CARRFS SYMPOSIUM PROGRAM by Jostein Algroy

Le premier symposium de l’Alliance canadienne de surveillance régionale des facteurs de risque [ACSRFR]

The First Symposium of The Canadian Alliance for Regional Risk Factor Surveillance (CARRFS)

« La surveillance locale des facteurs de risque : Mise en oeuvre »

“Local Risk Factor Surveillance: Making it Happen”

Hôtel Courtyard Marriott Toronto Du 2 au 4 février 2009

Courtyard Marriott Hotel Toronto February 2-4, 2009

Programme du symposium

Symposium Program

Disclaimer Copyright: The Canadian Alliance for Regional Risk Factor Surveillance [CARRFS] is a professional network organization whose purpose is to enhance the capacity of regional/local risk factors in Canada and operate independently from any government organization. The organization intended not to use any copyrighted material for this publication or, if not possible, to indicate the copyright of the respective object or photo. If there is any non indicated object or photo protected by copyright, or the copyright could not be determined, the unintended copyright violation will result in the removal of the object or photo from the publication or at least indicate it with the appropriate copyright after notification. All rights are reserved regarding the copyright of the CARRFS Symposium Program. The information in this document may be freely used and copied for non-commercial purposes, provided that the source is acknowledged. Acknowledgements: Photos on the following pages 13, 14, 20, 30, 31, 32, 33, 34, 35, 36 in this publication have been purchased and downloaded from iStockphoto Inc. - www.istockphoto.com with permission to be published for non-commercial purposes. The photos ID numbers are: 2399210, 6803739, 2872829, 1208589, 2259851, 3939111, 6144414, 3547982, 829131, 4876277, 4640146.

The Public Health Agency of Canada (PHAC) in collaboration with public health stakeholders across Canada is pleased to announce a new initiative on collaborative local-area chronic disease risk factor surveillance. The initiative is called the Canadian Alliance for Regional Risk Factor Surveillance (CARRFS). It is a network of public health stakeholders interested in working together to build and strengthening regional/local area chronic disease risk factor surveillance in Canada that will be used for chronic disease prevention and control. Representation on the CARRFS comes from local, provincial/ territorial, and federal public health stakeholders across Canada.

The Canadian Alliance for Regional Risk Factor Surveillance (CARRFS) Introduction from the Chair & Co-Chair We would like to welcome everyone to the first symposium of the Canadian Alliance for Regional Risk Factor Surveillance (CARRFS), “Local Risk Factor Surveillance: Making it Happen”. It’s very exciting to be part of a network like CARRFS that brings together a diverse, national audience. The next three years will be very busy for the CARRFS. There is currently an active membership drive and ongoing work in developing and implementing internal and external communication initiatives. The CARRFS will be working to identify opportunities to share information and resources, and build capacity through workshops and training. This symposium promises to be an opportunity to connect with international colleagues and learn from each other. There is no doubt that the CARRFS is a long term endeavour. The key to the success of the CARRFS is tapping into the expertise and leadership within the CARRFS to ensure our work reflects the identified needs of CARRFS members. The CARRFS can also demonstrate leadership by sharing Canada’s collective experience international and continuing to learn from a wider public health audience. Kathy Moran, Chair

Linda Spice, Co-Chair

In recent decades, risk factors such as smoking, alcohol abuse, stress, mental illness, poor nutrition, physical inactivity, and obesity have emerged as major public health issues in countries around the world, including Canada. Much of the concern for these issues is a result of their strong effect on a number of chronic diseases including an increased risk of heart disease, stroke, certain cancers, chronic respiratory diseases and diabetes. Putting these risk factors under the close scrutiny of a public health surveillance system is an efficient way to develop and evaluate the success of public health programs to prevent and control the current chronic disease epidemic. In 2005, a Federal/Provincial/ Territorial Task Group report on chronic disease risk factor surveillance made a recommendation to establish regionally/locally coordinated ongoing flexible public health data collection systems. In order to further explore the needs, characteristics, and feasibility of a collaborative regional network for chronic disease risk factor surveillance, a team led by PHAC organized a 2-day Think Tank Forum in Toronto in February, 2008. A total of 108 experts across Canada, representing the federal, provincial, territorial and regional governments, universities and nongovernment organizations, shared experiences and perspectives on how 3

to build capacity for collaborative regional/local area risk factor surveillance. By the end of the Think Tank Forum, a national working group of 30 experts was convened who met immediately to develop work plans based on the discussion at the forum. In addition, a national writing group of 25 authors was set up to write a scientific journal paper on the outcome of the think tank forum and theories of regional risk factor surveillance. This research paper will provide guidance to the CARRFS by summarizing the issues identified in enhancing capacity for regional risk factor surveillance. Current Organization The CARRFS was established in September 2008, at which time it had about 200 members across Canada. The activities of the CARRFS are managed by the Canadian Coordination Committee (CCC) which has 11 executive members (2008-2010). The Chair is Kathy Moran from Ontario, and the Co-chair is Linda Spice from Saskatchewan. Other executive members include Deborah Carr, Dan Otchere, Jostein Algroy, Bernard Choi, Beverly Billard, Eshwar Kumar, Gamil Shahein, Jane Griffith, and Joanne Thanos. The role of this committee is to oversee the activities of the CARRFS.

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environmental scan to assess the current status of regional risk factor surveillance across Canada and internationally. This project will identify needs, highlighting case studies across Canada, to inform planning and evaluation activities of the CCC. The 2009 CARRFS Symposium Planning Working Group organizes a national meeting on the scientific progress in regional risk factor surveillance slated for February 2009 in Toronto. The Membership and Publicity Working Group oversees new member recruitment and external publicity to promote the work of the CARRFS across Canada.

How to become a member of the CARRFS? Public health stakeholders interested in working together to build capacity for regional/local area chronic disease risk factor surveillance in Canada that will be used for chronic disease prevention and control are welcome to join the CARRFS network. To sign up as a member of CARRFS, please visit the CARRFS website: http:// www.peertopeer.ca/cgi-bin/ WebObjects/CARRFSMailingList

CARRFS - Canadian Coordination Committee (CCC) • Kathy Moran (ONTARIO York Region Community and Health Services Department) CHAIR, kathy.moran@york.ca, (905) 830-4444 ext. 4507 • Linda Spice (SASKATCHEWAN - PHAC Manitoba and Saskatchewan Region) CO-CHAIR, linda_spice@phac-aspc.gc.ca, (306) 780-6501 • Deborah J. Carr (ONTARIO Oxford County) Chair, Communications WG, dcarr@county.oxford.on.ca • Dan Otchere (ONTARIO Ontario Association of Public Health Dentistry) Chair, Environmental Scan Implementation WG, dan.otchere@peelregion.ca • Jostein Algroy (ONTARIO Ministry of Health Promotion) Chair, Symposium Planning WG, Jostein.Algroy@Ontario.ca • Bernard Choi (PHAC) Editorin-Chief [CARRFS], bernard_choi@phac-aspc.gc.ca • Beverly A. Billard (NS - Health Promotion & Protection), Bev.Billard@gov.ns.ca • Eshwar Kumar (NEW BRUNSWICK - Department of Health), Eshwar.Kumar@gnb.ca • Gamil Shahein (ONTARIO Eastern Ontario Health Unit), gshahein@eohu.ca • Jane Griffith (MANITOBA CancerCare Manitoba) jane.griffith@cancercare.mb.ca • Joanne Thanos (ONTARIO Ministry of Health and LongTerm Care), Joanne.Thanos@Ontario.ca

Several Working Groups are planning activities to carry out the vision of the CARRFS. • The Communications Working Group promotes internal communications among all network members, by maintaining a communication platform that includes virtual workspace and an email distribution list called [CARRFS]. • The Environmental Scan Implementation Working Group is implementing an

The Public Health Agency of Canada Dear Participants of the CARRFS Symposium I am delighted to welcome you to this exciting event. The title of the Symposium says it all: Risk Factor Surveillance: Making it Happen. One in two Canadians have a chronic disease, and four in five have a risk factor that could lead to chronic disease. Together we have to work to reduce this risk and this cannot be done without tracking risk factors in the population.

Mission and Vision Mission: To promote and protect the health of Canadians through leadership, partnership, innovation and action in public health. Vision: Healthy Canadians and communities in a healthier world.

Our challenge is to ensure that risk factor information is available to help guide and evaluate program at the regional and local. This will be our business during the symposium as we talk, listen, discuss and plan how to make this happen. I hope you have a full and engaging experience and find useful information and resources to help you in your work. Paula Stewart MD, FRCPC Director, Chronic Disease Surveillance Public Health Agency of Canada 5

2009 CARRFS Symposium Chair and CoChair

The planning of the first Symposium for the Canadian Alliance for Regional Risk Factor Surveillance started in September 2008. It has been a great pleasure to lead a group of top professionals and dedicated people who have spent hours of their free time to make sure that the Symposium is delivered in a professional manner. The purpose of this Symposium has been to bring together researchers, policy makers and health professionals to present and discuss the latest findings and expertise on regional/local risk factor surveillance in Canada. We organized the symposium around three themes: Content (what is regional/local risk factor surveillance); Methodology and Knowledge Transfer. We are very pleased with the response we have received from the community as we see high quality abstracts from all corners of the country, presenting ideas ranging from Student Wellness Surveys to using the Health Utilities Index to understand health dynamics. We are similarly proud of deliver four cutting edge, hands-on Workshops during the Symposium. Those teaching these workshops are experts in their respective fields and we expect that these workshops will give the participants valuable information which can be implemented quickly upon return to their organizations. We are furthermore extremely grateful to have been able to attract four internationally well-known keynote speakers to the symposium. It is our belief that their expertise and thought provoking ideas will give the participant something extra to discuss during the symposium as well.

Welcome to the 2009 CARRFS Symposium!

Last but not least, we will use this opportunity to thank all the people who was involved with planning the 2009 CARRFS Symposium. Without their involvement and dedication this Symposium would not be what it is. A special thanks to the Public Health Agency of Canada and Dr. Paula Stewart, Director, Chronic Disease Surveillance, who has managed to dedicate significant resources - financial and human resources, to the planning of the Symposium. Scientific program: Paula Stewart, Mary Lou Decou, Bernard Choi Secretariat: Monica MacLeod, Anne Lange, Julie Mair, Vista Vaughan Symposium website: David Crepeault, Melissa Porcari Symposium booth: Peter Walsh, Donna Bouchey, Regional office coordination: Linda Spice, Andrea Simpson, Technical advice: Gregory Sherman, Penny Farnham, Deirdre MacGuigan, Christina Bancej, French translation advice: Claudia Lagace, Cynthia Robitaille, Yves Proulx. Additionally we would like to thank Nawal Lutfiyya, Winnipeg Regional Health Authority and Catherine Hayes, NOR-MAN Regional Health Authority, Manitoba for their dedicated work during the last five months. Also a special thanks to the Ontario Ministry of Health Promotion, who has supported the Symposium. It has been a great pleasure to working with all of the involved people and we are looking forward to a engaging and inspiring event. Jostein Algroy Chair

Mary Lou Decou Co-Chair 6

Program Overview Time

Monday, Feb. 2, 2009

Tuesday, Feb. 3, 2009

Wednesday, Feb. 4, 2009

8:30 - 9:00

Welcome and Introduction Courtyard

Environmental Scan - Preliminary Report Courtyard

9:00 - 10:00

Keynote: Content Title: Risk factor surveillance over time: global to regional perspectives. Dr. David V. McQueen, Associate Director for Global Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, USA Courtyard

Keynote: Knowledge Transfer Title: So you think you can dance? Doing the tango between population health research and public health practice (without stepping on toes)? Dr. Patricia Martens, Director of the Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada Courtyard

10:00 - 10:30

Networking and Refreshment

10:30 - 11:45

Abstract: Content Track 1 Courtyard

11:45 - 1:15

1:15 - 2:00

Abstract: Content Track 2 Alexander A/B

Abstract: Content Track 3 Spadina A/B

Lunch Showcase: Skills Enhancement for Public Health Internal CCC & CARRFS Working Group Meetings

2:00 - 3:15

Keynote: Methodology Title: Surveys and Public Health Surveillance Systems Prof. David Northrup, Associate Director at the Institute for Social Research, York University, Toronto, Canada Courtyard Abstract: Methodology Track 1 Courtyard

Abstract: Methodology Track 2 Alexander A/B

Abstract: Methodology Track 3 Spadina A/B

3:15 - 3:45

Networking and Refreshment

3:45 - 5:00

Open CafĂŠ Forum Courtyard, Alexander, Spadina and Carlton

5:00 - 6:00

Private Time/Networking

6:00 - 9:00

Opening Reception: Keynote Speaker Title: The role of Ontarioâ&#x20AC;&#x2122;s new Agency for health Protection and Promotion Dr. Natasha Crowcroft, Director of Surveillance and Epidemiology, Ontario Agency for Health Protection and Promotion, Toronto, Canada Courtyard and Courtyard Foyer

Abstract: Knowledge Transfer Track 1 Courtyard

Abstract: Knowledge Transfer Track 2 Wood A/B

Abstract: Knowledge Transfer Track 3 Spadina A/B

Lunch Showcase: Geographical Information System (GIS) Workshop 1: GIS: Incorporating Spatial Analysis into Regional/ Local Risk Factor Surveillance Courtyard

Workshop 2: Creativity in the Capacity for Regional/ Local Risk Factor Surveillance in Canada Carlton

Workshop 3: Schoolbased Surveys: Making Them Work Spadina A/B

Workshop 4: Indicators of Community Vitality Wood A/B

4:00 - 4:30 Closing of the Symposium Courtyard

Networking and Buffet Dinner Spadina and Foyer

Program Monday, February 2, 2009 Time

DAY 1: Monday, Feb. 2, 2009

8:30 - 9:00 9:00 - 10:00 10:00 - 10:30 10:30 - 11:45 11:45 - 1:15 1:15 - 2:00

Internal CCC & CARRFS Working Group Meetings

2:00 - 3:15

3:15 - 3:45

3:45 - 5:00

5:00 - 6:00 6:00 - 9:00

Opening Reception: Opening Keynote Speaker: Title: The role of Ontarioâ&#x20AC;&#x2122;s new Agency for Health Protection and Promotion Dr. Natasha Crowcroft, Director of Surveillance and Epidemiology, Ontario Agency for Health Protection and Promotion, Toronto, Canada Courtyard and Courtyard Foyer

