Colorado’s MCH program continues to collect and analyze qualitative and quantitative data to augment the statewide needs assessment conducted in 2020 and inform state action planning and implementation. Preliminary work on the 2025 assessment has also begun. A description of these ongoing activities is included below.

On-going Needs Assessment Activities

Data to Action Priority Packages

The Colorado MCH program is approaching the data products for the 2021-2025 cycle differently than in the past. Instead of creating data products as separate items, there is now a more intentional effort to ensure individual products are aligned as a cohesive set of resources. The items that make up the “data to action priority packages” complement and reference different components of the package. The overarching goal is to integrate qualitative and quantitative data to tell the story of MCH in Colorado - both the processes and the outcomes are updated in the data packages throughout the five year cycle.

While the MCH Framework and MCH Snapshot are cross-cutting documents relevant to all priorities, the rest of the products are more specific. Items have continued to be added and, as part of the data package development, icons were created for each of the MCH priorities, strategic anchors and health impact areas. The icons (see table below) are now used in all MCH products and are also included throughout this application.

Colorado MCH Icons      

The most current versions of completed products are linked below and a more detailed description of some of the products follows:

• MCH Framework - A high level visual of the MCH program, the latest version more explicitly delineates the connection between strategies, outcomes and the measures used to track progress. Updated in FY2023.
• MCH Snapshot - An overview of data on the social determinants of health affecting the MCH population including geographical, social, and economic factors. Updated FY2023.
• Priority Overviews - A two-page high level summary of each priority. Updated in FY2023.
• Anchor Overviews - One to two-page high level summary of each strategic anchor.
• State Data Briefs - The Positive Child and Youth Development Brief was completed summer 2023. The rest of the briefs will be completed by December 2023.
• Evaluation Summaries - Annual assessment of progress by priority and strategic anchor. Updated in FY2023. 
• Picturing Colorado MCH - An MCH Storytelling project. Updated in FY2023

State Data Briefs

The first data brief (Positive Child and Youth Development) was completed this year using a new template created for the current five year cycle/upcoming needs assessment. The data briefs include more data visualization and less text than previous versions. The data brief template includes state data for core measures and population-based data for related measures. Disaggregated data to highlight disparities and inequities is also included along with context that explains drivers of inequities. Anecdotal quotes from survey participants are integrated throughout as applicable.

The MCH program identified the need to be more explicit in ensuring that a racial equity lens is employed in reporting and analyzing data within the historical, social and structural systems that contributed to health disparities. This led to the creation of the Racial Equity in Data Initiative (REDI). The MCH Epidemiology and Evaluation team is working with the Racial Equity Specialist, MCH Priority Coordinators and the MCH Program Specialist to ensure this perspective is woven into data briefs from the onset. The MCH Epidemiologist drafted a brief that addressed racial equity within MCH data sources that includes underreporting, sample sizes that may be too small to disaggregate and other overall challenges to racial equity in data. In addition, the Racial Equity Specialist and MCH Priority Coordinators will identify specific areas within the state action plans where there is historical, structural or social context that has been directly linked to health disparities in the data, and will publish supplemental material to the data briefs to give the additional context. See Section III.E.2.b.iii. MCH Data Capacity, State Systems Development Initiative (SSDI) for an update on this part of the REDI project. The MCH Epidemiologist and MCH Program Specialist will also collaborate with the Racial Equity Specialist to publish best practices and lessons learned in using a racial equity lens in the development of MCH products, including MCH data reporting.

In the upcoming year, local data tables will be created to provide local (county or regional) data for the newly proposed national performance measures and identified emerging issues, where available. As part of the local evaluation planning process, state MCH staff compiled information on local epidemiology and evaluation capacity and data access and usage through surveys and local learning communities. This information provided the MCH program with a better understanding of which population-based data and data products will be most useful for local public health agencies. The local data tables will be integrated into the quantitative piece of the 2025 needs assessment and will assist local agencies in planning work under the 2026-2030 priorities.

Picturing Colorado MCH (PCMCH)

This project began as an idea for a photo story project and evolved to encompass many storytelling mediums including: written word, voice recordings, video, and visual art. Since September 2021, the PCMCH team has taken the project from an idea into the project pilot stage. The team developed project promotion/collection plans and materials, including a community ambassador model where a trusted community member is paid a stipend to help recruit and collect stories. The community ambassador model is being piloted this summer. There are already several stories in the PCMCH library collected through LPHAs and the CDPHE youth advisory board, and the first community ambassador will gather more stories as part of the pilot. Additionally, the PCMCH team is currently working on a temporary website, which will serve as a space to share stories and a tool for communicating about the project until the official website is complete, which is anticipated in fall 2023.

From the conception of the PCMCH Project, community voice has been centered. In the past year, the PCMCH team met with CDPHE’s Community Advisory Board, Youth Partnership for Health Board, and created and conducted a community workgroup specifically for this project. Spanish interpreters were hired so that all attendees could fully participate in the discussions. The team presented ideas and project materials to the workgroups and made changes based on feedback received.

A goal of the PCMCH project is to use the collected stories to inform the Colorado MCH program, both as part of the upcoming MCH Needs Assessment and ongoing MCH evaluation. Stories will be coded and themed so that they can easily be accessed and included as qualitative data. PCHCH team members are working with the Needs Assessment Data Group to develop codes. The PCMCH team will work with MCH staff across the program to find other avenues where the stories can be used to inform MCH efforts.

