We redesigned MCRISP 1.0 by incorporating feedback from our prior work with CCPs to identify areas for improvement [6]. Multiple technologies were leveraged in the redesign process (Figure 1A). CCPs had a jointly developed custom health dashboard for their center and region (Figure 1B). More advanced dashboards were made for users working in public health and were easily developed with the new enhancements (Figure 1C).

MCRISP currently only enrolls child care centers located in Washtenaw County, Michigan. We invited, by email, 66 CCPs who had used MCRISP versions 1.0 or 2.0 to fill out a survey designed to assess their use and reaction to the new redesign (Multimedia Appendix 1). In total, 24 CCPs responded; the analysis includes the 19 complete responses. Data were compared using a 2-tailed paired-sample t test after confirming that the data did not violate normality. The α level was set at <.05.

This work was reviewed by the University of Michigan institutional review board and found to be exempt from classification as human subjects research.

Of 66 past and present CCP MCRISP users, 24 (36%) responded, with 19 fully completing the questionnaire. Of those who completed questionnaires, 13 (68%) had experience using both versions of MCRISP; 5 respondents only used MCRISP 2.0 and 1 had only used MCRISP 1.0.

Among respondents who completed the survey and who were familiar with MCRISP 2.0 (18/19), we queried about CCP use patterns and experience with its features. Notably, 100% of respondents submitted illness reports at least weekly, with 61% (11/18) submitting reports multiple times per week. Over 83% (15/18) of respondents indicated they somewhat or strongly agreed that automated weekly email summaries were helpful. Regarding engagement with educational documents and video content, 67% (12/18) and 39% (7/18) of respondents used them at least monthly, respectively, with 50% (9/18) of respondents sharing resources with parents and 78% (14/18) saying they viewed illness graphics at least monthly.

Among respondents familiar with both MCRISP 1.0 and 2.0 (13/19; 68%), respondents were likely to more strongly agree with statements about the positive aspects of MCRISP 2.0 than MCRISP 1.0, though this positive trend was statistically nonsignificant (Table 1).

MCRISP is unique as a community-based biosurveillance platform that not only integrates suggestions from CCP user focus groups but is also designed to facilitate a bidirectional flow of information. This approach is critical as community engagement, transparency, and inclusivity are paramount in research and public health initiatives. MCRISP is unique not only among other US-based surveillance systems but also among international counterparts such as the KIzSS network (Dutch abbreviation for National Multicenter, Day Care–Based Sentinel Surveillance Network for Infectious Diseases) in the Netherlands [7]. KIzSS is a government-sponsored, national surveillance network that releases reports annually. It lacks real-time data access for stakeholders, unlike MCRISP, which supports continuous, multidirectional data flow through a partnership between public health, researchers, and CCPs. MCRISP is reliant on CCPs as partners in maintaining the network’s surveillance capabilities; therefore, introducing changes risks causing disengagement among users who may find the new technology too difficult to use or fit into their workflow [8,9]. Our stakeholder-informed approach yielded improved system capabilities and maintained user engagement. To replicate a comparable public health–centered child care surveillance system, we recommend using focus groups and an iterative design philosophy to ensure stakeholders remain motivated to contribute data.

MCRISP currently operates within 1 county and does not include smaller or home-based child care facilities, which may limit its generalizability.

MCRISP represents a paradigm shift in community disease surveillance by leveraging the child care system. MCRISP can serve as a guide for developing a stakeholder-focused approach for public health surveillance initiatives.