Program Tuesday, February 3, 2009 Time

DAY 2: Tuesday, Feb. 3, 2009

8:30 - 9:00

Welcome and Introduction Mr. Jostein Algroy, Chair, Symposium Working Group Ms. Kathy Moran, Chair, Canadian Coordination Committee Dr. Paula Stewart, Director, Chronic Disease Surveillance, Public Health Agency of Canada Courtyard

9:00 - 10:00

10:00 - 10:30

Networking and Refreshment

10:30 - 11:45

Track 1 Abstract: Content Ms. Lynn Ann Duffley, Health and Education Research Group, New Brunswick Dr. Bin Zhang, New Brunswick Cancer Network, New Brunswick Ms. Kathy Moran, Public Health Branch, Ontario Courtyard

Track 2 Abstract: Content Ms. Ruth Sanderson, Region of Waterloo Public Health, Ontario Ms. Ruth Sanderson, Region of Waterloo Public Health, Ontario Dr. David Strong, Alberta Health Service Calgary Health Region, Alberta Alexander A/B

Track 3 Abstract: Content Dr. Heather Orpana, Statistics Canada Dr. Bernard Choi, Public Health Agency of Canada, Dr. Liping Zhang, Winnipeg Regional Health Authority, Manitoba Spadina A/B

11:45 - 1:15

Lunch Showcase: Skills Enhancement for Public Health

1:15 - 2:00

Keynote: Methodology Title: Surveys and Public Health Surveillance Systems Prof. David Northrup, Associate Director at the Institute for Social Research, York University, Toronto, Canada Courtyard

2:00 - 3:15

Track 1 Abstract: Methodology Dr. Lynne Warda, University of Manitoba, Manitoba Dr. Lynne Warda, University of Manitoba, Manitoba Ms. Erin Schillberg, Manitoba Health and Healthy Living, Manitoba Courtyard

Track 2 Abstract: Methodology Ms. Gail Butt, BC Centre for Disease Control, British Columbia Mr. Raymond Fang, Provincial Health Services Authority, British Columbia Ms. Cora Cole, Public Health, Nova Scotia Alexander A/B

3:15 - 3:45

Networking and Refreshment

3:45 - 5:00

Open CafĂŠ Forum

Track 3 Abstract: Methodology Dr. Philippa Holowaty, Halton Region, Ontario Ms. Harleen Sahota, Association of Public Health Epidemiologists, Ontario Mr. Robert Hawes, Public Health Agency of Canada, Spadina A/B

Courtyard, Alexander, Spadina and Carlton 5:00 - 6:00

Private Time/Networking

6:00 - 9:00

Networking and Buffet Dinner Spadina & Foyer

Program Wednesday, February 4, 2009

Time

DAY 3: Wednesday, Feb. 4, 2009

8:30 - 9:00

Environmental Scan - Preliminary Report Mr. Jostein Algroy, Chair, Symposium Working Group Dr. Dan Otchere, Chair, Environmental Scan Implementation Working Group Courtyard

9:00 - 10:00

10:00 - 10:30

Networking and Refreshment

10:30 - 11:45

Track 1 Abstract: Knowledge Transfer Ms. Jennifer Skinner, Haliburton, Kawartha, Pine Ridge District Health Unit, Ontario Ms. Lynn Ann Duffley, Health Education Research Group, New Brunswick Dr. Catherine Charette, Winnipeg Regional Health Authority, Manitoba Courtyard

11:45 - 1:15

1:15 - 3:45

4:00 - 4:30

Track 2 Abstract: Knowledge Transfer Ms. Maggie Campbell, Parkland Regional Health Authority, Manitoba Ms. Laura Plett, Canadian Cancer Society, Manitoba Dr. Bernard Choi, Public Health Agency of Canada Wood A/B

Track 3 Abstract: Knowledge Transfer Ms. Joanna Oliver, Halton Regional Health Department, Ontario Ms. Rachel Savage, Ontario Agency for Health Protection and Promotion, Ontario Mr. David Lingard, Ministry of Healthy Living and Sport, British Columbia Spadina A/B

Lunch Showcase: Geographical Information System (GIS) Workshop 1: GIS: Incorporating Spatial Analysis into Regional/Local Risk Factor Surveillance

Workshop 2: Creativity in the Capacity for Regional/Local Risk Factor Surveillance in Canada

Workshop 3: School-based Surveys: Making Them Work

Courtyard

Carlton

Spadina A/B

Workshop 4: Indicators of Community Vitality Wood A/B

Closing of the Symposium Dr. Paula Stewart, Director, Chronic Disease Surveillance, Public Health Agency of Canada Courtyard

Hotel Floor Plan

Hotel Vicinity Courtyard By Marriott Downtown Toronto is located in the heart of Toronto - at the intersection of Yonge Street and College/Carlton Street. As Lunch is on your own, there is a wide selection of restaurants and food courts. The restaurants will primarily be on Yonge Street - just outside the hotel. They will serve you everything from pizza, to pasta, to pho ga. If you are in a hurry, the nearest food court is at the lower level of the College Park complex with ten different venues. For those who donâ&#x20AC;&#x2122;t want to go outside, the Courtyard Marriott does have its own restaurant on the main floor - close to the check-in desk.

Webinar/Webcast The First Symposium for the Canadian Alliance for Regional Risk Factor Surveillance (CARRFS) is transmitting the Symposiumâ&#x20AC;&#x2122;s major presentations - introductions, keynote speeches, abstracts sessions and the closing session in real time in the form of a webinar/webcast. The reason for making the presentations available for Internet viewers is to make sure that those who could not attend the Symposium are able to obtain the information that is presented at the Symposium. For those who canâ&#x20AC;&#x2122;t listen to the presentation in real time, CARRFS will make all the webcast presentations available as audio podcasts in the near future. To obtain the information about when the podcasts from the Symposium are available - join CARRFS and you will automatically get the information.

Networking Events There is no symposium without networking. Feedback from the Canadian Alliance for Regional Risk Factor Surveillance (CARRFS) indicated that networking was an important component to the Symposium. The 2009 Symposium Working Committee has taken this into consideration and has incorporated three half hours networking events and coffee breaks, one Open CafĂŠ Forum and two networking receptions, good healthy food and a cash bar. This will allow delegates at the Symposium to mingle and create new contacts across the provinces with the purpose of learning from each other. 14

Opening Keynote Dr. Natasha Crowcroft, Director of Surveillance and Epidemiology, Ontario Agency for Health Protection and Promotion, Ontario, Canada Title: The role of Ontario’s new Agency for Health Protection and Promotion Time: 6:15 - 6:45pm, Day 1- Monday, Feb. 2, Courtyard Room Abstract:

Ontario has a new Agency for Health Protection and Promotion, as a result of the government’s commitment to Operation Health Protection and the renewal of public health. The Agency will serve as a hub, linking researchers, practitioners and front-line health care workers to the best scientific intelligence from around the world. It provides specialized scientific and technical advice and on-the-ground support to front-line health care workers, public health units and government. The Agency is currently bringing academic, clinical, public health and government experts together to focus on the areas of infectious disease, infection control and prevention, health promotion, chronic disease and injury prevention and environmental health. As part of its commitment to enhancing surveillance in Ontario, the Agency has become involved in the development of the Rapid Risk Factor Surveillance System. This will also play an essential role in providing indicators to underpin implementation of Ontario’s Public Health Standards.

Bio: Dr. Natasha Crowcroft Medical degree (Universities of Cambridge ‘84 and London ’87), MRCP (’92), MSc (University of London ’94), MFPHM (’96) FFPH (’04), (PhD, University of Cambridge ’05). Director of Surveillance and Epidemiology at the Ontario Agency of Health Protection and Promotion in Canada, Associate Professor, Department of Laboratory Medicine and Pathobiology and Dalla Lana School of Public Health, University of Toronto. Dr. Crowcroft is a public health physician with a background in clinical medicine, microbiology, field epidemiology, training and research. She has worked internationally in several European programmes and as adviser to the World Health Organization. Research interests include vaccine preventable diseases and encephalitis. 15

Symposium Keynote Speakers The three themes around which the Symposium is organized: content, methodology and knowledge transfer, each have assigned keynote speakers. Dr David V. McQueen will be delivering an overview of risk factor surveillance drawn from his life-long experience and engagement in the field. He will also provide the audience with the new challenges which regional risk factor surveillance are currently facing. Professor David Northrup will present the methodological challenges associated with measuring population health through the regional risk factor surveillance system. Dr. Patricia Martens will draw on her significant experience in Manitoba examining how knowledge from academic health research effectively gets delivered to provincial and regional policy makers and health professionals.

Dr. David V. McQueen Title: Risk factor surveillance over time: global to regional perspectives. Time: 9:00 - 10:00 am, Day 2 - Tuesday, Feb. 3, Courtyard Room Abstract:

Bio:

This presentation will in the first instance lay out the critical characteristics of a risk factor surveillance system. It will stress the development of a comprehensive system based on theory and epidemiological data. It will emphasize the importance of a strong concern with both technical and structural aspects in building a sustainable system.

Dr. David McQueen is a Senior Biomedical Research Scientist at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA. Since 1998 he has been the Associate Director for Global Health Promotion in the Office of the Director at the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Prior to that he was Director of the Division of Adult and Community Health at NCCDPHP and Acting Director of the Office of Surveillance and Analysis at (NCCDPHP), as well as Chief of the nationwide Behavioral Risk Factor Surveillance System. Prior to joining CDC he was Professor and Founding Director of the Research Unit in Health and Behavioural Change at the University of Edinburgh, Scotland (1983-1992), and prior to that Associate Professor of Behavioral Sciences at the Johns Hopkins University School of Hygiene and Public Health in Baltimore. His Doctoral training was in behavioral sciences at the Johns Hopkins University.

A portion of the presentation will assess the new challenges presented by the current emphasis on the social determinants of health, and how this changes the focus of surveillance. Finally some regional examples of surveillance will be presented to illustrate local use of surveillance. These examples will demonstrate the importance of using surveillance to provide evidence of effective health-related interventions.

He has an extensive record of presentations and publications in health promotion, chronic disease prevention and evaluation in public health. In recent years he has taken a leadership role in the development of behavioral risk factor surveillance systems globally and in the assessment of evaluation and effectiveness in health promotion. Currently he is president of the International Union for Health Promotion and Education (IUHPE), as well as leader of the IUHPE Global Programme on Health Promotion Effectiveness

Prof. David Northrup Title: Surveys and Public Health Surveillance Systems Time: 1:15 - 2:00pm, Day 2 - Tuesday, Feb. 3, Courtyard Room Abstract:

Bio:

Telephone surveys are critical to risk factor surveillance systems employed by public health agencies. Surveys with repeated cross sectional samples are used by the Behavioral Risk Factor Surveillance System (BRFSS) in the United States, the Rapid Risk Factor Surveillance System (RRFSS) in Ontario, and by many other jurisdictions. There are serious questions about the longterm viability of such general population surveys. Declining response rates, increasingly diverse populations in terms of language and culture, and the increasing use of cell phones threaten the representativeness of survey samples. In the Canadian context, we know little about how response rates relate to the health measures that are central to surveillance systems. In the short term, efforts are needed to slow down the declines in response rates. Advance letters, longer data collection time periods and better (trained) interviewers will help somewhat. The efficacy of possible middle-term solutions such as multiple modes of data collection, longitudinal designs and the use of panels needs to be explored. Over the long term there is a need for methodological research on the effects of low response rates on key data. Also studies that combine information from existing administrative records and surveys are likely to become more common. Agencies that use survey data from surveillance systems will need to effectively lobby decision makers as well as the public about the value of health research. The conduct of fewer, but better and more expensive surveys should be in our future.

David Northrup is Associate Director at the Institute for Social Research (ISR) at York University. ISR is the largest university-based survey research organization in Canada and the Institute=s purpose is to promote, undertake and critically evaluate applied social research. As the senior researcher at ISR, Mr. Northrup is responsible for the design, management and implementation of major surveys. He has over 25 years of experience in questionnaire design and data collection. His main methodological interest is the relationship between survey design and survey findings. Mr. Northrup was an instrumental partner in the development of the Rapid Risk Factor Surveillance Survey (RRFSS) in 2001 and 2002. At the Institute, he currently manages and directs the Primary Care Access Survey (PCAS) for the Ontario Ministry of Health and is also a member of the Ministryâ&#x20AC;&#x2122;s Expert Panel on connecting patients to family physicians (Health Care Connect). His substantive areas of interest include the relationship between health research and privacy of personal health information; election studies; how Canadians engage in their pasts; and, the use of polls in the development of public policy. Most recently, his work has been published in The Public Historian, BMC Medical Ethics and, the Journal of American Medical Informatics Association. Mr. Northrup holds a MA and teaches Survey Research Methods at York University.

Dr. Patricia J. Martens Title: So you think you can dance? Doing the tango between population health research and public health practice (without stepping on toes)? Time: 9:00 - 10:00am, Day 3 - Wednesday, Feb. 4, Courtyard Room Abstract:

Bio:

This presentation will discuss some models and implications of researcher-user interactions. What models have worked in Manitoba to ensure that provincial and regional policy-makers and program planners have research evidence for evidence-informed decision-making? How do university-based academic researchers interact with users of their research? A “case study” of The Need To Know Team in Manitoba will highlight an example of integrated knowledge translation (KT).

Dr. Patricia J. Martens, BSc, Cert.Ed, MSc, IBCLC, PhD. Dr. Martens is the Director of the Manitoba Centre for Health Policy, an internationally acclaimed university-based research centre focusing on population-based health services, public health and population health research.

As well, focusing on population health perspectives for public health is important, and may require paradigm shifts by those who analyze and ‘translate’ research. Understanding the implications of ‘upsteam, midstream, downstream’ interventions, as well as the Rose Theorem, are critical to those who wish to influence policy. Are there special considerations from the point of view of the epidemiologist or statistician working in population health? Working across paradigms, in a pragmatic approach to creating useful knowledge that translates into practice, is critical in future initiatives within Canada to benefit the health of all Canadians.

