infections among a patient cohort identified through the Centers for Disease Control and Prevention’s Emerging Infections Program Healthcare-Associated Infections Community Interface.
Methods: We defined incident CRE cases as Enterobacterales resistant to one or more carbapenems from normally sterile sites or urine among Denver metropolitan area residents between 2013 and 2024. We categorized exposures as invasive (normally sterile site) or noninvasive (urine only) CRE infection. Outcomes included hospitalization on the day of incident specimen collection (DISC) or 29 days after, ICU admission within seven days of DISC, post-acute care, and mortality. We compared demographics, age-adjusted Charlson comorbidity index (ACCI), risk factors, and outcomes using t-tests and Chi-square tests.
Results: Among 1,104 incident CRE cases, (968 patients) 215 (19.5%) were invasive. Compared to noninvasive cases, invasive cases were predominantly male (63.7% vs. 36.8%, p
Background/Purpose: Overdose prevention efforts increasingly rely on community-based organizations to provide low-barrier, relationship-centered services that reach people underserved by traditional healthcare systems. This poster presents findings from the Denver Department of Public Health & Environment’s (DDPHE) Year 3 evaluation of selected activities within the CDC-funded Overdose Data to Action (OD2A) program, including overdose prevention education and supply distribution, linkage to care, and drug checking efforts. The evaluation examined how these services were implemented across Denver communities and identified factors that supported or hindered engagement in overdose prevention efforts. It also explored how community partnerships, peer-led outreach, and low-barrier approaches contributed to equitable, community-informed overdose prevention.
Methods: Using a qualitative, implementation-focused evaluation approach, DDPHE conducted interviews with 18 community-based organizations, outreach workers, peer staff, and public health partners involved in overdose prevention services. Interviews were recorded and transcribed in full. Evaluators used a combined deductive and inductive thematic approach to identify implementation strengths, barriers, and recommendations for future program improvement.
Results: Participants emphasized that trust, dignity, peer support, and nonjudgmental care were central to successful overdose prevention efforts. Partnerships supported access to naloxone, safer use supplies, behavioral health services, and referrals to care. Persistent barriers included housing instability, stigma, transportation challenges, criminalization, staff capacity, and delays in sharing drug checking results. Participants also identified gaps in reaching some communities, particularly communities of color and individuals outside current outreach areas. Recommendations included expanding outreach, strengthening referral systems, increasing staffing and training, and improving drug checking infrastructure.
Implications: Findings point to the need for stronger systems coordination, more responsive drug checking infrastructure, and reduced administrative burden for community partners. Recommendations include investing in faster local testing capacity, strengthening referral and follow-up systems, improving real-time public communication of drug trends, and expanding culturally responsive outreach approaches to support equitable and sustainable overdose prevention efforts.
Social networks in minoritized communities are not peripheral to health systems; they are the primary structures through which care becomes possible amid structural inequities. This study conceptualizes social networks not simply as interpersonal connections but as critical health infrastructures that shape health experiences, including how health is understood and how communities collectively respond to inequities (Perry & Pescosolido, 2015). In these contexts, social networks serve as essential mechanisms for navigating systems that often define health in fragmented, exclusionary, or culturally misaligned ways.
The meaning of health is shaped through interactions within social networks and the health system, rather than residing solely within individuals or collectives. It is recognized, negotiated, and supported by family, peers, communities, and institutions, making it inherently relational. This study shifts from a purely behavioral focus to a meaning-centered approach, integrating relational processes across levels with social network structures, and centering communities that are often underrepresented in network-health research. Focusing on Latine, Vietnamese, and Native communities in a highly diverse urban neighborhood in Colorado, we examine how health emerges at the intersection of personal experience, shared contexts, and interactions with health systems.
This mixed-methods study combines unstructured, relational interviews with social network analysis (SNA) surveys, integrating ethnographic and survey approaches simultaneously. This ethnosurveys design captures the complexity of multilevel data, including life histories and relational contexts, allowing for a more nuanced understanding of lived experience.
