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Chronic diseases with behavioral risk factors are now the leading causes of death in the United States. A national Behavioral Risk Factor Surveillance System (BRFSS) monitors those risk factors; however, there is a need for national and state evaluations of chronic disease surveillance systems. The Department of Health and Human Services/Centers for Disease Control and Prevention (CDC) has developed a framework on evaluating noncommunicable disease--related surveillance systems; however, no implementation of this framework has yet been published. This article describes the process of, and offers lessons learned from, implementing the evaluation framework to assess the Alaska BRFSS. This implementation evaluation may inform assessments of other state and regional chronic disease surveillance systems and offers insight on the positive potential to consult key stakeholders to guide evaluation priorities.

Community Health Aides and Community Health Practitioners (CHA/Ps), the primary providers of healthcare in rural Alaska, share the importance of story as a culturally respectful way for creating meaning and broadening understanding. Story is woven into the fabric of cancer education courses for CHA/Ps. Between May 2004 and April 2007, 13 week-long cancer education courses were provided for CHA/Ps. In response to the written, end-of-course, evaluation question, "Do stories help you to learn? If yes, how?" Ninety-six percent (96%) of respondents (99/103) described ways that story supported their learning. Additionally, in May 2005, 293 (65%) of the 454 CHA/Ps responded in writing to a mailed cancer education survey. Of the survey respondents, 240 (86%) were women and 239 (86%) were Alaska Native people. Nearly all, 98% (224/229) of Alaska Native people and 93% (37/40) of non-Native people identified story as helping them learn. CHA/Ps, on both the cancer education course evaluations and the CHA/P written survey, identified story as a pathway for connecting people, facilitating understanding, enhancing remembering, engendering creativity, expanding perspective, envisioning the future and inspiring possibility. Through stories we share our feelings, heal wounds, deepen understanding, strengthen community and discover hope.