An Associate Professor in the Faculty of Medicine’s Department of Community Health Sciences at the University of Manitoba, she has held various research career awards, including a Canadian Institutes of Health Research (CIHR) New Investigator Award (2003-2008) and presently a CIHR/PHAC Applied Public Health Chair (2008-2013). Patricia has been invited to speak at over 200 presentations nationally and internationally, and has published over 100 articles, books and abstracts. Patricia’s interests in health services and population health research include projects on the health status and healthcare use of Manitoba’s rural & northern residents, mental health and the use of health care services by those with mental illness, the health of Aboriginal people, and child health (including evaluating community intervention strategies to increase breastfeeding rates). Dr. Martens directs The Need To Know Team, a collaborative research team of university academics working with planners from Manitoba’s 11 Regional Health Authorities and the Manitoba Department of Health. This Team’s research impact on health policy and planning was recognized through receipt of the prestigious CIHR’s national KT Award for Regional Impact in 2005.

Content

Methodology

Knowledge Transfer

Abstracts From the February 2008 Think Tank Forum, it was realized that CARRFS members wanted to share information and resources with their colleagues across Canada. They wanted opportunities to network and share experiences related to best practices, knowledge, and leadership at the local/ regional level. With these opportunities, we can share content, methodologies, and knowledge transfer experiences, be resources to others, and learn from other membersâ&#x20AC;&#x2122; journeys. To this end, a call for abstracts was presented to network members and many members were pleased to share their experience. Abstracts were selected according to the quality of their content, their relevance to the theme, clarity and innovation. While some of the topics "chronic disease risk factor" specific, others have more diverse content. Their applications are relevant to chronic disease risk factor surveillance and will prove to be valuable to all involved. A special thank to the Abstracts Review Committee for their dedicated work. The committee consisted of: Mary Lou Decou (Chair), Dr. Bernard Choi, Dr. Elizabeth Rael, Dr. Gunawardana Balasuriya, Dr. Nawal Lutfiyya, Ms. Deirdre MacGuigan and Ms. Andrea Simpson

Content - Track 1: Tuesday, February 3, 2009 Title: New Brunswick Student Wellness Survey: Making Use of the Content Presenting Authors: Ms. Lynn Ann Duffley, Health and Education Research Group, New Brunswick, Canada Bill Morrison, Associate Professor of Educational Psychology, University of New Brunswick, New Brunswick, Canada Location: Courtyard Time: 10:30am - 10:55am In January 2006, New Brunswick launched a Provincial Wellness Strategy and by February, the Department of Wellness, Culture and Sport was created to oversee its’ implementation. The goals of the Provincial Wellness Strategy include increasing healthy eating, enhancing mental fitness, increasing physical activity and promoting tobacco free living.

Title: 2007 New Brunswick Student Drug Survey Presenting Authors: Dr. Bin Zhang, New Brunswick Cancer Network, New Brunswick, Canada Ms. Gisele Maillet, New Brunswick Provincial HEP Coordinator, Addictions and Mental Health Services, New Brunswick, Canada Location: Courtyard Time: 10:55am - 11:20am New Brunswick Student Drug Use Survey Bin Zhang PhD, Gisèle Maillet BSW, RSW and Yvette Doiron-Brun, BSW, RSW: Epidemiologist, New Brunswick Cancer Network, Department of Health, NB, CA. ‡:Provincial HEP Coordinator, Addiction and Mental Health Services, Department of Health, NB, CA.: Director, Child and Youth Services, Addiction and Mental Health Services, Department of Health, NB, CA.

One of Strategy’s key components is the undertaking of research, surveillance and evaluation to make informed decisions regarding areas of priority. In 2006-07, the Department of Wellness, Culture and Sport partnered with the Department of Education to survey grades 6 to 12 students from 184 participating schools. This research was conducted by the Health and Education Research Group (HERG) at the University of New Brunswick, in partnership with the Université de Moncton, and working in collaboration with the University of Waterloo. The NB Student Wellness Survey 06-07 was coordinated in a manner to encompass the Youth Smoking Survey 06-07. Almost 40,000 Anglophone and Francophone students provided surveillance data on health attitudes and behaviours regarding physical activity, healthy eating, tobacco-free living, and/or mental fitness. By July 2007, participating schools were provided their results in feedback reports developed through the services of the University of Waterloo.

Objective The 2007 New Brunswick Student Drug Use Survey (NBSDUS) gathers information regarding substance use among Grades 7 to 12 ranging from 11 to 19 years of age across the entire province. The purpose of this study was to obtain the valid and precious epidemiological information about alcohol, tobacco, and other drugs use among these adolescent students.

These reports highlighted areas where schools could take action, in partnership with students, parents and community. By the fall of 2007, each school district received feedback reports with consolidated district results. HERG used the content to develop knowledge translation tools to encourage knowledge uptake and utilization of the surveillance findings. The knowledge translation tools were designed with the end-user in mind. To encourage integrated planning between health behaviour silos, the surveillance findings provided content for five themes: mental fitness; social relationships and influences; environments; healthy weights and lifestyles; and tobacco and other problem substance use. These themes formed the content for the 5 provincial fact sheets. To encourage utilization of feedback reports, the surveillance findings provided content for over 30 learning ideas for use by teachers in grades 6-12. This presentation will highlight the findings within each theme; and considerations for the content used in knowledge translation tools, e.g. curriculum connectors and provincial fact sheets.

Results The most commonly used drugs in adolescent students are alcohol, tobacco, and cannabis. This survey revealed decreases from 2002 to 2007 in the prevalence of cannabis, cigarette, and other drug uses. Significant decreases were observed in the use of cannabis (35% vs. 25%), cigarette (21% vs. 12%), psilocybin/mescaline (12% vs. 5%), non-medical amphetamines and Ritalin (11% vs. 3%). Compared to the 2002 NBSDUS, the prevalence of alcohol use remained relatively stable (50% vs. 53% for alcohol), whereas ecstasy use had slightly increased over the five-year period (5% vs. 4%). Three percent of students reported that they used methamphetamines at least once, and approximately 3% of students used cocaine/ crack in the year prior to the survey.

Method Two-stage cluster sampling was used to randomly select schools and classes. The probability proportional to size sampling was utilized to select schools in each Health Zone and the simple random sampling was implemented at the class level. A total of 8,042 students were randomly selected from 84 eligible schools and 348 classes with an overall 12% absenteeism rate during the survey. Six thousands and two hundreds thirty seven adolescents remained in the final sample which represented 38,031 of the total eligible students. The questionnaire consisted of 98 items and one open-ended question. Participation was voluntary, anonymous and confidential.

Recommendations 1)Continued support for resources relating to prevention initiatives addressing substance use among youth and intervention initiatives that seek to help those adolescents experiencing negative consequences as a result of their choice to engage in substance use; and 2) Standards, clear outcomes, and associated measures should be established in the evaluation of initiatives addressing substance use.

Title: Public Health Monitoring of Risk Factors in Ontario (PMO): Meeting Local Needs Through Collaboration Presenting Authors: Ms. Kathy Moran, Public Health Branch, Ontario, Canada Ms. Corry Curtis, City of Hamilton Public Health Service, Ontario, Canada Ms. Anne Marie Holt, Haliburton Kawartha Pine Ridge District Health Unit, Ontario, Canada Location: Courtyard Time: 11:20am - 11:45am Introduction In 2008, the new Ontario Public Health Standards (OPHS) established a requirement for surveillance in all Public Health Units in Ontario. Currently, there is an information gap for children and youth as existing data sources survey adult populations only, or do not provide a large enough sample for valid, reliable results. Methods The Ontario Student Drug Use and Health Survey (OSDUHS), conducted by the Centre for Addiction and Mental Health (CAMH), is the longest running school survey in Canada. Since 1977, the OSDUHS has surveyed approximately 4,000 students every two years to obtain provincial results essential to evidencebased program planning. Data collection is via a self-completed questionnaire, administered in the schools by trained interviewers from the Institute for Social Research at York University. For the 2009 cycle of the OSDUHS, six public health units partnered with CAMH to increase their local sample in the OSDUHS and to expand data collection to include risk behaviours of public health importance such as healthy eating, physical activity, healthy weights, substance use and violence. In each participating public health unit, a sample size of 1,000 students (500 elementary and secondary, respectively) will provide reliable local estimates. A consensus-building exercise among public health units was used to determine questionnaire content. Results The PMO builds on the infrastructure of the OSDUHS and the expertise of CAMH to collect data from October 2008 to June 2009. CAMH is responsible for all aspects of questionnaire design and data management, and each participating public health unit will receive a final dataset in November 2009 to complete local analysis, interpretation, report writing and dissemination. Conclusions The PMO builds on an existing, wellestablished survey that specifically targets youth and fills a clear information gap at the local level. Further development of the PMO will fulfil the need for timely, ongoing monitoring of health and risk behaviours of children and youth to facilitate evidence-informed program planning and evaluation, and foster relationships with academic and other partners to support research and knowledge exchange.

Content - Track 2: Tuesday, February 3, 2009 Title: Emerging Public Health Issues - a niche surveillance market for the Rapid Risk Factor Surveillance System (RRFSS) Presenting Authors: Ms. Ruth Sanderson, Region of Waterloo Public Health, Ontario, Canada Ms. Janet Philipps, Durham Health Department, Ontario, Canada Location: Alexander A/B Time: 10:30am - 10:55am One of the strengths of the Rapid Risk Factor Surveillance System (RRFSS) is its ability to develop new content in order to monitor emerging public health issues, including risk factors for chronic diseases. The purpose of RRFSS is to provide timely data relevant to local public health needs. RRFSS is used to monitor key public health issues among the general population yet is adaptable to collect information on emerging issues. The results from RRFSS are used to support program planning and evaluation, to advocate for public policy development, and to improve community awareness regarding the risk factors for chronic diseases, infectious disease and injuries. RRFSS began as a pilot project in 1999 and has been operating in Ontario with multiple health unit involvement since 2000. During the past decade RRFSS has developed over a hundred modules at a rate of 10-20 per year. This presentation will focus on describing the RRFSS content that has been developed over the past decade in the context of emerging public health issues in Ontario. An overview of the enabling process established within the RRFSS partnership that supports responsiveness will be discussed. Content areas such as support for smoking and pesticide by-laws, artificial tanning use, healthy eating and active living, and walkability will be explored to illustrate how content has been developed and utilized at the local level. The session will encourage the audience to consider how they could adopt and adapt the key components identified within RRFSS to successfully respond to emerging public health issues in their own jurisdictions through surveillance activities.

Title: Monitoring our skills with food

Title: Calgary Health Region Population Survey

Presenting Author: Ms. Ruth Sanderson, Region of Waterloo Public Health, Ontario, Canada

Presenting Author: Dr. David Strong, Alberta Health Services - Calgary Health Region, Alberta, Canada

Location: Alexander A/B Time: 10:55am - 11:20am In the new Ontario Public Health Standards, Chronic Disease Prevention includes a Requirement for Health Promotion and Policy Development that addresses “food skills”. However the definition of food skills and the identification of key indicators for monitoring is an emerging area of public health interest. As with many new concepts that require surveillance, the early stages of this work requires us to ask, what does concept include (e.g. ability to prepare food, minimize waste and keep food safe/minimize contamination) and how is it related to other concepts (such as food security, e.g. having enough healthy food or food access e.g. affordability, proximity and ability to shop)? Finally, to narrow down the indicators, one must ask are there key components of the concept that are good predictors of the concept within the population? In Waterloo Region, questions about food skills were included in a local area survey in 2008 of about 700 residents. Survey questions were adapted from existing questions used in: Region of Waterloo Public Health research (Community Activity Study, 2005); Nesbitt et al (2008) BMC Public Health 8:370; Food Skills for Families program, British Columbia Healthy Living Alliance; Wrieden et al (2007) - Public Health Nutrition 10(2): 203-11. The survey questions asked about type of groceries/foods in the home, self-rating of respondent’s food skills in several categories, time taken and who is responsible for preparation of main meal of the day, frequency of preparing a meal “from scratch”, self-rating of respondent’s food skills at age 18, consumption of foods grown in household garden currently and when a child. This presentation will focus on the development process, initial results and make suggestions on future steps to ongoing surveillance of “food skills” on a population level.

Location: Alexander A/B Time: 11:20am - 11:45am Introduction The Calgary Heath Region Population Survey (CHRPS) was developed in response to the WHO STEPwise challenge. The STEP approach focuses on the surveillance of established risk factors for major chronic disease burdens. The survey was implemented at the local level to identify health inequities across a population of approximately 1.2 Million encompassing both urban and rural areas Activities, methods, innovations The risk factors assessed in CHRPS include tobacco and alcohol use, nutrition, physical activity, hypertension, hyperlipidemia, body mass and mental health disease burden. Disease risk factors are analyzed and reported by 19 social districts (15 urban and 4 rural). The districts were developed collaboratively by Calgary Consortium members representing the Region, the City of Calgary, the Calgary Board of Education and the United Way. Using a Computer Assisted Telephone Interviewing (CATI) system and a random digit dialing methodology, approximately 2600 adults are surveyed per year. A three year reporting timeframe is used to ensure adequate representation at the social district level. The Risk factor information available through CHRPS is currently being mapped along with other indicators using a web-based geographic atlas. Outcomes results, lessons learned Risk factor health inequities across the 19 social districts have been identified and are reported to local service delivery decision makers. Risk factor profiles across the 19 Social Districts are strongly related to socio-economic determinants as well as other morbidity and mortality indicators. Identifying health inequities across subpopulations has provided valuable information for service planning within a regional structure. As an example, the CHRPS risk factor social district profiles have been used to identify geographic target areas for screening populations at high risk for developing chronic conditions as part of the Region’s Chronic Disease Management program. Conclusion/Recommendations While National surveillance provides support for Provincial service delivery decisions, risk factor surveillance at the local level provides a lens through which to make local service delivery decisions. The risk factor social district profiles will also allow for the development of projection models to understand the future morbidity burden at the social district level to help identify future service delivery requirements and health promotion opportunities most likely to reduce the growing health burdens.