Public health officials, education leaders, policymakers, and community advocates discuss and worry about outcomes of systemic structural factors or interpersonal experiences of discrimination. However, the structural mechanisms governing our closest relationships often remain unrecognized. We seek to bring focus to the impact of local social structures on meaning-making and resource mobilization, to elevate opportunities for interventions that, when enacted locally and informed by local social structures, can build solutions to population health challenges.
Paulina Erices-Ocampo is a Ph.D. candidate in Health and Behavioral Science at the University of Colorado Denver, holding a B.A. in Organizational Psychology from Penn State and an M.A. in Organizational Development from the University of Denver. An International Board Certified Lactation... Read More →
Background: Helicobacter pylori (H. pylori) is a gram negative bacterium that thrives in acid rich environments like the stomach. Once inside a host's stomach, it causes a chronic infection that predisposes the host to gastrointestinal illness including gastric cancers (Vakil, 2025). Recognizing routes of transmission of H. pylori and employing interventions to prevent transmission is important for gastric cancer prevention.
Purpose: The purpose of this presentation is to summarize routes of transmission of H. pylori and to discuss the public health strategies that can be used to reduce its transmission.
Methods: A scoping literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses-Scoping Reviews (PRISMA-ScR) process. Search engines included Academic Search Complete, Medline, and Cummulative Index to Nursing and Allied Health Literature - Complete (CINAHL Complete). Inclusion criteria included peer reviewed articles published in the past five years, written in English, available in full text, and focused on routes of transmission. Articles were reviewed first with an abstract review and then a full text review. A literature matrix was developed and articles were synthesized to identify transmission routes.
Results: Results suggest that there are five primary routes: fecal-oral, oral-oral, gastric-oral, anal-oral, and genital-oral. Exposures result from person-to-person, animal-to-human, foodborne, and occupational exposures. We describe evidence-based strategies to decrease H. pylori transmissions.
Implications: Decreasing H. pylori transmission has the possibility to reduce gastrointestinal illnesses, including gastric cancer, caused by H. pylori infection. Public health professionals have the capacity to employ strategies to decrease H. pylori infections, thereby improving the health among at-risk populatioins.
Kathleen Hall PhD, APRN, GNP-BC, AGPCNP-BC Dr. Hall obtained her PhD and MS degrees from the University of Arizona. Her area of research focuses on health promotion and disease prevention in vulnerable populations. She teaches in the nurse practitioner program at Colorado Mesa University... Read More →
Public health coalitions are essential for community-level prevention, yet evaluation methods on effective coalition functioning remain unsystematic. This study investigated which coalition characteristics most effectively drive motivation to ensure the success of the Community Organizing for Prevention (COFP) program within their community, measured by the COFP coalition survey.
Methods
Data were collected from 380 coalition members across 26 community coalitions within the COFP program. Using site-level aggregation, we analyzed 14 independent variables (IVs) across three components: Broadening the Power Base, Organized Community, and Collective Impact. To identify the organizational drivers of coalitions’ motivation to ensure the success of COFP, a variable-specific median split strategy was used. For each IV, sites were ranked in descending order of mean scores to create high and low performing groups. Welch’s Independent Samples T-tests were then used to identify statistically significant mean differences and standard deviations in motivation scores.
Results
Ten of 14 variables showed statistically significant associations with increased motivation (p < 0.05). The largest motivation differences were found in Goal Directedness (0.35) and Coalition Decision Making (0.31). Across variables, high-scoring sites exhibited a narrower standard deviation range (0.11–0.22) compared to low-scoring sites (0.26–0.33), suggesting that better-functioning coalitions are more motivated to ensure success of the COFP program.
Implication
A relationship exists between coalitions’ motivation for successful implementation of the COFP program and effective coalition functioning. By prioritizing coalition functioning, broadening the power base, and collective impact, coalitions may strengthen motivation for success and increase the probability of achieving long-term community impact. These findings may help establish a strategic example set of significant functional drivers for coalitions to focus on. This work aligns with the Stronger Together theme by providing a data-driven list of functional drivers of coalition motivation for building resilient and aligned public health coalitions.