Evaluation Summaries

Similar to previous years, priority evaluation reports were completed this year. This year’s evaluation summaries cover FY2022 (October 2021 - September 2022). There is a cross-cutting summary on the overall performance of the block grant including the strategic anchors, and a summary for each priority highlighting data, successes and challenges. Two-year objectives were written, with the timeframe ending in FY23 (Sept 30, 2023). Status of objectives as of the end of FY22 (Sept 30, 2022) is reported. Of the 37 objectives in the action plans, 24 (65%) were completed, 10 (27%) are in progress, two (5%) were put on hold, and one (3%) was not measurable due to a change with the data source. Even though two years isn’t sufficient time to show much change in performance measures, two NPMs are improving, two show no change, and one NPM (4A, 4B) is split, with one measure improving and the other showing no change. One SPM is improving, two SPMs show no change, and one SPM is getting worse.

Partnerships and Collaborations

Colorado’s MCH program values and fosters relationships across CDPHE programs, local public health agencies, and other Colorado state agencies, as well as with other statewide and community-based organizations. Working across sectors and with local, regional and state partners brings a variety of perspectives that inform both the needs assessment process and program implementation. Colorado’s MCH program included a broad purpose statement “To Increase Community and Family Resilience”  in the MCH Framework for the 2021-2025 program cycle to acknowledge and make space for partners in the interconnectedness of MCH work across priorities and populations and the variety of partners who are adjacent to, involved in or, in some cases, leading related strategies towards the bigger MCH vision of community and family resilience. A summary of key partners by priority can be found in the Partners Infographic.

Organizational Structure and Leadership Updates

Colorado’s MCH program uses a collaborative meeting infrastructure to best support the state and local implementation of MCH priorities. Colorado MCH entered the third and final stage of transition to the 2021-2025 MCH priorities in July 2022. Designated leadership positions coordinate state and local MCH planning and implementation. Lyz Sanders joined CDPHE in November 2022 as the MCH Section Manager/Title V Deputy Director. In this role, she oversees the state action planning process and supports communication and coordination amongst the priority coordinators throughout the state planning and implementation processes. MCH Priority Coordinators continue to serve as conveners of teams with content expertise that are responsible for the development and implementation of the state action plan. In addition to state planning and implementation, Lyz Sanders also oversees the contract monitoring and technical assistance for 14 local public health agencies that receive more than $50,000 in MCH funding annually and the technical assistance for 42 local public health agencies that receive less than $50,000 of funding through a combined contract with CDPHE’s Office of Public Health Practice, Planning and Local Partnerships. There were no other structural state program staffing changes this year.

In October 2021, the MCH Local Support Team (Liaisons) piloted a new local support model developed collaboratively with priority coordinators, staff from the Workforce Development Section and other subject matter experts within the MCH program to support the first year of local implementation for agencies receiving more than $50,000 annually. The model included the pilot of a local support plan, created at the beginning of each grant year to provide a centralized space for agency-specific technical assistance needs. The local support plan is included in the local public health agency’s quarterly reporting document for shared communication and collaboration between state and local MCH staff. 

Team FAD (Focus, Advise, Decide) serves as the leadership team for the MCH program, with representation from staff with diverse perspectives and roles across the program. In addition, state MCH staff are invited to participate in monthly all-staff meetings that alternate between business meetings and learning communities. Local MCH staff are invited to participate in bimonthly MCH managers calls, with bimonthly local learning communities for all local MCH staff held in the alternate months.

2025 Needs Assessment Planning

Preparation for the 2025 MCH needs assessment to select 2026-2030 priorities has begun. The process design phase will conclude in October 2023, culminating in the completion of a full data to action plan–including data collection and analysis, community and stakeholder engagement, and communication activities. The needs assessment leadership structure has also  been determined, with the following groups slated to lead the process:

• Team FAD+ - Team FAD (Focus, Advise, Decide) is an existing leadership team that has been expanded to include the strategic anchor leads and MCH Deputy Director, who is providing overall coordination for the needs assessment, to serve as the needs assessment leadership and decision making body.
• Data Workgroup - consists of epidemiology and evaluation staff and data subject matter experts who will create and implement a plan for quantitative and qualitative data collection and analysis.
• Priority Coordinators - MCH staff who develop and implement priority action plans and provide input into the needs assessment process.

In addition, the needs assessment leadership structure is enhanced by efforts and support of the MCH Community Advisory Board, local liaisons and agencies, the Youth Partnership for Health, and Parent to Parent of Colorado.

As shown in this timeline, the process design phase will ensure the ongoing communication between all workgroups, facilitate proper scoping of the assessment process, and will be followed by data collection and review.

Emerging Public Health Issues

The MCH public health issues that were prioritized through the 2020 needs assessment process remain as the top areas of focus for Colorado’s MCH program. That said, two emerging issues that have not explicitly been included in MCH work are climate change and housing. The Built Environment team is currently exploring opportunities to more intentionally include strategies to address climate change moving forward. To explore the potential public health role in housing, staff from across the Prevention Services Division, have launched an internal learning community and submitted an abstract to the Public Health in Rockies Conference (September 2023) to share ideas and elicit input from public health partners statewide.