One of the three MCH strategic anchors is community inclusion. Community refers to the people who are most impacted by inequities resulting from geography, race and ethnicity, immigration status, language, sexual orientation, gender identity, socioeconomic status, and other structurally marginalized identities. Colorado uses the de Beaumont Foundation’s definition of community inclusion as “an authentic, mutually beneficial, and collaborative process of working to address issues that affect the health and well-being of particular communities, which often involves prioritizing health equity. Community engagement exists on a spectrum; involves equitable distribution of decision-making power and a focus on community partnering and collaboration; and is rooted in trust and respect.” Colorado’s MCH program implements multiple strategies to support inclusion amongst youth, families and community members who reflect the MCH population in achieving positive outcomes across the life course. This includes:

• MCH Community Inclusion Specialist
• Community Advisory Board
• Youth Partnership for Health
• Youth Advisors
• Family Leader Engagement

CDPHE Community Advisory Board (CAB)

In 2018, Colorado’s MCH program identified that a formal infrastructure for community inclusion and engagement would strengthen MCH priority implementation. As a result, the Community Advisory Board was developed and launched in October 2019. Primarily funded by MCH, Colorado’s Women, Infants and Children (WIC) program has also contributed funding. The board’s membership is reflective of the communities that are most impacted by MCH priority work and is composed of dynamic individuals who have a wide range of expertise, including lived and professional experience. Members represent varying sexual and gender identities, both native and immigrant experiences, as well as different languages, races, and ethnicities. Processes for facilitation include simultaneous interpretation in both Spanish and American Sign Languages. Programs/initiatives seeking feedback have included:

• Sexual Violence Prevention Program specific to the Healthy Kids Colorado Survey Data (Colorado’s Youth Risk Behavior Survey)
• CDPHE’s COVID-19 Response
• CDPHE’s Office of Health Equity
• Boulder County Public Health
• CDPHE’s Child Fatality Review Program
• CDPHE’s Violence and Injury Prevention Program
• MCH Program 2021-2025 Priorities
• MCH Program’s Racial Equity Strategic Anchor
• MCH’s Prosocial Connection Implementation Team

The variety of programs within and beyond the MCH program that access the advisory board consistently highlights its value. Below are a few comments from staff who have come to the Community Advisory Board:

• Engaging the CAB confirmed that we were right to have concerns about primary seat belt law as a strategy to increase seat belt use in Colorado. It was really powerful to hear CAB members share candidly their concerns with the proposed law and that also made an impact on our system partners when we shared the feedback with them at our prioritization meeting in April 2020. It is likely now that we will not prioritize primary seat belt for the 2020 Child Fatality Prevention System legislative report, and it has inspired the internal CDPHE team to re-think our motor vehicle work and the ways we can continue to engage communities to identify ways to increase seat belt use that do not put folks in danger through contact with law enforcement.
• Explored new options offered by CAB members; got quicker buy-in from partner programs when I had the sound-bites of experiences
• The process to engage CAB was mentioned in a legislative report. Their feedback about the MMRC-developed recommendations unveiled areas for additional clarity and specificity, especially pertaining to the intersection between race and maternal mortality/morbidity and implementation.
• Engaging CAB will inform the way we communicate about the MCH priorities.
• It was an incredibly valuable experience, and upended how we are approaching equity and engagement, which has oddly trickled over to other states doing the same program work-- Colorado is pushing others to be more attentive to the citizens we serve!
• The CAB is an essential partner for us as we collect community input for the development of our annual legislative report and specifically on the child fatality prevention recommendations in that report.
• Personally, I think public health tends to over-academicize EVERYTHING and that's not accessible or digestible to the PUBLIC. I don't hold an MPH, and I deeply appreciated the honesty in the CAB feedback, both in the data itself, but in how we were failing to present it to the communities represented in the data. Reminds me of an old mentor, who told me: if you can't explain it to a 9-year old and they walk away understanding it all, you over-thought it.

In the fall of 2021, the MCH Community Inclusion Specialist onboarded 20 community members and updated practices for the Community Advisory Board. 

Youth Partnership for Health (YPH)

For the past 21 years, the Youth Partnership for Health has met monthly during the academic year to provide feedback and recommendations to programs and initiatives. Members receive training on topics related to public health, such as the MCH core competencies, the 10 essential services of public health, social determinants of health, health equity and positive youth development. Maintaining a diverse group of youth continues to be a priority. Members range in age from 13-19, represent urban, mountain and rural experiences, varying sexual and gender identities, both native and immigrant experiences, as well as different races and ethnicities. The Youth Partnership for Health is coordinated by MCH staff and continues to receive financial support from numerous CDPHE programs, including state-funded tobacco and marijuana programs, to sustain this mechanism for soliciting youth input.