Content - Track 3: Tuesday, February 3, 2009 Title: Using the Health Utilities Index to understand health dynamics Presenting Authors: Dr. Heather Orpana, Statistics Canada, Canada Mr. Vincent Dale, Assistant Director in Health Statistics Division, Ontario, Canada

Title: Surveillance of trends and distribution of stroke mortality by subtype, age, sex and geographic areas in Tianjin, China, 1999 - 2006 Presenting Author: Dr. Bernard Choi, Public Health Agency, Canada Location: Spadina A/B

Location: Spadina A/B

Time: 10:55am - 11:20am

Time: 10:30am - 10:55am

Introduction Tianjin is a local region in China. The Tianjin Center for Disease Control (CDC) was set up in 1999 and at the time of the study had accumulated 8 years of surveillance data (1999 to 2006). This is a collaborative study of the Tianjin CDC, the Public Health Agency of Canada (Bernard Choi), and the University of Michigan (Matthew Boulton) in the USA.

Statistics Canada contributes to health surveillance through both data collection and an extensive program of research and analysis. This session will provide an overview of the National Population Health Survey (NPHS) and the annual, focus content and special projects component of the Canadian Community Health Survey (CCHS). Recent research using these datasets will be presented to illustrate how research and analysis can feed back into the process of identifying surveillance needs. Specifically, analysis of the Health Utilities Index (HUI) will be presented. Statistics Canada has recently validated a categorical approach to interpreting the HUI which will facilitate its use by the broader public health community. HUI is a widely used measure of health related quality of life included on several population health surveys. It combines information about functional health status with preference scores into an overall index of health related quality of life. While the HUI has been extensively used as a summary measure of population health, it has not been as widely used in the area of surveillance. Key findings from recent cross sectional and longitudinal research using the Health Utilities Index to predict mortality and to understand healthy aging will be presented.

Objective The objective of this study was to analyze the epidemiological trend and distribution of stroke mortality in the city of Tianjin, China, in order to provide evidence for the prevention and control of stroke. Methods The study was based on 102,718 cases of stroke mortality in Tianjin between 1999 and 2006. Cause of death was coded according to the International Classification of Diseases into stroke subtypes. Standardized mortality rates were calculated for stroke and its subtypes, adjusted for age and sex using the year 2000 world standard population. The age, sex and geographic distribution of stroke and subtype mortality were analyzed. Chi-square tests were used to determine the statistical significance of differences in mortality trends. Results The overall stroke mortality rate in Tianjin declined from 133.52/100,000/year in 1999 to 102.52/100,000/year in 2006. The mortality rate was higher in males than in females, and increased with age. The distribution of subtypes of stroke mortality in Tianjin changed over time. Hemorrhagic stroke was the leading cause of stroke mortality in 1999-2001. Cerebral infarction became the leading cause in 2002-2006, accounting for more than 50% of total stroke mortality. An important finding of the study was that the proportion of ischemic stroke in all stroke deaths was 66.65% in the urban population in 2006. This was over 20% higher than that in the rural area. Stroke mortality in the rural area was mainly hemorrhagic stroke, around 62.67%. Conclusions There are significant differences in the distribution of stroke mortality by subtype, age, sex, and geographic areas in Tianjin, China. Various subtypes of stroke are associated with different risk factors and therefore require different prevention and control measures. This study provides pertinent information for the formulation of public health policies and programs for the prevention and control of stroke.

Title: The Importance of Mental Health Risk Factor Surveillance: The Case of Depression Presenting Authors: Dr. Liping Zhang, Winnipeg Regional Health Authority, Manitoba, Canada Dr. M. Nawal Lutfiyya, Chronic Disease Epidemiologist, Winnipeg Regional Health Authority, Manitoba, Canada Location: Spadina A/B Time: 11:20am - 11:45am Introduction The World Health Organization recognizes depression as one of the most disabling disorders in the world. Further, depression is the second most common condition encountered in general medical practice. It is associated with a significant burden of morbidity and mortality for adults including: functional impairment, a loss in productivity, a higher risk of suicide as well as higher health care expenses. For women depression has a lifetime prevalence of roughly 2.5 per 1000; for men the lifetime prevalence is approximately 1.0 per 1000. In addition, high rates of depression exist in individuals with multiple co-morbidities. Nevertheless, questions regarding depression as a mental condition have not been included in the Canadian Community Health Survey (CCHS) as core questions---only as optional ones. This is not insignificant given the CCHS was designed to produce cross-sectional estimates to address priority health data gaps at national, provincial and regional levels. It is also one of the few nationally representative data sources in that includes risk factor data coupled with social determinants of health data facilitating a robust risk factors analysis. Method We used multivariate techniques to analyze the 2001-2002 CCHS data for Manitoba adults in order to ascertain risk factors for depression. The dependent variable for the analysis was depression defined as having a > 80% probability of depression. The independent variables entered into the model were age, sex, marital status, household income, race, education, self-defined health status, and chronic disease. All of the variables were dichotomous and were recoded from their original coding. SPSS version 17.0 Complex Samples was used to perform the analysis. Results: Logistic regression analysis yielded that being female (OR=1.666 CI=1.160-2.392) and having a self-defined health status as fair to poor vs. good to excellent (OR=3.060 CI=1.944-4.816) were the strongest predictors of depression. Conclusion Depression is a significant public health concern. Surveillance for this condition is difficult given privacy issues. Our results indicate that ongoing depression surveillance could reveal important information for health care planner. The CCHS provides an opportunity to collect data on depression for risk factor surveillance purposes. To date this opportunity has not been fully realized.

Methodology - Track 1: Tuesday, February 3, 2009 Title: Bicycle Helmet Surveillance in the Winnipeg Health Region: Enhancing Community Area Health Assessment with Observational Data Presenting Author: Dr. Lynne Warda, University of Manitoba, Manitoba, Canada Location: Courtyard Time: 2:00pm - 2:25pm The sampling design described here demonstrates a surveillance system which has allowed us to monitor helmet use by neighbourhood income level over time, and more recently to incorporate our sites into regionally defined community areas for health assessment. We have been observing bicycle helmet use at 190 Winnipeg sites since 1996. Observations are made at five location types: parks, schools, residential streets, major intersections, and cycling paths. In Winnipeg, an equal number of schools and parks were randomly selected from sampling frames of all elementary schools and parks. For major intersections and residential street locations, a city map divided into 190 neighbourhoods was used. Neighbourhoods without a school or park already assigned were alternately assigned to residential street or major intersection. Observation sites were selected to ensure that the five location types were assigned equally to six zones. Neighbourhood household median income was defined for each observation site using a City of Winnipeg map categorizing median income into four strata. More recently, the sites were re-coded to reflect Winnipeg Regional Health Authority-defined community areas. The geographies used to characterize the Winnipeg Health Region include Community Areas (12) and Neighbourhood Clusters (25). Population health profiles have been created by the WRHA for each of the 12 Community Areas; selected health issues are mapped at the Neighbourhood Cluster level. Our bicycle helmet observation sites are well represented in each Neighbourhood Cluster. This has allowed helmet analyses at the neighbourhood level by socio-economic variables as well as relevant health outcomes (e.g. injury rates in the same area). We are now able to examine helmet use trends in the context of other community risk and outcome variables in the WRHA by coding our historical sites into these community areas. This system has also been used to monitor the impact of a low cost helmet initiative, by adding participating schools and coding them by community area; helmet use at these sites was then compared to neighbourhood, community, and regional level rates. We have successfully used summer students as helmet observers, which has raised research capacity and provided sustainable funding for data collection.

Title: Measuring progress in injury prevention: Using handheld technology to monitor child and youth injury prevention behaviour Presenting Author: Dr. Lynne Warda, University of Manitoba, Manitoba, Canada

Title: Do the risk factors differ for sporadic Campylobacter, Salmonella and VTEC in different regions within Manitoba? An analysis of the methodology and results of a collaborative study.

Location: Courtyard

Presenting Author: Ms. Erin Schillberg, Manitoba Health and Healthy Living, Manitoba, Canada

Time: 2:25pm - 2:50pm

Location: Courtyard

Injuries are the leading cause of death for Canadian children and youth, and are responsible for almost 15% of hospitalizations in this age group. In order to monitor and measure progress in injury prevention across Canadian jurisdictions, the Canadian Injury Indicators Development Team was established to define and evaluate key injury indicators, including health consequences of injuries (outcome indicators), risk/protective indicators, and policy indicators.

Time: 2:50pm - 3:15pm

Part of the next phase of this project is to undertake a Risk Indicator Survey examining the prevalence of key observable injury prevention behaviours, including bicycle helmet use, child and youth passenger restraint and car seat use. The purpose of this study is to evaluate a standardized method to observe injury risk/ protective behaviours at multiple Canadian sites representing different geographic, socioeconomic, and rural/urban compositions, and over time. We have proposed a method of local data collection where multiple observations are taken by a single observer in defined neighbourhoods selected by population profile (e.g. SES, rural/urban); this allows efficiency in data collection, as helmet/seatbelt/other observations are collected within a given neighbourhood. This also creates neighbourhood profiles of injury risk/ injury promotion indicators. Our progress to date has established hardware and software requirements and options for the Risk Indicator Survey, and demonstrated with pilot observational work that this method is feasible and efficient for observational surveys of injury prevention behaviours. In the next phase of the project data collection will be completed using PDAs with web-based reporting. A standardized training package will be used to facilitate consistency across sites and observers. The students in each region will be responsible for collecting and analyzing injury risk indicator data for their region, and will have the opportunity to interact with and compare results with the other research students replicating this study across the country. This system can be adapted to any geographic level, and could be used to monitor local, regional, or national trends. It may also be adapted to measure any injury-related risk/promotion factor, such as walkability, playground surfacing characteristics and hazard assessment, traffic speed, or traffic calming measures.

Introduction Campylobacter, Salmonella and Verotoxin-producing Escherichia coli (VTEC) infect hundreds of Manitobans annually. Knowledge of the specific risk factors for each pathogen with respect to geographical area is crucial in order to establish proper public health messages and thus see a decrease in these rates. Due to the fact that these infections are common and widespread in the Manitoba population they impact many areas of the health care system including front line workers, public health staff and researchers. Thus it is vital for these groups to collaborate in order to administer timely, cost effective information to inform policy makers and bring about change in health policy. Methods This study, conducted from May to September 2007, utilized collaborations between Manitoba Health and Healthy Living, 8 Regional Health Authorities (RHAs) and Cadham Provincial Lab to recruit Manitobans with lab-confirmed cases of Campylobacter, Salmonella and VTEC. A detailed questionnaire covering a wide range of risk factors was administered to participants. Questionnaire responses were analyzed using case-case comparisons of pathogens and locations. An attempt to obtain case-nominated controls, by encouraging cases to recruit individuals in their age group and geographic area, was unsuccessful. Results Through this methodology researchers were able to contact over 88% of lab confirmed cases of Campylobacter, Salmonella and VTEC in Manitoba. Of all cases contacted 51% completed the questionnaire. A variety of significant differences were found between pathogens and locations including differences in; age, contact with water/sewage, food history, contact with animals, recreational and incidental exposure and symptoms. Conclusions The methodology utilized provided a cost effective method of contacting a significant amount of cases while working in conjunction with health professionals across the province. Although a great deal of useful pathogen and geographically specific information was obtained several lessons were learned. The utilization of case-nominated controls was unsuccessful, although cases were willing to recruit members of their family. The number of cases was low for some pathogens, thus continuing the study through another spring/summer season could have allowed for more robust results. Overall this methodology provided valuable data covering most of Manitobaâ&#x20AC;&#x2122;s RHAs while utilizing minimal resources. Partial funding provided by the Western Regional Training Center for Health Services Research.

Methodology - Track 2: Tuesday, February 3, 2009 Title: Reconciliation and Surveillance Reporting in the Enhanced Hepatitis Strain Surveillance System Project Presenting Authors: Ms. Gail Butt, BC Centre for Disease Control, British Columbia, Canada

Title: Using Administrative Data to Identify Local Risk Factors in Hospital Utilization Presenting Author: Mr. Raymond Fang, Provincial Health Services Authority, British Columbia, Canada

Title: “Understanding Our Health” a collaborative effort by Community Health Boards and Public Health Services Presenting Author: Ms. Cora Cole, Public Health, Nova Scotia, Canada

Ms. Liza McGuinness, Hepatitis Service Division, BC Centre for Disease Control, British Columbia, Canada

Location: Alexander A/B

Time: 2:25pm - 2:50pm

Time: 2:50pm - 3:15pm

Location: Alexander A/B

Introduction Identifying local risk factors in health and healthcare utilization crucial to disease control and healthcare planning has been drawing increasing attention from healthcare communities in recent years. The challenge, however, is how to obtain local level data for the purpose of local risk factor surveillance. Here, we propose to identify local risk factors for hospital care utilization for neighbourhood areas by use of health services administrative data.

Introduction Community Health Boards (CHBs) have a legal mandate, and Public Health Services (PHS) have a functional mandate to assess the health of the populations they serve. In an attempt to fulfill these mandates collaboration efforts resulted in a community health assessment plan that employs a number of community diagnostic tools at the local level. Of these tools is a grass roots health status survey.

