Core SIPP States in Action
The following success stories highlight how Core SIPP implements, evaluates and disseminates injury prevention strategies into action.
Health Equity
Traumatic Brain Injury (TBI)
Shared Risk and Protective Factors (SRPF)
Adverse Childhood Experiences (ACEs)
What did Colorado do?
Colorado’s Weld County Department of Public Health and Environment (WCDPHE) improved their ability to review local land use codes for the 32 communities in Weld County. Local land use codes establish zoning and the processes used for housing development. WCDPHE staff examined land use codes to increase community engagement in housing affordability policy decision making and program design. The goal is to connect built environment policies to the injury and violence prevention field. Improving housing affordability, nutrition security, and transportation safety policies would lead to an increase in economic resilience.
WCDPHE increased their knowledge of housing affordability terms and land use strategies. Colorado Core State Injury Prevention Program (Core SIPP) staff connected WCDPHE with the Colorado Department of Local Affairs (DOLA) to identify local communities who received DOLA’s 1271 funding. The 1271 grantees are communities who must plan and carry out a strategy to increase affordable housing in Colorado through community planning policies.
Colorado Core SIPP held a networking event that provided WCDPHE and the 1271 grantees working in Weld County the opportunity to create shared goals and use each other’s knowledge, skills, and partnerships to create more housing affordability. About 20 representatives from eight local communities (Garden City, Greeley, Johnstown, Keensburg, Eaton, Evans, Windsor, and Kersey) attended the event on August 4, 2022. A WCDPHE participant said, “this event helped our team make connections with municipal staff and start the conversation around our project and the support we can provide.” WCDPHE connected with the city of Evans after the event and supported a local community engagement event that collected feedback on community development, including housing. WCDPHE created a network with local communities and improved their communication and ability to work across the area on housing affordability efforts.
WCDPHE is a local public health agency funded through the Office of Health Equity (OHE) at the Colorado Department of Public Health and Environment. WCDPHE receives technical assistance through CDC’s Core SIPP to strengthen economic resilience in local communities by informing housing affordability policies. Increasing economic resilience through housing, food, and transportation would reduce risk factors associated with adverse childhood experiences, transportation safety, and traumatic brain injury. WCDPHE’s strategy builds community members’ knowledge and capacity to be involved in housing conversations at the local level.
How did they plan this event?
Core SIPP provided guidance, training, and resources for WCDPHE staff to create more equitable housing conversations in Weld County communities. Additionally, Core SIPP staff hosted a networking and learning event in August 2022 for the WCDPHE and DOLA funded 1271 grantees.
Why did they host this event?
Community development and city design processes include community engagement. WCDPHE found that certain community members are underrepresented in the community development and city design process for Weld County. Residents in the county who participate in city design and community engagement are more likely to be English speakers, educated, and have higher incomes. Many residents who speak languages other than English, have less education, and earn a lower income do not engage in these processes. These residents face greater housing disparities in Weld County. WCDPHE wants to increase representation and equity by including these community members in discussing and identifying policies that would increase housing affordability strategies in communities through their OHE grant. Colorado Core SIPP held the networking event to include representatives from these communities in community development and city design processes. Broadening representation to develop policies, such as housing policies, can create more well-rounded and community supported policies and programs.
What did Alaska do?
Alaska Core State Injury Prevention Program (Core SIPP) coordinated traumatic brain injury (TBI)-related communication efforts across state partners. The goal is to improve knowledge about TBI, encourage early detection and treatment of these injuries, and prevent and reduce these types of injuries across the state. Alaska Core SIPP created a communications plan to ensure partners share data, evidence-based information, and resources with focus populations. The focus populations for this project were youth in schools, youth in the juvenile justice system, parents, and teachers.
How did Alaska improve knowledge of traumatic brain injuries?
Alaska Core SIPP created the “Defend Your Brain” public education campaign across the state. This campaign included creating a TBI website along with 36 social media messages. The campaign focused on early detection, treatment, and prevention of TBI. The website and social media messages helped people find resources and support after a brain injury. Alaska Core SIPP shared these materials across various channels including the Alaska Department of Health Facebook and Instagram pages, websites, TV, YouTube, and Snapchat between April and June 2022. This strategy resulted in over 2,650,000 displays of online messages and over 4,700 visits to the Defend Your Brain campaign website. The social media campaign alone reached 225,181 Alaskans.
Alaska Core SIPP hired a Youth Brain Injury Coordinator in September 2022 hosted by Alaska’s educational resource agency, the Southeast Regional Resource Center. This position focuses on supporting the Division of Juvenile Justice and building school supports for children who experience TBI. The Youth Brain Injury Coordinator also:
- Assists with the formation of brain injury teams in the schools.
- Holds presentations and educates students and families about TBI.
- Helps with school education plans, accommodations, and behavior strategies.
- Eases communication between school, medical, and juvenile corrections staff.
- Creates flyers about the Youth Brain Injury Program and what it offers, such as training for teachers on brain injury and best practices in the classroom.