This session examines how the Consolidated Framework for Implementation Research (CFIR) was applied within a statewide communicable disease needs assessment and strategic planning process in rural Wyoming. Rural public health systems face unique challenges related to geography, workforce limitations, stigma, funding instability, confidentiality concerns, and fragmented access to care. The purpose of this project was to identify barriers and facilitators influencing communicable disease prevention, testing, treatment, and service delivery, and to develop a data-informed strategic plan responsive to local context and system capacity.
Methods included a mixed methods approach integrating epidemiological surveillance data, provider interviews, listening sessions, stakeholder engagement, surveys, and systems-level analysis. Participants included healthcare providers, public health professionals, community stakeholders, and Wyoming residents. CFIR-guided protocol development, qualitative inquiry, data organization, and interpretation of implementation barriers and facilitators in rural settings. The framework also supported accelerated analytic processes following delays caused by disruptions to government funding.
Findings demonstrated that geographic isolation, workforce shortages, stigma, inconsistent service availability, and structural barriers continue to influence communicable disease outcomes and care-seeking behaviors in rural communities. Results also highlighted the importance of community engagement, cross-sector collaboration, and localized approaches when translating surveillance data into actionable public health strategies.
Attendees will leave with practical strategies for integrating implementation science and mixed methods approaches into needs assessments, strategic planning, and public health practice. The requested 1-hour format allows additional time for discussion of real-world CFIR applications, audience engagement on implementation challenges, and collaborative dialogue on adaptable strategies for rural and resource-limited systems.
Here, we present a clinical initiative to proactively identify patients with HCV who have clinical encounters within a large healthcare system in Colorado (UCHealth) and connect them with treatment using a dedicated care navigator.
A repository of patients previously diagnosed with HCV who were hospitalized was created by extracting positive HCV PCR test results from the electronic health record (EHR) for patients hospitalized between Jan 1, 2025 and Dec 31st, 2025. In addition, the care navigator queried the EHR weekly to identify patients with newly positive HCV PCR over the past 7 days. The care navigator then reviewed the charts of all identified patients to determine whether each patient had already been linked to HCV care.
Results are preliminary as this project is ongoing. Of 297 charts reviewed, 20.5% were not yet connected with care and were eligible for inclusion. Of other 236 patients, 198 (83.9%) were already encaged in care and 15 (6.4%) were deceased. To date, 55 patients have attempted contact. 25 were unreachable (49%), which meant that they no longer had an operational phone number, or I was unable to leave a message. 11 (21.6%) answered the phone and, of those, 8 were interested in care navigation. 1 was successfully connected with care. The patient mix is 66% male, 33.3% female, 0.3% non-binary, and 0.3% trans female.
Preliminary results demonstrate that many patients with HCV encountered in acute care settings have unique barriers to treatment. Medical and social barriers to care were frequently encountered barriers to linkage to HCV care. Although our findings demonstrate the potential challenges of initiatives targeting high-risk patient populations that may not be receiving longitudinal care, they also highlight the importance of leveraging any clinical opportunity to engage patients in care, including emergency department and inpatient hospitalization encounters.
Background. The Colorado Pay for Performance (P4P) program provides funding to long-term care facilities that meet specific quality measures in antimicrobial stewardship (AS) and infection prevention and control (IPC). To support these initiatives, the Colorado Department of Public Health and Environment (CDPHE) partnered with the Department of Health Care Policy and Financing (HCPF) to deliver statewide training in implementation of AS and IPC initiatives to nursing homes and assisted living residences.
Method. We conducted two 90-minute virtual training sessions in June and October 2025. We collaborated with the Colorado Health Care Association and Center for Assisted Living (CHCA) and Telligen (a Quality Innovation Network-Quality Improvement Organization) to promote the events. The curricula focused on AS, catheter-associated urinary tract infection prevention, enhanced barrier precautions, and the Centers for Disease Control and Prevention’s Infection Control Assessment and Response tools. We used post-training surveys to evaluate content relevance, participant confidence, and future educational needs.