Time: 2:00pm - 2:25pm Introduction The Public Health Agency of Canada has a national program for the enhanced surveillance of hepatitis B (HBV) and C (HCV). Hepatitis Services at the British Columbia Centre for Disease Control collects provincial surveillance data (except Vancouver) on acute cases of HBV and HCV, including risk factor information. This Enhanced Hepatitis Strain Surveillance System (EHSSS) project sends non-nominal information to the Public Health Agency of Canada. Centralized HCV testing at the BC Centre for Disease Control and the ability to compare laboratory data with other data reservoirs expanded the scope of this project to include linkages with other public health agencies and initiatives to improve surveillance reporting. Methods The EHSSS project receives daily notification of all provincial acute HCV and HBV cases and reconciles quarterly with the laboratory database to ensure their accurate and timely identification. Notifications of acute cases are also sent from the lab to the relevant public health units for data entry into the provincial public health database and patient follow-up. Vancouver Coastal Health, the other BC site responsible for acute HCV and HBV surveillance for the Public Health Agency of Canada receives notifications of acute cases for Vancouver. The EHSSS data, because of its cross check with the laboratory database, is now used as the starting point for regular reconciliations between the provincial public health database and the Vancouver Coastal Health database. Results Reconciliations between the EHSSS database and the provincial public health database identified missing or mis-dentified cases of acute HCV in the public health database. In turn, public health data confirmed additional acute HBV cases for the EHSSS project. Reconciliations with the Vancouver Coastal Health database identified missing acute HCV cases. Conclusions Provincial surveillance reporting and follow up of acute HCV and HBV cases improved through regular reconciliations of the EHSSS database, the Vancouver Coastal Health database, and the provincial public health database. Additionally, the EHSSS project directs all acute HCV and HBV blood samples to the National Microbiology Laboratory for genotyping. Regular reconciliation between the three databases ensures all available samples are genotyped.

Methods The City of Richmond, B.C. is divided into five neighbourhood areas (South Arm, Richmond Centre, Blundell, Steveston and Each Richmond) each with similar size of populations. All health care utilization records for Richmond residents during the 2003/04 fiscal year available in the BC Ministry of Health Services’ administrative database were collected and analyzed. This process involved linkage of the BC Client Registry, Hospital Discharge Abstract Database (DAD) and Medical Services Plan (MSP) databases using the personal health number (PHN). The resulting linked dataset provides a complete description of individual citizens from the five neighbourhood areas on the basis of their health condition and healthcare utilization experience. Multivariate logistic regression models were used to identify risk factors for hospitalization in each of the five neighbourhood areas. Results We found age, level of co-morbidity in the previous year, diabetes, ischemic heart disease, congestive heart failure, cancer, chronic renal failure and arthritis are risk factors for hospitalization in all five neighbourhood areas. However, hypertension is a risk factor only in the East Richmond area, whereas mental disorder is a risk factor for all areas except East Richmond. Meanwhile, COPD is a risk factor in all areas rather other than South Arm. Furthermore, having an identifiable family physician is a protective factor in the South Arm, Steveston and East Richmond areas. Finally, being female is a protective factor in all five neighbourhood areas.

This presentation will chronologically map the process used by CHBs and PHS to develop this plan. A review of the survey selection process, methodology, data analysis and an overview of the results will also be provided. Methods In consultation with Statistics Canada, PHS and the CHBs adapted the Canadian Community Health Survey (CCHS) to reflect the strategic health directions of the local stakeholders. Using the CCHS as a model for data collection approximately 3,555 surveys were conducted, and the results used to inform community level, and district level health plans. Outcomes Twelve technical health status reports have been produced. Results from the Public Health Service technical report will be presented in context of the research objectives, strategic directions and program targets. Conclusions This grass roots research enhanced the partnership between nine volunteer Community Health Boards and Public Health Services while increasing the understanding of research and evidence based decision making at a local level. In addition, local communities now have local evidence on which to generate their own health plans.

Conclusions While common risk and protective factors for hospitalization exist in Richmond, areaspecific factors were also identified. Findings of area-specific risk and protective factors are especially important to regional medical health officers and health authorities in developing public health policy for chronic disease prevention and the management and planning of primary healthcare resources for local communities.

Methodology - Track 3: Tuesday, February 3, 2009 Title: Spatial analysis of the GTA Perinatal Surveillance data using the Rapid Enquiry Facility (RIF)

Title: Core Indicators for Chronic Disease and Risk Factor Surveillance

Presenting Author: Dr. Philippa Holowaty, Halton Region, Ontario, Canada

Presenting Author: Ms. Harleen Sahota, Association of Public Health Epidemiologists, Ontario, Canada

Location: Spadina A/B

Time: 2:00pm - 2:25pm

Time: 2:25pm - 2:50pm

The Child Health Network for the GTA requested small area mapping and spatial analysis of low birth weight accross the Greater Toronto area (GTA), using livebirths for 2007 from the Niday (perinatal) database. The pattern of low birth weight across census tracts in the GTA was uninterpretable through simple GIS mapping, with small counts in rural areas appearing as areas of high risk. Use of the Rapid Enquiry Facility (RIF) as an extension of ArcView facilitated the calculation of relative risks, adjused for small numbers (based on Empirical Bayes modelling). The RIF also automates the calculation of age adjusted rates (not used here) and adjusts for co-variates (prematurity and SES in this case). The RIF interacts with WinBUGS (full Heirarchical Bayesian modelling) and SaTscan for GIS modelling to find clusters of higher risk, and exports results into RIF maps and into Excel. The resulting maps showed consistent areas of higher risk and were more informative for public health practitioners. The RIF is a useful tool for making sense of small area analysis. The talk will focus on the utility of this approach and the practical issues of using the RIF and interpreting the results at the local level.

Introduction Core Indicators for Public Health in Ontario (Core Indicators) is a collaborative volunteer initiative amongst professionals in the broader public health epidemiology community which started in 1998. Over 120 public health indicators, accompanying resources, data sources and syntax files are housed on the Association of Public Health Epidemiologists in Ontarioâ&#x20AC;&#x2122;s (APHEO) website (see www.apheo.ca). Activities. Innovations Core Indicators fills a void in Ontario by standardizing indicator definitions and calculation methods for use at the local level. With funding from the Public Health Agency of Canada (PHAC), a project manager has been hired to coordinate tasks on chronic disease and risk factor surveillance. Chronic disease indicators are currently being revised, reviewed and created along with associated resources, data sources and syntax files. One example is the creation of new syntax files for indicators on Food Insecurity and Adolescent Body Mass Index to assist with the analysis of older data. Methodologies change over time as a result of new guidelines and these new syntax files facilitate trending analyses. A new resource on standardization of rates is currently being finalized. Another development is recruitment for a new working group to address Built Environment. Planned tasks include identifying data sources, types of indicators on Built Environment and an environmental scan of relevant public health policies. Indicators are also currently being aligned with the new Ontario Public Health Standards. Outcomes Deliverables for July, 2009 include posting new and revised chronic disease and risk factor indicators, data sources and resources on the APHEO website. Other deliverables include improved data quality, project awareness, incorporating the Core Indicators in provincial surveillance protocols and other documents. A new working group and progress on Built Environment is anticipated. Conclusions Core Indicators provides standardized indicator definitions and calculation methods to public health epidemiologists in Ontario for use at the local level. Core Indicators is currently at a new stage of growth and development through the acquisition of funding. This will enhance capacity for chronic disease surveillance.

Title: Multilevel Modelling of the Social Determinants of Obesity: Implications for Regional and Local Area Risk Factor Surveillance Presenting Author: Mr. Robert Hawes, Public Health Agency of Canada, Ontario, Canada Location: Spadina A/B Time: 2:50pm - 3:15pm Introduction The World Health Organization has described the accumulation of excess body fat as a central determinant in the development of cardiovascular disease, cancer, musculoskeletal disorders and diabetes 1. Based on sentinel data from the national health surveys, a near doubling of adult obesity has occurred in Canada over the past 25 years 2, increasing from 13% in 19781979 to 23% in 20043. This epidemic of obesity has typically been described as a protracted imbalance between energy intake and expenditure 4-6; however a revitalized focus on health equity has elevated the social determinants of health to the forefront of obesity research 7-12. How the social determinants influence the development of obesity over time is central to the formation of cogent health policy, though not yet identified in the Canadian context. Methods In response, we conduct a multivariate analysis of three consecutive cross-sectional health surveys from 2001, 2003 and 2005. Selfreported height and weight, age, gender, marital status, income, education, immigrant status, ethnicity, and location of residence were collected from a nationally representative sample of 386,830 individuals, in addition to lifestyle-related variables such as smoking, alcohol use, and fruit and vegetable consumption. Multilevel logistic regression was used to evaluate the contribution of social and lifestyle factors in the prediction of obesity, while simultaneously adjusting for regional and provincial homogeneities of measurement. Results Immigrant status, visible minority status and highest income quintile were significant predictors of obesity, after controlling for demographic and behavioural covariates; this suggests three independent effects that influence obesity in a more direct manner than other social determinants of obesity. In addition, lifestyle factors for obesity were significantly mediated by the inclusion of social determinants, indicating that an â&#x20AC;&#x2DC;upstreamâ&#x20AC;&#x2122; approach to population health policy may yield considerable returns in obesity control. Conclusions The relevance of contextual factors in this "new paradigm of public health" is empirically supported using recent data from the Canadian national health surveys. The extension of this methodology to regional and local area surveillance activities is warranted, and recommendations for multilevel data collection initiatives are provided.

Knowledge Transfer - Track 1: Wednesday, February 4, 2009 Title: Surveillance to Action: the Winnipeg Regional Health Authority’s Community Engagement Strategy

Title: Using the Niday Perinatal Database to Inform Preconception Health Program Planning

Title: New Brunswick Student Wellness Survey: After The Data Analysis

Presenting Authors: Ms. Jennifer Skinner, Haliburton, Kawartha, Pine Ridge District Health Unit, Ontario, Canada

Presenting Authors: Ms. Lynn Ann Duffley, Health Education Research Group, Fredericton, New Brunswick, Canada

Ms. Catherine MacDonald, Family Health Dep., Haliburton Kawartha Pine Ridge District Health Unit, Ontario, Canada

Bill Morrison, Associate Professor of Educational Psychology, University of New Brunswick, New Brunswick, Canada

Location: Courtyard

Time: 10:30am - 10:55am

Time: 10:55am - 11:20am

Time: 11:20am - 11:45am

Introduction The Niday Perinatal database is an internet-based surveillance system that provides perinatal information for every baby born in the Eastern and Southeastern Ontario region (hospital and home births) as well as maternal data. Data entry occurs online, in real-time enabling timely and accessible data retrieval for the purpose of program planning and health status reporting.

In January 2006, New Brunswick launched a Provincial Wellness Strategy and by February, the Department of Wellness, Culture and Sport was created to oversee its’ implementation. The goals of the Provincial Wellness Strategy include increasing healthy eating, enhancing mental fitness, increasing physical activity and promoting tobacco free living. One of the Strategy’s key components is the undertaking of research, surveillance and evaluation to make informed decisions regarding areas of priority. In 2006-07, the Department of Wellness, Culture and Sport partnered with the Department of Education to survey grades 6 to 12 students from 212 eligible schools.

Introduction Epidemiologic surveillance is carried out in order to assess the health of a community or population, to ascertain early health-related concerns and to assist health planners with program development. Epidemiologic surveillance is an essential public health activity. When done well it is systematic, ongoing and populationbased. For surveillance to be meaningful it is often recognized that three types of indicators need to be collected: health outcomes, risk factors and intervention strategies. Collecting and analyzing surveillance data must be accompanied by a sound knowledge translation strategy.

Methods Preconception health education was identified as a priority for the 2009 calendar year by the Family Health Department in the Haliburton, Kawartha, Pine Ridge (HKPR) District Health Unit. Program planners used information extracted from the Niday database to inform their workshop planning and to identify the priority population. Maternal and newborn data were abstracted for the year 2007 for the HKPR District, including maternal age, parity of mother, mothers’ tobacco use during pregnancy, attendance at prenatal classes and first trimester visits as well as babies’ birthweight and babies’ gestational age at birth. The data were analysed using frequencies and cross-tabulations. Results The proportion of women within each age category (<20, 20-24, 25-29, 30-34, 35+) who smoked after 20 weeks of pregnancy decreased with increasing age. The proportion of low birthweight (LBW) babies was higher for women < 20 years (4.4%) and for women aged 35+ (7.3%). There was a higher proportion of preterm babies observed among the 35+ age group than amongst younger pregnant women. The proportion of women who attended a first trimester visit was highest amongst older women. Attendance was lower among pregnant women in the younger age groups. The proportion of women who attended prenatal classes was relatively similar across age groups. Conclusions The Niday database is an effective surveillance system, providing timely access to current, relevant and accurate perinatal information. These features make it a particularly useful tool for program planning. This case study is an excellent example of population health assessment, surveillance and research and knowledge exchange, as outlined in the Foundational Standard of the Ontario Public Health Standards. Based on the information extracted from the Niday database, a preconception health workshop is currently being planned for 2009 that will target young mothers (<24 years old) in the HKPR District. The presentation will describe this case study on knowledge transfer as well as the Niday database and its functionality as a surveillance tool.

This research was conducted by the Health and Education Research Group (HERG) at the University of New Brunswick, in partnership with the Université de Moncton, and in collaboration with the University of Waterloo. The NB Student Wellness Survey 06-07 was coordinated in a manner to encompass the Youth Smoking Survey 06-07. Almost 40,000 Anglophone and Francophone students from 184 participating schools provided responses on health attitudes and behaviours regarding physical activity, healthy eating, tobacco-free living, and/or mental fitness through the use of three survey instruments. By July 2007, participating schools were provided their results in feedback reports developed through the services of the University of Waterloo. These reports highlighted areas where schools could take action, in partnership with students, parents and community. By fall 2007, each school district received feedback reports with consolidated district results. In 2007-08, following the data analysis, HERG initiated a series of knowledge mobilization efforts with districts, schools and communities to assist school and district personnel, students, and community members to promote healthy lifestyle behaviours among students by assessing their priorities, building upon strengths within school communities, and implementing action plans. HERG continues to provide on-going support, by encouraging schools and districts to integrate their actions within existing programs, grants and activities. By September 2008, over 65% of New Brunswick schools had accessed their School Feedback Reports on Youth Smoking as compared to about 30% of schools nation-wide. Results of this surveillance initiative; successes and challenges of the knowledge mobilization efforts; and the implications for student wellness will be discussed.

