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

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What is RRFSS

Rapid Risk Factor SurveillanceSystem

Key Public Health Issues Able to Monitor

Family History

Obesity

Hypertension

Diabetes

Smoking

to New Public Health Issues Adaptable

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Local

Timely

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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

Who Can Join RRFSS?

Any Public Health Unit in Ontario

… but thereis a cost.

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When is the Survey Conducted?

• There are three 4-month data cyclesper year.

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How is Data Collected

• Institute for Social Research (ISR) at York University

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How Long is the Survey?

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How is the Questionnaire Organized?

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• Decided annually by all participating HUs

• Asked for at least one year

• May rotate alternating years

• Mandatory – CANNOT opt out of these

AGE SEX BMI TOBACCOUSE INCOME

• Selected by each HU individually

• Can add or delete each cycle

What are some of the Topics/Modules?

See QMap

Your Turn!Are there any topics you would be interested in? Please circle the topic.

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Must We Use the Entire Module?

But …• Must start at the beginning

of a module

• Cannot jump back in once stopped

No

Can We Develop Modules?

Yesbut you must followa process:• Complete Module Submission

Request Form

• Should be applicable to multiple PHUs

• Can work with your own if no other PHU interested

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)

What is the Sample Size?

400 3 1,200interviews/HU cycles/year interviews/year

RRFSS has a larger sample size than the CCHS in some PHUs.

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

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Is the Sample Size Big Enough?

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Sampling Procedures

• Random selection of households – using random digit dialing

• Random selection of respondent – household member with next birthday

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Household Weights

• Maximize ability to generalize the survey results (the sample) to the population

• Probability of selection depends on size of household

Household Weights

Size ofHousehold

ChanceSelected

Weight

1adult

2adults

3adults

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.

Calculations were used to determine sample size for results to be generalizable

So, is it Still Representative?

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!

How Do We Ensure Accurate Results?

• Confidence intervals & coefficient of variation

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.

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Probability

Probability

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Probability

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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

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%)

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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 cannotreport this number

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RRFSS is Self-Reported? Are there limitations to this?

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Distorted Perceptions

Distorted Perceptions

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?

Memory Recall

What is the total amount of time you spent sitting, last Wednesday? (hours & minutes)

Sensitivity

In groups of two, please answer the following …

What is your age?

How much do you weigh?

In your lifetime, have youEver had suicidal thoughts?

What is your yearly totalIncome (before taxes)?

Self-Reported Measures

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What RRFSS Recall