Results. A total of 210 participants from 130 facilities across 116 zip codes attended the June (n=116) and October (n=94) sessions, with five attending both (Figure 1). The most frequent roles included infection preventionists (26%), directors (18%), and registered nurses (16%) (Figure 2). Among 44 survey respondents, the most applicable topics were EBP, IPC modules, and personal protective equipment. The median confidence score for applying the training was 4 (range: 1-5). Respondents expressed the most interest in future training regarding EBP, AS, and multidrug-resistant organisms.
Conclusions. Linking public health training to existing P4P incentives enabled broad educational reach across a geographically diverse provider population. This interagency partnership successfully engaged a multidisciplinary workforce and increased participant confidence in implementing IPC and AS initiatives. This model demonstrates how leveraging financial incentives can effectively align state-level public health goals with facility-level quality improvement.
Tuberculosis (TB) remains the number one cause of mortality from an infectious disease globally. Malnutrition is both a driver and a result of TB and is associated with disease progression and unfavorable treatment outcomes.
Methods:
We reviewed medical charts for people starting treatment for active TB in seven Colorado counties to describe the prevalence of malnutrition and its association with selected demographic, clinical, and social factors. Malnutrition was defined as body mass index (BMI) 5% of total body weight in 6 months or >10% at any time point.
Results:
Eighty-three patients began treatment in 2025. Of these, 17 (20%) met our definition of malnutrition. Ten patients had a BMI
Background/Purpose: MA enrollment has grown rapidly nationwide and now represents a majority of Medicare enrollment in Colorado. As enrollment patterns change, understanding differences in utilization and spending between MA and TM populations is increasingly important for public health planning, health system decision-making, and policy discussions. This study evaluated enrollment growth, utilization, and spending trends among Colorado MA and TM beneficiaries from 2018–2024.
Methods: Researchers conducted a retrospective claims-based analysis using CO APCD data from 2018–2024 among MA and TM beneficiaries. Outcomes included inpatient hospitalizations, emergency department (ED) visits, 30-day readmissions, and per member per month (PMPM) medical spending. Measures were evaluated annually to assess changes over time and compare across coverage types.
Results: Between 2018 and 2024, MA enrollment increased from 353,232 to 584,992 beneficiaries, while TM enrollment declined from 590,970 to 544,954. By 2024, MA represented approximately 52% of the combined MA and TM population. TM beneficiaries consistently demonstrated higher inpatient hospitalization and 30-day readmission rates. Hospitalization rates declined in both populations, from 138 to 111 per 1,000 in MA and 182 to 145 in TM. PMPM medical spending increased overtime in both programs; however, MA spending remained consistently higher despite lower inpatient utilization, suggesting important differences in care delivery, pricing, or service mix.
Implications:
As MA enrollment continues to grow, differences in utilization and spending patterns between MA and TM populations may increasingly influence Medicare spending, access, health care delivery, and future policy discussions across Colorado communities. Findings from this analysis highlight the importance of using statewide claims data to support collaborative public health and policy planning.
As part of Colorado's largest safety-net hospital system, the Infectious Disease Clinic at Denver Health provides primary care for patients living with HIV and follow-up care for other serious infections. The clinic experiences a 20% no-show rate for appointment outcomes, defined by an unanticipated patient absence from a scheduled appointment. Missed appointments disrupt care continuity and clinic efficiency. This analysis evaluated demographic, appointment, and access-related characteristics associated with no-show outcomes to ensure standard reminder procedures meet the diverse needs of the patient population.
Methods:
We examined 22,904 scheduled appointments for 3,253 patients seen at the Infectious Disease clinic between January 2024 and June 2025. We used multivariable log binomial regression, clustered by patient, to assess the associations between age, race/ethnicity, prior no-show history, appointment lead time, time of day, day of week, insurance type, and distance to clinic with a no-show outcome.