- Spreads awareness of new brain injury resources in Alaska for educators, parents, and school support staff.
Why did Alaska create this campaign?
Alaska has one of the highest rates of TBI [PDF – 37 pages] in the nation. Alaska TBI-related mortality was the highest in the nation and more than twice the national average between 2016 and 2021.

The Alaska Department of Health (AK-DOH) developed brain injury awareness, prevention, and screening efforts to focus on disproportionately affected populations. About 40% of youth involved in the juvenile justice system have a history of brain injury. The AK-DOH Core SIPP staff coordinated a brain injury awareness public education campaign, developed a standard process for brain injury screening in the juvenile justice system, and connected youth who experienced TBIs to community and school-based supports.
California
What did California do?
The California Core State Injury Prevention Program (Core SIPP) team created a webinar called “Shared Risk and Protective Factors: The Future of Injury and Violence Prevention Work!” The webinar occurred in the summer of 2022, and highlighted work from Oregon and Safe States Alliance subject matter experts. The goal of the webinar was for California Department of Public Health’s (CDPH) Injury and Violence Prevention Branch (IVPB) staff to:
- Gain a basic understanding of the shared risk and protective factor (SRPF) approach for injury prevention
- Understand the value of using a SRPF approach with their resources and programs and support the health department’s focus on incorporating health equity, using an anti-racist lens, and aligning with California’s public health priorities
- Learn how other states use a SRPF approach to improve outcomes in injury and violence prevention
This activity connected California injury prevention staff with resources from the Safe States Alliance and other state partners. The webinar helped lay a foundation for California staff to advance injury and violence prevention work through a SRPF approach. California Core SIPP continues to use the SRPF webinar recording to help direct new staff.
What was the impact of the webinar?
California’s Core SIPP team administered a six-question follow-up survey to injury prevention staff to guide future SRPF efforts. The data from the survey will help a new workgroup continue the team’s SRPF growth, learning, and implementation in their programs. The webinar:
- Encouraged collaboration and strengthened relationships the Oregon state public health department and other SRPF subject matter experts
- Created a basic SRPF understanding for their branch
- Solidified plans to create a branch wide SRPF workgroup (which kicked off in May 2023) to incorporate this new knowledge into injury and violence prevention work. Future meetings are planned for the coming year.
Why did they create the webinar?
CDPH wanted to incorporate a SRPF approach into all injury and violence prevention work. Including a SRPF approach aligns with CDPH’s priorities to advance population health equity through social determinants of health, anti-racism, and trauma-informed decisions. CDPH found that IVPB staff had different levels of familiarity with SRPFs. This led the Core SIPP team and CDPH leadership to create a webinar that introduced all IVPB staff to the SRPF approach. The intended audience was IVPB staff who are responsible for a variety of violence prevention and unintentional injury prevention programs and surveillance activities.
New Mexico
What did New Mexico do?
New Mexico Core State Injury Prevention Program (SIPP) developed an introductory training for the New Mexico Injury Prevention Coalition (NMIPC) and partners on shared risk and protective factors (SRPFs), injury prevention, and the social ecological model (SEM). The University of New Mexico Prevention Research Center, NMIPC, and the New Mexico Department of Health staff helped develop the training, which took place on National Injury Prevention Day in November 2022. The training raised awareness and improved knowledge of how the SRPF approach can apply to injury prevention. Objectives of the training included describing risk factors and general causes of adverse childhood experiences (ACEs), traumatic brain injuries (TBIs), and motor vehicle crashes (MVCs). New Mexico Core SIPP created a pre- and post-test to evaluate how well participants understood SRPFs and the SEM before and after the presentation. New Mexico Core SIPP developed the training based on analysis of the pre-test and evaluated the training based on the post-test. The training also provided an opportunity to discuss injury prevention in New Mexico using a SRPF approach.
What was the impact of the training?
Mexico Core SIPP sent out a pre- and post-test survey to the 50 registered participants. A total of 37 participants responded to the pre-test, and 28 responded to the post-test. Only 21% of participants strongly agreed that they understood shared risk factors and 13% strongly agreed that they understood shared protective factors for injury prevention before the presentation. All participants reported a better understanding of the concept of shared risk and protective factors following the presentation. Each survey participant found the presentation useful to their work. Participants had diverse ideas of the shared risk and protective factors that they found most important to address. Participants prioritized improving access to safe childcare, mental health services, and economic opportunities and reducing access to alcohol at community events.
Why did they create the training?
The SRPF approach helps injury prevention professionals to build on the protective factors already in place while focusing on reducing specific risk factors for New Mexico communities. New Mexico faces many challenges to improve injury outcomes. These challenges include high rates of poverty, including children living in poverty, lack of economic opportunity, and high rates of ACEs. New Mexico Core SIPP decided to move injury prevention efforts away from individual level outcome-based approaches towards SRPF approaches. SRPF approaches have the potential to impact multiple outcomes. New Mexico also has a centralized Public Health System that relies heavily on partners to carry out health programs. These partners generally focused on individual level outcomes, and New Mexico Core SIPP recognized a need for injury-related SRPF and SEM education for all staff and partners. The CDC Core SIPP funding provided a concrete way to provide training on these approaches to staff and state partners.