Presenting Authors: Dr. Catherine Charlette, Winnipeg Regional Health Authority, Manitoba, Canada Mr. Carlos Campos, Winnipeg Regional Health Authority, Manitoba, Canada

Actions The Winnipeg Regional Health Authority (WRHA) conducts an ongoing community health assessment that is multifaceted entailing: ongoing surveillance of multiple health indicators, development of focused reports targeting emergent health-related concerns (e.g., immigrant and refugee health), and a comprehensive health assessment report produced on a five year cycle. These activities are epidemiological in nature and the ultimate goals of the community health assessment are to maintain and improve the health status of the WRHA population, and to reduce inequities in health status between population groups. To ensure that these goals are met, the WRHA has developed a community engagement knowledge translation strategy. This process is decidedly different from community consultation. Community engagement entails bringing decision-makers together for a presentation of analyzed surveillance data with evidence-guided recommendations for consideration. Discussions are then facilitated in order for a wide array of stakeholders to participate in the development of action plans. Once initiated these action plans will become part of the intervention related data that are collected and monitored. Lessons Learned Community engagement is different from community consultation. Engaging a wide array of stakeholders in action planning in response to evidence based issues arising from ongoing health surveillance, empowers those involved to both attempt to solve problems as well as monitor the impact of the interventional activities. Conclusions: Beginning from knowledge translation perspective surveillance to action strategies must involve partnerships between researchers, epidemiologists, and all levels of programmatic and decision making stakeholders.

Knowledge Transfer - Track 2: Wednesday, February 4, 2009 Title: Community Health Assessment in Manitoba: A Foundation for Chronic Disease Surveillance Presenting Authors: Ms. Maggie Campbell, Parkland Regional Health Authority, Dauphin, Manitoba, Canada Ms. Cathrine Hynes, NOR-MAN Regional Health Authority, Manitoba, Canada Location: Wood A/B Time: 10:30am - 10:55am Introduction Regionalization of health services in Manitoba led to the formation of a Community Health Assessment Network (CHAN). CHAN exemplifies the power of partnerships in community health assessment (CHA) and health planning using a population health approach in the identification of regionspecific and province-wide needs and priorities. This team includes representatives from academic research, the provincial government, eleven Regional Health Authorities (RHAs) and CancerCare Manitoba (CCMB). CHA supports chronic disease surveillance in Manitoba by examining factors related to chronic disease, identifying gaps in the data and developing partnerships to address them, and providing a forum for knowledge exchange and collaboration. Methods CHAN incorporates a population health framework, an alliance with the research sector to obtain data on select indicators, community engagement processes, and the identification of new partnerships. An evaluation component informs future CHA planning as well as ongoing chronic disease surveillance. This approach allows for knowledge creation and integration and the development of capacity for evidence-informed decision making in planning and program development / delivery. Results The establishment of a sustainable CHA network has resulted in the adoption of a province-wide population health framework with a core set of comparable indicators, as well as an ongoing forum for knowledge exchange. The findings from the first two CHAs described the burden of chronic disease at the district as well as the regional and provincial level, identifying four common chronic conditions of concern: cardiovascular disease, diabetes, cancer and diseases of the respiratory system. Variations among the RHAs were observed in the prevalence and incidence of each of these conditions and associated risk factors. Innovative chronic disease prevention initiatives based on identified needs are underway throughout the health regions in Manitoba. Conclusion: Manitoba’s collaborative process for comprehensive CHA and health planning has been fundamental in facilitating innovative chronic disease surveillance activities. CHAN facilitated the implementation of a Youth Health Survey in school divisions across Manitoba. This will be used for school-based planning and to evaluate a change in the physical education curriculum. An assessment of risk factors will be used to inform regional and provincial health planning as well.

Title: From Concept to Action Presenting Author: Ms. Laura Plett, Canadian Cancer Society, Winnipeg, Manitoba, Canada

Title: Enhancing global capacity in the surveillance of chronic diseases: seven themes to consider

Location: Wood A/B

Presenting Author: Dr. Bernard Choi, Public Health Agency of Canada, Canada

Time: 10:55am - 11:20am

Location: Wood A/B

The Canadian Canacer Society Knowledge Exchange Network (CCS KEN) began in 2004 with the emphasis on assisting health promotion practitioners and communities to use evidence from research in identifying best practices to use in particular communities. It began as a pilot project in 2 regional health authorities (RHAs). As is commonly known, it takes 10-14 years before research evidence sees the light of day in practical usage. CCS KEN is working towards reducing the time that it takes for research evidence to become available to practitioners. It does this through 2 functions - by meeting face to face and through searching out systematic reviews and pulling together health promotion initiatives that demonstrate effectiveness. CCS KEN has developed a website to highlight these initiatives which can assist practitioners in finding evidence. CCS KEN assists practitioners in how to find evidence and use it within their particular context through a mentoring relationship. Practitioners, along with their community group, identify the health issue they desire to address. Using the best practices synthesis, they work together to find the initiatives that would best address the health issue, the resources and the goals of the group. This requires a few meetings first to identify the issue and then to review the available options to meet the community's goals.

Time: 11:20am - 11:45am

Lessons Learned An important lesson is to allow communities to choose their initiatives based on their practical reality which may not always be the best practice from literature. Manitoba has recently completed surveillance of all Grade 10-12 students. With the data, community groups and schools will be able to target specific interventions in relation to physical activity, tobacco use, and nutrition. With the implementation of knowledge brokering, communities are able to move beyond theoretical concepts to practical, relevant application of what works best for their community.

Introduction Chronic diseases are now a major public health problem not only in developed but also in developing countries. Although chronic diseases are non-communicable at the disease level, they are readily transferable at the risk factor level. With increasing human progress and technological advance, the global epidemic of chronic diseases will become an even bigger threat to public health. Objective This presentation outlines seven themes to enhancing public health capacity. Although originally developed for chronic diseases, the themes can also be applied to other public health areas. Methods Based on their own experiences and publications, and literature review, the authors contributed ideas and working examples in various countries to help enhance the capacity in chronic diseases surveillance, prevention and control. In particular, new non-traditional, innovative ideas and solutions were sought. Results Ideas and working examples to help enhance the capacity in chronic disease surveillance, prevention and control were collected, and grouped under seven themes, concisely summarized under the acronym “SCIENCE” – Strategy, Collaboration, Information, Education, Novelty, Communication, and Evaluation. Conclusions The art of “SCIENCE”, and especially the new non-traditional innovative ideas that the authors have experienced or read about in their work, can help enhance the capacity in chronic disease surveillance, prevention and control. They can help achieve the new World Health Organization global goal of reducing chronic disease death rates by 2 percent annually, generate more new ideas, and ultimately bring chronic diseases under greater control.

Knowledge Transfer - Track 3: Wednesday, February 4, 2009 Title: Development of a Chronic Disease Risk Factor Inventory Matrix

Title: Enhancing Ontario’s RRFS website to facilitate knowledge exchange

Presenting Authors: Ms. Jonna Oliver, Halton Region Health Department, Ontario, Canada

Presenting Authors: Ms. Rachel Savage, Ontario Agency for Health Protection and Promotion, Ontario, Canada

Ms. Kim Bergeron, School of Kinesiology and Health Studies,Queen’s University, Ontario, Canada. Location: Spadina A/B Time: 10:30am - 10:55am Introduction Building on the work of PHAC’s Centre for Chronic Disease Prevention and Control, APHEO was approached to provide their expertise in the development of a prototype of a chronic disease risk factor inventory matrix structure (matrix). The intended users of this matrix are policy makers and public health practitioners. The goal of the matrix is to provide up-to-date information on emerging and established risk factors and determinants related to chronic diseases in Canada. Activities The APHEO Work Group (Work Group) developed a matrix prototype, based on a list of chronic diseases, risk factors and determinants identified by various chronic disease experts. Work Group members used literature reviews commissioned by PHAC to guide the development of this prototype. Pilot testing on the structure, function and usefulness of the prototype was conducted with a group of chronic disease experts and other APHEO members. Their feedback was used to further guide enhancements for development of a web-based user interface application prototype. The web-based application was showcased at a PHAC Consensus Conference in November 2008. Outcomes The prototype allows the user to query the matrix for select chronic disease and/ or risk factor information, including prevalence, incidence, economic burden, mortality, morbidity, disability-adjusted life years and potential years of life lost. Indicators of risk/burden/impact are presented (where available), including relative risk, odds ratio, hazard ratio, population attributable risk or fraction, and attributable risk or fraction. Results can be stratified by age, sex, ethnicity and SES. All query reports contain relevant information for the interpretation of the results provided. For example the strength of the evidence of the relationship between the selected risk factor and chronic disease is included. The matrix will support hyperlinks to other data sources. Next Steps Based on feedback and discussion with experts at the PHAC Consensus Conference, the Work Group is working to incorporate the information, provide and write a final project report to be submitted to PHAC. This report will highlight the process that was used and include recommendations on how to proceed beyond the prototype stage so it can become an ongoing source of up-to-date information related to chronic disease risk factors.

Dr. Kathleen S. O’Connor, Director of Research and Education, KFL&A, Ontario, Canada Ms. Alanna Leffley, Health Department, Owen Sound, Ontario, Canada Location: Spadina A/B

Title: Use of Risk Factor Surveillance Data to Create Model Core Program that Support a Public Health Approach to Prevention of Hams Associated with Psychoactive Substance Presenting Authorss: Mr. David Lingard, Ministry of Healthy Living and Sport, British Columbia, Canada Mr. Warren O’Brian, Ministry of Healthy Living and Sport, British Columbia, Canada Location: Spadina A/B

Time: 10:55am - 11:20am

Time: 11:20am - 11:45am

Introduction In Ontario, the Rapid Risk Factor Surveillance System (RRFSS) provides timely data on public health issues to support public health programming and evaluation. Increasingly, the internet has been identified as a powerful tool to share surveillance system resources and results. A 2005/2006 evaluation of RRFSS highlighted the potential to improve sharing of key RRFSS reports and results through enhancements to the RRFSS website. In 2007, the existing RRFSS website was evaluated and website improvements were identified and implemented.

Introduction Robust risk factor surveillance capacity provides data required to formulate sound policies and programs, allocate resources effectively and to support system-wide decisionmaking to prevent and reduce harms from substance use. In 2005, the Province, four BC health authorities and Health Canada combined resources to launch the BC Alcohol and Other Drug (AOD) monitoring project led by the Centre for Addictions Research of BC. The AOD monitoring project collects and organizes multiple streams of data related to risky substance use and associated harms in BC. Also in 2005, British Columbia's public health system began development of 21 model core public health programs to serve as performance improvement tools and achieve increased consistency, capacity and quality of public health services across the province. The Ministry of Healthy Living and Sport was in a position to link these two initiatives.

Methods Prior to implementing website enhancements, the website was evaluated through telephone interviews with RRFSS representatives, an online survey of website visitors, usability testing and a card sorting exercise. The results were used to identify areas for enhancement. As part of improvements to the website, a web-based query system was simultaneously built to allow website visitors to query core prevalence data more easily. Results Short-term improvements in the areas of organization, navigation, search capabilities and content were implemented and evaluated positively by RRFSS representatives. Long-term suggestions were made and are awaiting implementation. These suggestions include adding content to the site such as analytical tools and local RRFSS reports; developing an online calendar; developing and instituting a moderated forum for RRFSS members to provide a place where members could interact; and developing a system to allow RRFSS data sets to be downloaded directly from the website. All improvements were perceived as vital to improving knowledge exchange within the RRFSS partnership. Additionally, a web-based query system was created for core prevalence data and shared with RRFSS members at the annual workshop in June 2008. Experiences of local public health units using this query system to share RRFSS results with various stakeholders such as public health unit staff and community and academic partners will be described. Conclusions Website enhancements can help to alleviate some of the burden at the local level by providing easy access to surveillance results and information as well as provide a platform to share and discuss findings with staff and stakeholders. Recommendations for ongoing improvements and maintenance of the website will be discussed.

Methods In 2008, health authority and Ministry partners developed a model core public health program to prevent harms associated with psychoactive substance use, including a logic model describing activities, outputs and outcomes. Available data sets, including those collected and organized through the AOD, were presented as potential core program indicators, and agreement among partners on those selected was sought and confirmed. Ultimately, each outcome within the logic model was linked to indicators drawn from provincial risk factor and substance use data. Lessons Learned Government is uniquely positioned to link research, surveillance and monitoring to policy and program development. Early attention to creating relevant, usable streams of data to monitor population-level risk factors is best built on meaningful partnerships among researchers, policy developers and service delivery partners. Using a logic model approach made explicit the link between surveillance data and optimal policy and program development. This in turn led one additional health authority to join the AOD partnership. This experience is being applied to other model core programs, such as mental health promotion and mental disorder prevention. Conclusion Collecting, organizing, analyzing and presenting multiple streams of risk data in formats usable to measure policy and program outcomes helps build mutual understanding among researchers, policy developers and service delivery partners in the short-term. Using this data to measure policy and program impact will, over time, promote systemwide accountability for results.

Workshops The CARRFS Symposium Working Group has organized four workshops for this symposium, all timely topics for regional risk factor surveillance. The first workshop is put together by Charles Burchill from the University of Manitoba’s Faculty of Medicine’s Center for Health Policy, focuses on the use of Geographical Information Systems (GIS) for risk factor surveillance. This workshop will provide an overview of the basic concepts of GIS accompanied by demonstrations of these concepts. The second workshop has been developed by Cristina Ugolini and Lara Murphy of Saskatoon Health Region’s Public Health Observatory and will discuss the processes involved in developing their Health Authority’s Public Health Observatory and Comprehensive Community Information System. The third workshop, with presenters from Manitoba, Ontario and New Brunswick, is focused on school-based risk factor surveillance. This workshop will explore the experiences in these three provinces with the development and execution of school-based youth risk behavior surveys. Presenters will discuss in detail the development and implementation of their surveys as well as their knowledge translation efforts. The last workshop will explore the scope and application of indicators of community vitality by showcasing how various indicators can be used to analyse population health evidence at the local level. The presenters for this workshop, Verlé Harrop, Alton Hollett, and Doug May, bring considerable experience and expertise to this undertaking. 31

Workshop 1: GIS - Incorporating Spatial Analysis into Regional/Local Risk Factor Surveillance Time: 1:15 - 3:45pm, Day 3 - Wednesday, February 4, Courtyard Abstract Geographical Information System (GIS) software can be used to augment planning, monitoring, analysis, and research capabilities in medicine and public health. GIS can facilitate the standardization and integration of diverse data resources for health and disease surveillance activities. The overarching goal of this workshop is to introduce attendees to the main concepts of GIS and how geographic information can be used in health planning, research and policy development. The workshop will provide an overview of the basic concepts of GIS accompanied by demonstrations of these concepts. Group discussions will be interspersed throughout the workshop. This workshop should be considered a springboard for building new skills. AcrGIS software will be demonstrated in the workshop and a free copy with a 60-day license will be provided to each participant. Objectives 1) To introduce attendees to how GIS can be used to augment planning, monitoring, and analysis in public health. 2) To demonstrate how GIS facilitates the standardization and integration of diverse data resources, and permits the management and convergence of various risk factor and disease surveillance activities. 3) To explain the essential components needed (e.g., software and additional training) to being successful with using GIS.