Despite the COVID-19 pandemic, the council continued to meet virtually and provide feedback to interested partners. Partners that have utilized their expertise include:

• Children’s Hospital of Colorado
• SCL Health
• University of Colorado Health
• CDPHE Maternal Mortality Prevention Program
• Peer Assistant Services - SBIRT Program
• EEqual - Non-profit Organization
• CDPHE Child Fatality Review Program
• CDPHE Breastfeeding Program
• CDPHE Suicide Prevention Program
• Child Protection Ombudsman of Colorado
• MCH Prosocial Connection Priority Team
• CDPHE School Based Health Center Program
• Denver Public Health Colorado Young Drivers Alliance - Youth Workgroup

These programs have reported the following experiences with their consultations with the Youth Partnership for Health:

• We gained insight from talking to the youth. Being able to understand their experiences allowed us to understand what is important to them and the obstacles they face in obtaining information.
• We really appreciated the youths’ honesty; we appreciated how they expressed a lack of knowledge about our agency and their needs. We also really appreciated that, even without any experience with an ombudsman’s office, the youth were able to share their perspectives.                                                                                    
• I thought that YPH members brought a new perspective that I did not originally have.
• It was so great to hear from everyone on their thoughts and opinions about breastfeeding. Not only did you inform me greatly on improvements we need to make for youth support and education in school, but you also sparked ideas and provided input that will hopefully be used in the next few years to enact state legislation to provide better protections for breastfeeding students.                                                                                    
• Presenting to YPH is absolutely a highlight of the year for us.
• YPH members are the best audience - super insightful and engaged. We will definitely include all of the feedback members gave us. This really strengthens the work that we do and helps ground us in experiences of young people across Colorado.                                          
• I did find my time with Youth Partnership for Health valuable The youth were able to provide feedback to questions pertaining to teen driving and graduated driver’s license outreach. They provided valuable insight stemming from their experience which is great. They ranged from a variety of areas, so that was good as well to have different regions covered to gain varying perspectives.                                                        

In the fall of 2021, the MCH Community Inclusion Specialist onboarded 22 youth and updated practices for the Youth Partnership for Health. 

Youth Advisors

Over the past nine years, the MCH program has employed Youth Advisors to support MCH implementation efforts. The Youth Advisors obtain feedback from young people across Colorado, so they are able to incorporate that perspective into their efforts. In addition, they support adult professionals in growing their capacity for effective youth engagement by providing ongoing consultation opportunities, as well as participating in leadership positions on various efforts including the Colorado’s Shared Risk and Protective Factor Conference Planning Committee, Colorado Public Health Association Health Equity Coalition’s Youth Health Equity Action Team, and the AMCHP conference planning committee. This past year, they assisted AMCHP in launching Youth Voice Amplified, which elevates young people's contributions to the MCH field, particularly state Title V programs. In addition, the MCH Youth Advisor supported Colorado’s Shared Risk and Protective Factor Conference in partnering with a statewide youth engagement group to simultaneously host a youth-specific conference (the Collaborative Youth Summit) in conjunction with its conference for adult professionals. Young people were able to attend all of the keynote sessions and any sessions of interest at the “main conference” while also having their own unique opportunities to attend youth-led workshops, network with young people and groups across the state, and have their own space to be empowered and inspired by one another. The Youth Advisors continue to present at statewide conferences such as the Shared Risk and Protective Factor Conference, Collaborative Youth Summit, AMCHP, and MCHB webinars, where they have been a powerful force in the integration of authentic youth engagement. Colorado’s Youth Advisors across numerous state and local agencies and organizations are collaborating on a project that will bring a shared approach to “youth-friendly” professional development opportunities. This project is called “YEETS - The Youth Employee Empowerment Training System.” This system provides Youth Advisors across multiple states, with opportunities that support the development of relevant skills, as well as leveraging shared resources across organizations.  This project was born out of Youth Advisors' desire to receive meaningful and relevant training content specific to being young people in the workforce.  Facilitated by an informal collaborative of Youth Advisors, state agency staff and non-profit partners, YEETS is in the process of discussing a plan for sustainability and exploring numerous potential partnerships, including that of CareerWise. 

