Chronic Disease Surveillance Modernization Toolkit: A Model of Collaborative Innovation

OVERVIEW

Kahuina and the Council of State and Territorial Epidemiologists (CSTE) co-designed and launched the Chronic Disease Surveillance Modernization Toolkit from scratch in just five months. This cutting-edge resource provides State, Tribal, Local, and Territorial (STLT) public health practitioners with actionable guidance to modernize data systems and strengthen prevention and surveillance programs.

CHALLENGE… AND OPPORTUNITY

Chronic disease data has historically been fragmented and dispersed across unconnected systems — including public health, health care, insurance, and social services — making it difficult to access. Much of that data was incomplete and outdated. This placed burdens on STLT health officials, who are regularly understaffed, underfunded, and working under tight deadlines.

In 2025, the challenges facing these officials became more daunting. With COVID-19 emergency funds receding, many health departments were hit with steep budget cuts and a loss of institutional knowledge. This strained their capacity to monitor and treat chronic diseases — such as heart disease, cancer, obesity, diabetes, and hypertension — that continue to kill millions of Americans every year.

At the same time, however, federal and state investments in public health since 2020 have resulted in a wealth of new online resources that did not exist even a few years ago. This created an opportunity. By modernizing and linking these resources, it would possible to help STLT officials continue to conduct impactful interventions that improve health outcomes across all communities.

KAHUINA’S APPROACH

In early 2025, CSTE seized this opportunity by creating a web-based toolkit. This online resource would provide implementation guidance for its National Strategic Plan for Chronic Disease Data Modernization and strengthen data capacity across STLTjurisdictions. To accomplish this ambitious goal, CSTE turned to Kahuina’s expertise in applied epidemiology, chronic disease surveillance, public health informatics, and data systems.

We approached the project with our signature blend of strategic clarity, empathy, and human-centered design. Partnering with CSTE and an interdisciplinary team of diverse STLT experts and data modernization partners, we led a co-creative process with naive groups to design, build, and deliver a dynamic, accessible web-based toolkit through fun and engaging virtual sessions.

Our methods included:

• Key informant interviews to gather diverse practitioner perspectives.

• Collaborative design workshops using virtual platforms to generate ideas and align priorities.

• Iterative usability testing to refine and validate the toolkit in real time through interactive, asset-driven activities.

This inclusive and adaptive process ensured every voice was heard.

Over three months, Kahuina designed, coordinated, and facilitated five sets of key informant interviews — each including two to five STLT experts — as well as two design and two usability sessions with a total of more than 40 participants. These engagements informed the toolkit’s content, resources, structure, and web-based layout. By combining our expertise in chronic disease and data modernization with digital formative facilitation techniques, we collaboratively developed a user-ready toolkit that reflects STLT capacities and needs.

During one usability session, a participant recognized their feedback reflected in the revised toolkit and shared, “I’ve never felt more seen or heard.” That moment captured the spirit of the project — stewardship, teamwork, and shared purpose in action. Participants described the process as “energizing” and “a bright spot” in a difficult year.

RESULTS

In just five months, Kahuina successfully created and delivered the Chronic Disease Surveillance Modernization Toolkit — a comprehensive, implementation-ready resource that supports data modernization in all 50 states. Over 3,000 state and local public health practitioners now have relevant definitions, data sources, communities of practice, and strategic guidance in one place, at the click of a button.

More than a public health resource, the toolkit is a model of inclusive collaboration. By drawing on real-life experiences, future STLT professionals will be able to take concrete steps to reduce disease burden and improve community health.

Through stewardship, teamwork, and leveraging our collaborators' collective strengths, we helped CSTE bring this project to life.

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