John Snow’s mapping of the London Broad Street cholera outbreak in 1854 is the first example of what would come to be known as GIS.

Content The use of GIS has great potential both for the management of chronic disease and for the analysis of populationbased, clinical and administrative health care data. In addition to demonstrating the basic concepts of using GIS, this workshop will address how the growing

use of GIS is transforming epidemiological surveillance activities to inform health planning, and public health research. For example, the workshop will discuss and demonstrate how GIS can be used to combine geo-referenced data with large population-based databases to create a common data set for efficient multivariate and trend analyses that can be used in a variety of health and disease surveillance efforts such as: • Geographical distribution and gradients in disease prevalence and incidence. • Geospatial and longitudinal disease trends. • Identification of differential populations at-risk based on risk factor profiles. • Differentiating and delineating risk factors within a population. • Population health assessment. • Intervention planning; assessment of various intervention strategies and their effectiveness. • Anticipating epidemics. • Real-time monitoring of risk factors and diseases, locally and globally Prerequisite Knowledge for workshop participation There are no major pre-requisites for this session. Participants should be generally familiar with the concept of GIS. Workshop Chair M. Nawal Lutfiyya, PhD Epidemiologist Winnipeg Regional Health Authority and Faculty of Medicine, University of Manitoba, Department of Community Health Sciences 1800-155 Carlton Street Winnipeg, Manitoba R3C 4Y1 Canada Phone: 203-926-7069 Email: nlutfiyya@wrha.mb.ca

Workshop Presenter Charles Burchill, MSc Manitoba Centre for Health Policy University of Manitoba, Winnipeg, Manitoba R3E3P5 Canada Phone: (204)789-3429 fax(204)789-3910 E-mail: Charles_Burchill@cpe.umanitoba.ca 32

Workshop 2: Creativity in the Capacity for Regional/Local Risk Factor Surveillance in Canada Time: 1:15 - 3:45pm, Day 3 - Wednesday, February 4, Carlton Abstract Evidence, Action Equity: Making Population Health Information Count is the vision of the Saskatoon Public Health Observatory (PHO), Public Health Services. Good information presented in a timely fashion can lead to better decision making. The PHO has been building its approach to surveillance of both communicable and chronic disease within the resident population of Saskatoon Health Region (SHR) through: • Program of health surveillance including communicable and chronic disease and the underlying determinants of health that monitors health and disease trends and highlighting areas for action; • Program of population health research in line with agreed regional priorities • Knowledge translation for evidencebased public health practice. • Training and teaching of practitioners and future practitioners in evidencebased public health practice. In addition, the PHO is also working with several local human service partner agencies to develop the Comprehensive Community Information System (CCIS), a unique regional risk factor surveillance system, that will draw together information from different sources in new ways to improve health. Workshop presenters will discuss the processes involved in developing the Public Health Observatory and CCIS.

The Public Health Observatory coordinates surveillance and analyzes these data from a number of spheres of activity

Objectives 1) To introduce attendees to how a Public Health Observatory (PHO) can be used for public health planning, monitoring, and on-going risk factor surveillance and data analysis. 2) To demonstrate how a Public Health Observatory facilitates the management and convergence of various risk factors, i.e., social determinants of health and disease surveillance activities. 3) To explain the essential components needed to create this Public Health Observatory model in Saskatoon. 4) To demonstrate the PHO’s Comprehensive Community Information System prototype. Content The workshop will describe how the observatory was established, how it presently works, what it has been able to accomplish, what vision exists for future work and finally what challenges are anticipated in sustaining the CCIS surveillance system. Presenters will demonstrate the observatory’s webbased portal prototype. Prerequisite Knowledge for workshop participation There are no major pre-requisites for this session. Participants should be generally familiar with risk factor surveillance. Workshop Chair Cristina Ugolini Manager, Public Health Observatory Public Health Services Saskatoon Health Region e-mail: Cristina.Ugolini@saskatoonhealthregion.ca Phone: 306.655.4480

Workshop Presenters Cristina Ugolini Manager, Public Health Observatory Public Health Services Saskatoon Health Region Phone: 306.655.4480 Email: Cristina.Ugolini@saskatoonhealthregion.ca

Lara Murphy Epidemiologist and Project Coordinator Comprehensive Community Information System, Public Health Observatory Public Health Services Saskatoon Health Region Email: lara.murphy@saskatoonhealthregion.ca Website: http://www.saskatoonhealthregion.ca/ your_health/ps_public_health_pho_about.

Workshop 3: School-based Survey: Making Them Work Time: 1:15 - 3:45pm, Day 3 - Wednesday, February 4, Spadina A/B

Abstract Successful school-based youth risk behavior surveys need to seek and establish collaborative research alliances with local, provincial and national partners. Typically these include the following partners: school districts, regional health authorities, universities, and national public health agencies such as the Public Health Agency of Canada. Done well such surveys can provide a rich source of data that allow for the assessment and monitoring of health and risk behaviours engaged in by youth. The data, once analyzed can assist schools, health authorities and others to develop programs and policies to impact the health behaviours of youth. Since presently there is no national school-based youth risk factor behaviour survey in Canada, the process of establishing such a survey either regionally or nationally will be addressed in this workshop. All presenters have had considerable experience establish-ing and implementing such surveys. Objectives To explore in an interactive way effective methods to conduct risk factor surveys in the school setting including: • Working with the schools to identify survey content including child, family, educator, and school and community environment indicators. • Getting consent and high response rates. • Survey method – questionnaires and physical measurements • Communicating the results and promoting action

• Evaluation of the process and starting the cycle again • Implication for surveillance in Canada Content The workshop will explore the experiences nationally and in three different provinces (Manitoba, New Brunswick and Ontario) with the development and execution of schoolbased youth risk behavior surveys. Presenters from each province will discuss developing necessary partnerships and planning the survey, consenting procedures, survey methodology and knowledge translation efforts. Also the choices involved in the survey cycles (frequency) will be addressed. Workshop attendees will become familiar with the steps necessary to planning and developing a school-based youth risk factor survey and benefit from a discussion of the lessons learned from successful projects. Prerequisite Knowledge for workshop participation There are no major pre-requisites for this session. Participants should be generally familiar with risk factor surveillance and be interested in school-based surveys. Workshop Chair Jane Griffith, PhD CancerCare Manitoba Phone: 204.787.2178 Email: Jane.Griffith@cancercare.mb.ca

Workshop Presenters

Evidence-informed decision-making is critical to maximizing the effectiveness of schoolbased health programs and policies.

Tannis Erickson Manitoba Youth/School-Based Survey Interlake Regional Health Authority Phone: 204.642.4552 E-mail: terickson@irha.mb.ca Lynn Ann Duffley School-based Risk Factor Survey in New Brunswick Phone: 506.447.3173 or 1.888.390.2822 E-mail: duffley@unb.ca Please visit: www.unbf.ca/education/herg Jane Griffith, PhD CancerCare Manitoba Phone: 204.787.2178 E-mail: Jane.Griffith@cancercare.mb.ca

Steve Manske, PhD Centre for Behavioural Research and Program Evaluation Lyle S. Hallman Institute University of Waterloo Waterloo, Ontario, Canada N2L 3G1 Phone: 519.888.4518 E-mail: manske@healthy.uwaterloo.ca Dr. Bill Morrison Associate Professor of Educational Psychology Faculty of Education University of New Brunswick Executive Director Health and Education Research Group Eamil: wmorriso@unb.ca 34

Workshop 4: Indicators of Community Vitality Time: 1:15 - 3:45pm, Day 3 - Wednesday, February 4, Wood A/B Abstract The purpose of this workshop is to explore the scope and application of indicators of community vitality (or health). The focus of the workshop is to substantiate the indicators, methods and models currently in use (or being developed) to assess community vitality at the neighbour-hood or municipal level. This theme proposes place as an intermediary of individual and collective health, by paying attention to such topics as the built and social environment to understand health outcomes. Spatial indicators have the potential to enhance local risk factor surveillance by contextualizing individual and group-level data, so that it becomes possible to study patterns (behavioural, social) and the relationships in situ. This workshop will showcase how various indicators can be used to analyse population health evidence at the local level.

their lives. This information may be useful to explain the health portrait of individuals and groups within a particular (social) geography. Place is likely more than a spatial unit; it may have a more direct influence on health than previously understood.

Objectives 1) To provide a venue to discuss indicators of community vitality 2) To showcase methods and models to assess community vitality 3) To explore the utility of spatial indicators to analyse health status

Prerequisite Knowledge for workshop participation There are no major pre-requisites for this session.

Content What is the role of place in health? Is it incidental or consequential? How would we know? These are questions that public health researchers, practitioners, and decision makers have begun to consider in earnest. In a special supplement of the Canadian Journal of Public Health, a number of methods and theoretical models explain the possible intersections of place-based (social, physical, and work-related) factors. These eco-social indicators tell us something about the context in which people live

As communities strive for continual improvement capturing accurate and timely data that reflect the well-being of a community is becoming increasingly important.

This workshop will expose participants to innovative practices that track and try to explain the links between health status, physical and social environments, at the local level. These systems share a common characteristic – they collect and integrate information from diverse sources, many of which fall outside the health portfolio. Participants will be able to come into direct contact with those who have conceptualized, constructed, and utilized indicators that measure community vitality to inform and report on public health interventions and policies.

Workshop Chair Andrea Simpson, MSc. A/ Regional Surveillance Analyst / Analyste régional(e) de la surveillance par intérimaire Public Health Agency of Canada Atlantic Region Agence de la santé publique du Canada Région de l'Atlantique Tel/Tél: 902.426.2400 Fax/Téléc: 902.426.9689 E-mail/courriel: andrea_simpson@phacaspc.gc.ca

Workshop Presenters Verlé Harrop PhD Senior Researcher, Applied Health Research, Research Services Atlantic Health Sciences Corporation P.O. Box 2100 Saint John, New Brunswick E2L 4L2 Canada Phone: 506.648.7944 Fax 506.648.6173 Email harve@reg2.health.nb.ca Alton Hollett Assistant Deputy Minister Economics and Statistics Branch Government of Newfoundland and Labrador, Department of Finance

P.O. Box 8700 St. John's, NL, A1B 4J6 Email: ahollett@gov.nl.ca Doug May, PhD Department of Economics Arts and Administration Building, Room AA-3077 Memorial University of Newfoundland St. John's, NL, A1C 5S7Canada Phone: 709.737.8274 website: http://www.mun.ca/econ/ faculty_and_staff/may/ Email: dmay@mun.ca 35

Open Café Forum This session at the 2009 CARRFS Symposium will allow participants to discuss issues and topics of high interest and concern with other attending CARRFS members. Recognizing that there are many issues and topics that are relevant for CARRFS members which might not be covered in a formal session, the Symposium organizers have open up the event to allow an opportunity for participants to discuss their own “burning” questions. Prior to the Symposium, please think about a symposium-related topic or question which you want to have discussed among your peers.

Participate and Enjoy!

Open Café Forum - The Process This is the procedure for the Open Café Forum on Tuesday, February 3, 2009 from 3:45pm to 5:00pm: 1: Question/topic areas to be requested. Participants will be asked to write their questions on the ‘post-it’ sheets placed in the Courtyard Foyer - just outside the Courtyard plenary room. All the questions must be signed with names (readable) and posted on the board during the morning network and refreshment break that starts at 10:30am 2: An assigned working group will review the suggested questions and pick 7 to 10 questions to be discussed. 3: The chosen questions will be written on the top ‘post-it’ sheet and placed in the Courtyard Foyer - one question per sheet. Participants will be asked to sign up for question during the lunch. 4: Introduction of chosen questions will be made prior to the Keynote address at 1:15 pm 5: Working group to review numbers and assign room numbers to each question and post room numbers prior to network break at 3:15pm 6: The author of the chosen question will start/chair the discussion. Each person in the group is given a short introduction. 7: Each group is being asked to provide a one page overview of the discussion to be handed in to the chair of the Open Café Forum

Catherine Hynes, Chair, Open Café Forum 38

Showcase The 2009 Symposium Working Committee is pleased to introduce Showcase to the Symposium. The Purpose is to provide the participants with cutting edge technologies which can inspire them to use in their own jurisdiction. The two showcase will take place during the lunch break Tuesday Feb. 3 and Wednesday, Feb. 4 in the Courtyard plenary room.

1: Skills Enhancement for Public Health To strengthen our public health system, it is essential to develop a competent public health workforce using a competency-based approach.Through a series of Internetbased modules in English and French, the Skills Enhancement program helps public health practitioners increase their knowledge, skills and abilities to support the core competencies for public health. Applying these skills will result in sound evidence-based decision-making and planning to protect and maintain the health of the public. The Program is designed for public health practitioners across Canada, for example, public health nurses, environmental health professionals, health promoters, program managers, dental hygienists, dietitians, policy analysts, and other public health practitioners.The Program provides continuing education at its best - an adult learning environment for public health practitioners who want to strengthen their public health knowledge and skills and make better-informed public health decisions.The Internetbased modules are offered over an 8-week period during Fall, Winter, and Spring sessions. Modules are available in both English and French to public health practitioners across Canada. Interdisciplinary teams of learners from across the country are guided through the Canadianfocused content and assignments by a trained facilitator, and are connected through discussion boards. Each module is relevant and specific to Canadian public health practice. Online, distance learning is both more affordable and flexible than traditional continuing education opportunities, and participation occurs according to the schedules of the learners within the 8 week timeframe.