The Youth Advisor model continues to be replicated within several state, local and community organizations, including the Colorado Departments of Education, Human Services and Labor and Employment; Denver Public Health; San Luis Valley’s Tu Casa Inc; Boulder County Public Health; Rise Above Colorado; Denver Public Schools; The Denver Chamber of Commerce; and the Eagle River Youth Coalition. The Youth Advisor model continues to be integrated into Communities That Care collaboratives across the state. Additionally, the Youth Advisors convene a collective called Statewide Youth Network United (SYN United) where Youth Advisors evaluate their work together and create joint resources and presentations.

Since the fall of 2018, MCH Youth Advisors have provided over 120 consultations to various national, state, local and community organizations. These consultations focus on the specific programmatic request, but are geared primarily toward increasing the capacity of programs to engage young people effectively in their work moving forward. Specific to MCH, Youth Advisors have conducted various consultations with the MCH priorities leads and have created the Youth Engagement Roadmaps, such as this one.  These roadmaps serve as a tool to support on-going conversation to guide the integration of authentic youth engagement strategies into the MCH work. The MCH Youth Advisor was selected to present an informative poster session about this at the 2021 AMCHP conference.

During the summer of 2021, the MCH Youth Advisor focused her time on the MCH Built Environment priority, helping to draft the year 2 and 3 state action plan, developing resources,  such as “how to” guides. These guides assist local public health agencies in engaging young people in data collection and dissemination through mechanisms such as community-based participatory research, hot-spot mapping, and digital storytelling.

Colorado Family Leader Engagement

The MCH program contracts with Parent to Parent of Colorado to increase engagement of family leaders in the implementation of MCH program efforts, with a focus on families of children and youth with special needs. Lisa Franklin serves as Colorado’s designated Family Leader for the Title V block grant, drawing on her lived experience as a parent of a child with special health care needs, as well as extensive experience establishing and participating in family advisory councils to provide consultation, technical assistance and expertise to support meaningful community engagement. Lisa is an active participant in AMCHP’s Family Engagement Community of Practice and serves as Colorado’s delegate at the AMCHP national conference. MCH’s current contract with Parent to Parent of Colorado continues through September 2024 with annual scope of work renewal. The contract’s current focus is to:

• Build the capacity of MCH state staff to engage parents and caregivers of children and youth with special healthcare needs. 
• Inform the development of MCH family engagement strategies that are included in MCH priority implementation efforts with a focus on the CYSHCN population.
• Act as a liaison between the MCH program at CDPHE and existing family leadership organizations.
• Help Colorado’s MCH program infuse the CYSHCN caregiver experience into health care, human services and early childhood systems initiatives.
• Serve as Colorado’s designated Family Leader for the Title V MCH block grant and AMCHP family leaders delegate. This includes providing and/or ensuring the provision of family perspective(s) to inform the strategic direction of the MCH program; contributing relevant content to the MCH Block Grant annual report and application for the upcoming year and participating in the annual in-person block grant review with federal partners; participating in the annual AMCHP conference on behalf of Colorado’s MCH program.

MCH Collaboration with CDPHE Community Inclusion Efforts

In 2018, a department-wide community participation policy was created, requiring all CDPHE programs to engage the community within their programmatic work. CDPHE staff are also expected to operationalize the Colorado Equity Alliance’s Community Partnership Principles into their business practices in order to reduce barriers to effectively engage community members, as well as to identify and inform systems improvements that support effective community engagement. To support uptake and implementation of these principles, MCH staff co-lead and participate in the Prevention Services Division’s Community Engagement Workgroup.

The workgroup prioritized areas of focus for expanding and strengthening internal practices that support community engagement. This led to the Prevention Services Division removing two provisions in the request for applications procurement process to lessen the administrative burdens of smaller, grassroots organizations, which are often led and/or staffed by people of color. The work group also held internal information sessions to educate program staff on the role that Financial Risk Assessments for external contracting can play in equity and engagement. As part of the goal to embed community perspectives in CDPHE’s grant application processes, the work group developed a common definition of “community” for consistency across the division. The work group developed a guide on best practices for providing incentives to support community participation, as well as guidance on how to systematically embed costs for language services as part of standard, program budgeting. Diversity, equity and inclusion in hiring and other human resources practices was also an area of focus identified by the workgroup. As a matter of aligning resources and time for the greatest impact, this focus area has been intentionally integrated into the division’s Racial Equity Plan.

Beyond CDPHE, the MCH Community Engagement Specialist leads a community of practice across four state agencies (CDPHE and the Colorado Departments of Human Services, Education and Health Care Policy and Financing) which is focused on sharing best practices and aligning policies for engaging family and community.