Results:
When evaluating these characteristics, we found that younger patients (17–25 years) had the highest risk of a no-show outcome compared to those aged ≥66 years [adjusted risk ratio (aRR)=2.34, 95% confidence interval (CI): 1.86–2.93]. Hispanic and Black, non-Hispanic patients had higher risk than White, non-Hispanic patients (Hispanic aRR=1.33, CI: 1.20–1.48; and Black, non-Hispanic aRR=1.35, CI: 1.19–1.53). Patients with Medicare/Medicaid/financial assistance had a higher risk of a no-show outcome compared to commercial insurance holders (aRR=1.82, CI: 1.66–1.99). Prior no-show outcomes within 365 days (aRR=1.36, CI: 1.26–1.46) and scheduling appointments >31 days in advance (aRR=2.68, CI: 2.35–3.05) were also associated with an increased risk of a no-show outcome.
Implications:
The risk of a no-show outcome varies across patient subgroups and appointment characteristics, indicating that uniform reminder strategies are insufficient. Targeted, equity-focused interventions addressing structural and behavioral barriers may improve attendance, clinic efficiency, and continuity of care.
Ashley Bader (she/her) is a Data Scientist on the Data Science and Informatics team at the Public Health Institute at Denver Health. Her work focuses on transforming clinical and operational data into reports that support quality improvement projects, program evaluation, and grant... Read More →
Background / Purpose: The COVID-19 pandemic disrupted multiple aspects of community health, including mental health, healthcare access, physical activity, and household economic stability. Although data collected in 2022 do not reflect current conditions in 2026, they provide an important early post-pandemic baseline to identify local public health priorities and populations requiring continued monitoring. This study used the 2022 Larimer County Community Health Survey to describe key community health needs and inform potential areas for local intervention.
Methods: A weighted descriptive analysis was conducted using 2,700 adult respondents from the 2022 Larimer County Community Health Survey. Survey weights were applied to improve representativeness. Main outcomes included frequent mental distress, diagnosed mental or psychosocial condition, food insecurity, physical inactivity, skipped dental or medical care during the pandemic period, and healthcare access barriers. Weighted prevalence estimates and 95% confidence intervals were calculated overall and stratified by age, gender, income, education, and food insecurity status.
Results: In weighted analysis, 38.5% of respondents reported a diagnosed mental or psychosocial condition, 38.7% were physically inactive, 31.8% skipped dental or medical care during the pandemic period, and 25.5% reported frequent mental distress. Adults younger than 65 years, women, low-income residents, and food-insecure individuals consistently showed higher burden across multiple outcomes. Residents at or below 100% of the federal poverty level had substantially higher prevalence of food insecurity (37.6% vs. 2.3%), physical inactivity (60.0% vs. 34.5%), skipped care (51.5% vs. 28.1%), and mental distress (41.0% vs. 20.0%) compared with residents above 400% FPL.
Implications: Findings highlight important early post-pandemic public health needs in Larimer County. Results support targeted interventions focused on mental health, food security, healthcare access, and low-cost physical activity programs, particularly for younger adults, women, low-income, and food-insecure populations. Comparison with 2025 Health Survey may help assess whether these differences persisted or changed over time.
PhD Candidate, Animal Population Health Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University
Sami Bahadur completed a DVM and a Master’s in Pathology in Pakistan and is currently pursuing a PhD in Clinical Sciences with a focus on Epidemiology at Colorado State University through the Fulbright Program. He has a strong background in veterinary medicine, public health, and... Read More →
This session highlights a public health initiative aimed at improving clinical safety, reducing environmental impact, and lowering costs through the transition from single‑use to reusable sharps containers. The purpose of this work was to examine safety concerns related to sharps‑handling incidents across clinical and off‑site settings, assess the environmental burden of disposing nearly 1,000 pounds of plastic waste annually, and evaluate whether a reusable sharps container system could address these needs while remaining cost‑effective. Methods included reviewing documented safety events among clinical staff, analyzing workflow patterns for sharps container use across Sexual Health, Immunizations, WIC, school‑based, and community programs, and conducting a cost and waste assessment comparing single‑use and reusable systems. Data was drawn from staff reports, vendor contract information, and clinic utilization patterns. Results showed repeated safety incidents involving overfilled or unsecured sharps containers, a large annual plastic waste footprint from single‑use containers, and a projected cost savings of approximately $8,081.55 or more per year with reusable containers. Transitioning to reusable containers also reduces staff exposure risks by providing secure, vendor‑maintained units that can be safely swapped on site. Implications for public health professionals include recognizing how operational decisions directly influence staff safety, environmental sustainability, and program costs. Participants will leave with actionable insights into how sustainable systems can be integrated into clinical operations without added burden, how to evaluate similar waste‑stream challenges within their own organizations, and how small‑scale system improvements can contribute to broader public health goals in environmental stewardship, worker protection, and resource optimization.
