Background Prompted by an external peer review, CDC's CFS program reached out to local health departments (LHDs) to disseminate and evaluate need of CFS educational materials. Methods We conducted needs assessments with LHDs in 18 states and disseminated educational materials to LHDs in 15 states. Follow-up phone calls were conducted with LHDs that received educational materials. The follow-up interview included 18 questions about CFS material use, perception, and knowledge. Results Seventy-seven (85%) LHDs participated in the needs assessment and 74 (96%) reported previously hearing of CFS. Ninety-three percent of LHDs had no CFS program or materials. CFS was not rated a public health priority, yet 90% of LHDs were interested in receiving information. Materials were sent to 121 LHDs; evaluation of materials were conducted with 89 LHDs (75% response rate). LHDs incorporated CFS materials into existing programs and dissemination formats (e.g. kiosks and printed materials). Materials were distributed in two ways: directly to individuals (patients and healthcare staff) and through third party sources (e.g. health fairs, clinics, kiosks). Past use of materials did not impact LHDs' plan to use materials in the future. LHDs using materials rated CFS a public health concern (p=0.015) and staff learned from materials (p=0.001). Conclusions Lessons learned included importance of developing concise and easily transportable materials that will facilitate use in the community and the need to understand how LHDs operate so that outreach methods can be tailored to meet their needs. Competing health priorities was the most common reason given by LHDs for not using the CFS materials.