1. Deanna E. White, Adam Stevens, John Barbaro, Kristy McGill and Lynne Russell

2.  What is RRFSS  RapidRisk Factor Surveillance System 2

3. Key Public Health Issues  Able to Monitor  Family History Obesity Hypertension Diabetes Smoking 3

4. to New Public Health Issues  Adaptable  4

5.  Local  5

6.  Timely  6

7.  How Can We Use RRFSS?  To support program planning and evaluation To advocate for public policy development To improve community awareness of risks for CDs, IDs and injuries 7

8.  Who Can Join RRFSS?  Any Public Health Unit in Ontario … but there is a cost. 8

9.  When is the  Survey Conducted? There are three 4-month data cycles per year. 9

10.  How is Data Collected  Institute for Social Research (ISR) at York University 10

11.  How Long is the Survey?  11

12.  How is the Questionnaire  Organized? 12

13. Decided annually by all participating HUs Asked for at least one year May rotate alternating years Mandatory – CANNOT opt out of these AGESEXBMI TOBACCO USE INCOME 13

14. Selected by each HU individually Can add or delete each cycle 14

15.  What are some of  the Topics/Modules? See Q Map Your Turn! Are there any topics you would be interested in? Please circle the topic. 15

16.  Must We Use the  Entire Module? But … Must start at the beginning of a module Cannot jump back in once stopped No 16

17.  Can We Develop  Modules? Yes but you must follow a process: Complete Module Submission Request Form Should be applicable to multiple PHUs Can work with your own if no other PHU interested 17

18.  How to Choose Optional  Align with health unit’s data needs Measure the variable over time (decrease in chronic disease prevalence?) Data is not available from other data sources (use and awareness of parenting programs) 18

19.  What is the Sample Size?  40031,200 interviews/HUcycles/yearinterviews/year RRFSS has a larger sample size than the CCHS in some PHUs. 19

20.  Who is Included  in the Sample? 18 years of age and older English or French speaking Reside in private homes With landline *some cell phone numbers were included 20

21.  Is the Sample Size  Big Enough? 21

22.  Sampling Procedures  Random selection of households – using random digit dialing Random selection of respondent – household member with next birthday 22

23.  Household Weights  Maximize ability to generalize the survey results (the sample) to the population Probability of selection depends on size of household 23

24.  Household Weights  Size of Household Chance Selected Weight 1 adult 2 adults 3 adults 100%Given weight of 1 50%Given weight of 2 33.3%Given weight of 3 This helps to prevent under- representation in larger households and over-representation in small households. 24

25. Calculations were used to determine sample size for results to be generalizable  So, is it Still  Representative? 25

26.  Is the Survey  Valid & Reliable? Modeled on the Behavioural Risk Factor Surveillance System (BRFSS) conducted by the Centres for Disease Control and Prevention (CDC) in Atlanta Many questions also taken from the CCHS and the National Population Health Survey (NPHS) The original design was tested for reliability and validity Yes! 26

27.  How Do We Ensure  Accurate Results? Confidence intervals & coefficient of variation 27

28.  The Confidence  Interval (CI) How confident are we in the point estimate (i.e., value)? E.g., 6% … (85% CI: 3% - 9%). What does 95% mean? … based on probability. 28

29.  Probability  29

30.  Probability  30

31.  Probability  31

32.  Significance Testing  Statistically Significant NOT Statistically Significant What does this have to do with the CI? Likely happened The results are probable It could have happened by chance alone 32

33.  Significance Testing  Your Turn! Please complete section one. Circle statistically significant statements. We use the CI to determine whether something is statistically significant. If the CIs do not overlap than they are SS Example: Percentage of females vs males who smoke: Females:70% (60%-80%) Males: 30% (20%-40%) 33

34. 34

35.  Coefficient of Variation  Your Turn! Please circle the asterisk in the table. Refers to the precision of the estimate Usually a result of small numbers (i.e., 2/800) Interpret with caution presented with an *asterisk An empty cell means the value is not precise (in fact, incorrect), so we cannot report this number 35

36.  RRFSS is Self-Reported?  Are there limitations to this? 36

37.  Distorted Perceptions  37

38.  Distorted Perceptions  38

39.  Hawthorne Effect  In groups of two, please answer the following … How many times per day, week or month do you drink 100% fruit juices such as orange, grapefruit, or tomato juice? How often do YOU wear a seatbelt when YOU DRIVE a car, van or truck: Would you say, all of the time, most of the time, about 1/2 the time, less than 1/2 the time, or never or almost never? 39

40.  Memory Recall  What is the total amount of time you spent sitting, last Wednesday? (hours & minutes) 40

41.  Sensitivity  In groups of two, please answer the following … What is your age? How much do you weigh? In your lifetime, have you Ever had suicidal thoughts? What is your yearly total Income (before taxes)? 41

42.  Self-Reported Measures  42

43.  What RRFSS Recall  43