Talitha Appel is a registered nurse who serves as the Associate Director of Community Health Nursing at Arapahoe County Public Health, where she oversees the Community Health Nursing Operations team, including informatics, billing, and Employee Health & Wellness. Talitha is currently... Read More →
Background: Unsafe storage of firearms in households with children is associated with increased risk of suicide and unintentional injury. Since 2015, numerous states have passed Child Access Prevention laws (CAP laws) to reduce youth access to firearms. This study examines the association of CAP laws on unsafe gun storage among US households with children.
Methods: A blocked cross-sectional study was conducted using household responses from the United States Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS). The study sample included 22,979 households in 2017, 2021, 2022, 2023, and 2024 that reported having children and firearms present in the home. States were categorized based on having a CAP law in effect during survey years. The primary outcome was self-reported unsafe firearm storage. Differences in unsafe storage between CAP law states and non-CAP law states were estimated with a 95% confidence interval.
Results: Households in states with CAP laws reported a 5.85% decrease in unsafe gun storage compared to states without CAP laws (95% CI, 5.09%-6.61%). However, data restricted to the years 2017 and 2021 did not indicate a significant difference, indicating nuance in the data.
Implications: CAP laws are associated with a decrease in reported rates of unsafe gun storage in households with children. Prior studies have suggested that decreasing access to lethal means of suicide has a significant impact on reducing youth suicide mortality. Variability in sections of the data suggests that although CAP laws should be included included in youth suicide prevention measures, complimentary interventions like physician counseling and public education should likely be considered a well.
Background/Purpose: Social media influencers (SMIs) are increasingly shaping how individuals with health conditions access information about their health, engage with online support systems, and engage in behaviors and treatment. Online health communities are becoming pivotal spaces for health education, support, and behavioral influence. This ongoing mixed-methods study investigates health communication among four health conditions: arthritis, diabetes, perinatal mental health, and neurodiverse parenting. Based on the elaboration likelihood model, we aim to understand the interaction of influencer characteristics and communication styles with audience trust, engagement, and health behavior change.
Methods: Participants included SMIs and their followers and were recruited from Instagram. Influencers were invited to complete a survey, participate in a qualitative interview, and facilitate recruitment of their followers. Followers also completed a survey, and a subset participated in focus group interviews. We will use qualitative and quantitative approaches to understand the relationships between influencer characteristics, audience trust, involvement, and self-reported behavioral engagement.
Projected Results: Preliminary observations suggest that online health communities respond significantly differently to digital health research and influencer-based communication. Researchers anticipate that influencers who are viewed as more trustworthy, relatable, knowledgeable, and connected to their communities may encourage greater audience engagement and participation within online spaces.
Implications: Findings from this work may help shape future public health communication efforts within digital spaces. By better understanding how people build trust, engage with health content, and connect within online communities, researchers and public health professionals can develop more effective and community-centered approaches to digital health outreach, education, and support.
Emergency response in a war zone is a challenge for first responders and public health workers, requiring a highly collaborative and coordinated response. Practitioners must be able to provide care with limited resources, often with additional challenges including limited access to resources such as power, fuel, transportation, equipment, supplies and volunteers. In this poster, an early response to the Russian invasion in Ukraine is described where a veterinary tent is set up at a border station on the Danube River in Romania. The following year, a mobile veterinary clinic is built in Arizona and deployed to the front lines of Ukraine. Implications of the migration of over six million Ukrainian refugees, and their pets, must be considered in regard to the spread of zoonotic and other infectious disease during the early stages of the conflict.