What will Minnesota do?
Minnesota Core State Injury Prevention Program (Core SIPP) is creating a publicly available dashboard visualizing data on adverse childhood experiences (ACEs) protective and risk factors. They considered 78 protective factors that could help prevent ACEs. Based on a series of meetings with over 100 school behavioral health professionals, the 78 factors were prioritized and refined to a list of 15 factors that they could track over time.
How will they create the dashboard?
Minnesota Core SIPP will analyze the quality of potential Minnesota ACEs data sources and gather the data they collected from school professionals. The dashboard will include key data indicators from several sources, including:
- Argonne National Laboratory
- The American Community Survey
- The Minnesota Student Survey
- Minnesota Department of Human Services
- Minnesota Department of Public Safety
- Minnesota County Health Rankings
- Minnesota Department of Education
- U.S. Department of Agriculture Food Environment Atlas
- U.S. Census Bureau
Why are they creating the dashboard?
Schools expressed a need to better understand ACEs that children in Minnesota experience, and a need to better understand protective factors. Minnesota does not have a readily available resource for school district staff about the number of people in Minnesota who experience ACEs or who have ACEs-related risk and protective factors organized by age, race, ethnicity, and school district. This dashboard will serve as a centralized location for pertinent ACEs information to help inform action and prevention efforts.
What did North Carolina do?
North Carolina Core State Injury Prevention Program (Core SIPP) developed a new program named Adverse Childhood Experiences (ACEs) and Suicide Prevention in a Remote Environment (ASPIRE). The ASPIRE program included: 1) a six-month Collaborative Learning Institute (CLI) training program on using systems thinking approaches for ACEs and suicide prevention planning and 2) two toolkits designed to improve learning and demonstrate best practices for ACEs and suicide prevention.
Partners who conducted the program were the North Carolina Injury and Violence Prevention Branch, University of North Carolina (UNC) Injury Prevention Research Center, UNC Gillings School of Global Public Health, and the Rural Opportunities Institute. North Carolina Core SIPP collects and analyzes data after each CLI round to improve the structure and delivery of the program and tools in the next round. There have been a total of five CLI cohorts since 2020.
How did North Carolina use systems thinking approaches to improve suicide and ACEs prevention?
The CLI program combined systems thinking approaches with an understanding of ACEs- and suicide-related risk and protective factors to inform prevention. The program included virtual learning with supportive resource materials, recorded sessions for review and additional learning, skill-building exercises, and ongoing feedback and support from coaches.
One of the first tasks for suicide prevention was to add to the outcomes and various types of shared risks and protective factors found in CDC’s Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence [PDF – 16 pages]. North Carolina Core SIPP recruited specifically for teams working in suicide prevention, in addition to teams working in ACEs prevention, in the first round of the CLI. The year one webinar co-hosted by the Safe States Alliance highlighted CLI outcomes from that team. This webinar description is archived on the Safe States website.
Evaluation data collected through focus groups with CLI teams, post-webinar surveys, and pre- and post-test surveys before and after each CLI session and for the overall program, revealed several program strengths. Participants stated an appreciation for the dedicated time to work together as a team on ACEs strategic planning alongside a coach. One participant wrote, “I really like that each group has a CLI rep to help guide us when we have questions or are confused.” Several participants noted a change in perspective that helped their team approach ACEs in a new way. One participant noted, “This institute gave us the lens that we needed to reframe our work in a meaningful and clear way.” North Carolina Core SIPP plans to complete follow-up surveys and/or interviews with previous CLI participants to learn more about outcomes they experienced after participating in CLI. Questions for the participants will include: Are they still functioning as a team? Has their collaboration strengthened because of CLI? Have they implemented a new strategy or developed a new policy based on participation? Do they have new partners? Were there changes within organizations that participated? Has the overall ACEs prevention system changed in their community?
Why did North Carolina create the ASPIRE program?
ACEs and suicide have related risk factors. Communities in North Carolina aim to prevent both suicide and ACEs by creating programs and strategies. However, most of these efforts do not use a systems thinking approach when creating their programs and strategies. Systems thinking could improve their communication about how their programs interact to prevent counter-productive outcomes or duplicated efforts. A systems thinking approach ensures programs and strategies meet the needs of children and families and are created with collaboration, aligned with other community efforts, and have enough resources to support them. There are more than 40 ACEs task forces across the state that can integrate systems thinking into their programs and strategies. Organizations that are a part of these task forces include local public health and social services, child advocacy centers, and other family support services agencies. Increasing the use of systems thinking in planning and establishing ACEs programs requires an improvement in skills, resources, and knowledge through training and technical assistance.