2: Geographical Information System - GIS The GIS Infrastructure is a focal point for the promotion, research, and use of geomatics in Canadian public health practice. We work directly with public health professionals to provide geomatics resources that support their spatial information needs, tailored to their range of skills and experience. We do this by acting as spatial data custodians, providing tools and mapping services, developing and delivering training materials, and engaging in research activities and collaborations.

Abstract Authors Bio Ms. Kim Bergeron, School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada. Kim has extensive experience working in the Ontario public health system, particularly in the area of chronic disease prevention. She is currently working on a PhD in the School of Kinesiology and Health Studies at Queen’s University. In her role as a consultant, she assists organizations in developing ideas into successful projects. She works with organizations to facilitate a shared understanding and enhance their knowledge capacity by conducting research and engaging in evidence-informed practice. Ms. Gail Butt, BC Centre for Disease Control, British Columbia, Canada Phone: 604-660-4724 Email: gail.but@bccdc.ca Gail Butt, RN, MHSc, PhD(c), has been the Associate Director of BC Hepatitis Services at the BC Centre for Disease Control since 2001. She is currently completing research for her Ph.D dissertation through McMaster University on the relationship between service integration and need, capacity, and access in nurse-led clinical service networks. She is the project director of the Health Canada multi-centre collaborative project "Enhanced Surveillance for Hepatitis B & C in British Columbia." Ms. Maggie Campbell, Parkland Regional Health Authority, Manitoba, Canada Phone: 204-622-6233 Email: mcampbell@prha.mb.ca As Executive Director, Planning & Evaluation, Maggie has regional responsibility for strategic planning, health plan development, and community health assessment. Her work experience includes education, community development and health promotion. Maggie is a member of Manitoba's Community Health Assessment Network. Mr. Carlos Campos, Winnipeg Regional Health Authority, Manitoba, Canada Carlos is also Coordinator of the WRHA Health Interpreter Training and Recruitment Project of the WRHA Language Access Program. Carlos worked in the Language and Ethnicity Indicators Data Collection Project for the Unit and also coordinated the Improving Access to Health Services for Immigrant and Refugee Communities project in the Brandon Regional Health Authority. Carlos completed a Baccalaureate degree in Psychology in El Salvador and a Master of Sciences in Information and Communication in Ball State University, Indiana. He has carried out the implementation of qualitative research, community based research, community consultation, and project evaluation. His areas of investigation include language access, gaps and barriers to access health services, and access to technology and information about settlement and integration for newcomers. Most recently, Carlos has been involved in the evaluation of an inner city immunization program in Winnipeg and the development of dissemination and engagement strategies for the Immigrant and Refugees focused report of the WRHA Community Health Assessment.

Dr. Catherine Charette, Winnipeg Regional Health Authority, Manitoba, Canada Phone: 204-926-7033 Email: ccharette2@wrha.mb.ca Catherine Charette is a Research Associate at the Winnipeg Regional Health Authority. She leads or contributes to a variety of research and evaluation activities and is the coordinator of the 2009 Community Health Assessment. Her research interests include poverty, underserved populations, and urban disparities. Catherine obtained her Ph.D. in Interdisciplinary Studies (Sociology, City Planning, and Geography) from the University of Manitoba where she studied the demographic, socio-economic and cultural aspects of inner city change. She obtained a master’s degree from Iowa State University where she researched resident satisfaction in governmentassisted housing. She was the recipient a SSHRC Doctoral Scholarship and a Canada Mortgage and Housing Graduate Scholarship. Prior to joining the WRHA, Catherine worked at the Universities of Winnipeg and Manitoba where she: conducted research and needs assessments on neighbourhoods, housing, and underserved populations; taught courses on housing, communities. Dr. Bernard Choi, Public Health Agency of Canada, Canada Phone: 613-957-1074 Email: Bernard_Choi@phac-aspc-gc.ca Dr. Bernard Choi is a Senior Research Scientist at the Public Health Agency of Canada. He is also an Associate Professor in the Department of Public Health Sciences, University of Toronto; and an Adjunct Professor in the Department of Epidemiology and Community Medicine at the University of Ottawa. He has a PhD (epidemiology) from the University of Toronto, an MSc (occupational health and safety) from England, and a BSc (biochemistry) from Hong Kong. He has conducted original research and published widely in the epidemiology and surveillance of chronic diseases, such as cardiovascular disease, cancer, asthma and diabetes; and risk factors, such as smoking, alcohol, nutrition and physical inactivity. He has published a series of Choi’s novel statistical equations and mathematical procedures. Currently his research interest is in chronic disease and risk factor surveillance, knowledge translation, program evaluation and international health. Ms. Cora Cole, Public Health Epidemiologist, Eastern Nova Scotia, Nova Scotia, Canada Phone: 902-566-5489 Email: cora.cole@publichealth.ns.ca Cora is a Public Health Epidemiologist for two health authorities in Eastern Nova Scotia (Guysborough/Antigonish/Strait and the Cape Breton District Health Authorities). She has worked in Public Health for almost 10 years. Cora is a member of the Association of Public Health Epidemiologists in Ontario, CPHA and the Public Health Association of Nova Scotia. Cora is involved in a number of local and provincial projects which focus on public health information management and best practices. She has a passion for evaluation leading to the improvement of public health programs, and policies. Recent projects include the Understanding Our Health Survey, and the implementation of a Balanced Scorecard.

Ms. Corry Curtis, Health Promotion Specialist, City of Hamilton Public Health Services, Ontario, Canada Her public health experience includes work in both tobacco control and injury prevention. Corry currently works within the youth substance abuse prevention portfolio, developing, implementing and evaluating effective, evidence-based youth prevention programs. Mr. Vincent Dale, Assistant Director in Health Statistics Division, Statistics Canada, Ontario, Canada Vincent Dale is responsible for the Canadian Community Health Survey. I have worked on CCHS since 1999 in a variety of roles including content development, data collection and dissemination. Ms. Lynn Ann Duffley, Health and Education Research Group, University of New Brunswick, New Brunswick, Canada Phone: 506-447-3173 Email: duffley@unb.ca Lynn Ann has worked for 27 years in health promotion and policy. In August 2007, she joined UNB’s Health and Education Research Group as a research associate on secondment from the Canadian Cancer Society (CCS). As Director of Wellness Initiatives, her graduate work in surveillance and knowledge translation focuses on health attitudes and behaviours of students & parents. She is interested in knowledge translation as a means to move evidence into policy and practice; with has a strong commitment to tobacco control. Her work experience includes 14 years with the CCS working on public issues & communications; and 8 years with the Heart & Stroke Foundation promoting heart health. In 2005, Lynn Ann received the National Award of Merit from the Non-Smoker’s Rights Association for her contribution to protecting and improving public health. She is serving her 2nd term as the National President of the Canadian Council for Tobacco Control. Mr. Raymond Fang, Department of Population & Public Health, BC Provincial Health Services Authority, British Columbia, Canada Phone: 604-875-7355 Email: rfang@phsa.ca Raymond Fang is a seniorstatistical scientist in the Department of Population & Public Health, British Columbia Provincial Health Services Authority (PHSA) since 2005.Raymond’s work focuses on developing population health surveillance initiatives and projects in B.C. His research interests are determinants of health and healthcare services utilization, causality modeling of chronic diseases and socioeconomic inequities in health. Before joining PHSA, Raymond was a statistician with BC Cancer Agency and conducted epidemiological research on cancer surveillance and identification of occupational and environmental carcinogens. Raymond is active in knowledge dissemination. Each year he makes multiple presentations at regional, national and international conferences and seminars. As an invited speaker, Raymond presents to the BC Ministry of Health, other government bodies and universities. He has authored or co-authored articles at peerreviewed scientific journals including a paper linking

Abstract Authors Bio Mr. Robert Hawes, Public Health Agency of Canada, Canada Phone: 613-946-6735 Email: robert_hawes@phac-aspc.gc.ca Robert Hawes is a research analyst within the Chronic Disease Surveillance Division at the Public Health Agency of Canada, and a PhD candidate in Population Health at the University of Ottawa. His current research activities include the social determinants of chronic disease, and the application of modern quantitative techniques to improve risk factor surveillance. Dr. Philippa Holowaty, Halton Region Health Department, Ontario, Canada Phone: 905-825-6000 x 7858 Email: philippa.holowaty@halton.ca Dr. Philippa Holowaty is an epidemiologist at Halton Region health department and has been a public health epidemiologist since 1996. She is also Assistant Professor at McMaster University (PT)CSEB. Ms. Anne Marie Holt, Senior Epidemiologist and Manager of Epidemiology & Evaluation Services at the Haliburton Kawartha Pine Ridge District Health Unit. Ontario, Canada Anne Marie Holt has been working as an epidemiologist in public health in Ontario for 8 years. She received her bachelors of science at the University of Waterloo in Health Studies and continued her Masters degree in Community Health & Epidemiology at the University of Toronto. She began her career in public health at Toronto Public Health. She has been an active member of the Association of Public Health Epidemiologist in Ontario executive for several years and is currently representative to the Association of Local Public Health Agencies Board of Directors. She has been involved for several years with the Rapid Risk Factor Surveillance System in Ontario and has since had the opportunity to be one of the partners in the “Public Health Monitoring in Ontario Study” with the Centre for Addiction and Mental Health. Ms. Catherine Hynes, Regional Manager, Decision Support of the NOR-MAN Regional Health Authority, Manitoba, Canada Catherine is responsible for coordinating decision support services within the NRHA by providing a resource and support role to all departments and teams within the NRHA to effectively use qualitative and quantitative data for evidencebased planning. Lead for NRHA Comprehensive Community Health Assessment, Client Satisfaction, Risk Factor Surveillance, and Community Engagement / Consultation activities. Mr. David Lingard, Ministry of Healthy Living and Sport, Government of British Columbia, British Columbia, Canada Phone: 250-952-1578 Email: david.lingard@gov.bc.ca David Lingard, BSc is a Research Analyst with the Communicable Disease and Addictions Prevention (CDAP) Branch of the BC Ministry of Healthy Living and Sport. Prior to David's work with CDAP he was a research assistant with Dr. Brian Emerson, a specialist in community medicine and a medical consultant with the provincial government. David has sought admission to medical school in the fall of 2009 in hopes to pursue a career in public health. Ms. Alanna Leffley, Health Department, Owen Sound, Ontario, Canada Alanna is the epidemiologist at a rural health department in Owen Sound Ontario. She has been a RRFSS member since 2002 and was on the Website Evaluation and Enhancement Group.

Dr. M. Nawal Lutfiyya, Chronic Disease Epidemiologist, Winnipeg Regional Health Authority, Manitoba, Canada Dr. Lutfiyya came to Winnipeg from the University of Illinois-Chicago College of Medicine at Rockford where she was the Director of Research for the Department of Family and Community Medicine. She also held a joint appointment in the School of Public Health at UIC. Nawal trained at the University of Iowa in Iowa City and the University of Massachusetts at Amherst. She took her undergraduate training in sociology and social psychology at the University of Manitoba. In addition, Nawal completed both post-doctoral and fellowship training. Dr. Lutfiyya has taught clinical epidemiology, preventive medicine, health communication and chronic disease management to medical students and analytic methods and biostatistics to both medical and graduate students. Dr. Lutfiyya is well published and her work can be found in a wide variety of journals such as the International Journal of Health Care Quality, the Journal of General Internal Medicine and the Journal of Women’s Health Ms. Catherine MacDonald, Family Health Dep., Haliburton Kawartha Pine Ridge District Health Unit, Ontario, Canada Catherine is a graduate of Trent University with a Bachelor of Science in Nursing, 2006. She is a Public Health Nurse in the Family Health Department of the Haliburton Kawartha Pine Ridge District Health Unit in Port Hope, Ontario. She is currently a Team Lead in Reproductive Health, works in the Healthy Babies Healthy Children and Canadian Prenatal Nutrition Program programs, and has developed an interest in working with adolescent parents. Ms. Gisele Maillet, New Brunswick Provincial HEP Coordinator, Addictions and Mental Health Services, New Brunswick, Canada A social worker who has worked mostly with youth and their families in various capacities including as a school social worker and within the hospital system in child psychiatry, pediatrics and neonatal intensive care. Gisele is currently New Brunswick’s Provincial HEP (Health, Education and Enforcement in Partnership) Coordinator with Addictions and Mental Health Services, working towards advancing the efforts of community based committees whose work focus on substance use prevention and health promotion. Gisele is currently completing research for Masters Degree in Social Work. Her research focuses on parental perceptions of societal reactions following perinatal death. She lives in Cocagne, NB with her two children, Janie and Marcel Ms. Liza McGuinness, Hepatitis Services Division, BC Centre for Disease Control, British Columbia, Canada Ms. Liza McGuinness, received an MA in Anthropology from the University of Victoria. She has managed numerous health research projects centering on chronic illnesses such as HIV/AIDS, diabetes, cancer and hepatitis C. She currently manages multiple research projects for the Hepatitis Services Division including the Enhanced Hepatitis Strain Surveillance research on acute hepatitis C and B. Ms. Kathy Moran, Public Health Branch, Ontario, Canada Phone: 905-830-4444 x 4507 Email: kathy.moran@york.ca Kathy Moran is an epidemiologist with extensive experience developing and implementing the local rapid risk factor surveillance system in Ontario called the the Rapid Risk Factor Surveillance System (RRFSS). She brought lessons learned from RRFSS to expand local surveillance for children and youth in the development of the Public Health Monitoring of Risk Factors (PMO).

Bill Morrison, Associate Professor of Educational Psychology, Faculty of Education University of New Brunswick, New Brunswick, Canada Dr. Bill Morrison is Executive Director Health and Education Research Group. As a psychologist and academic, Dr. Morrison has been actively involved in projects focusing on health research, program evaluation, and the implementation of communitybased rehabilitation services for high-risk children and their families. Over the past ten years he has received funding from CIHR, Health Canada, the National Crime Prevention Center and the Department of Wellness, Culture and Sport to complete a range of research initiatives related to tobacco control, crime prevention, student and workplace wellness and knowledge translation of health research in educational and clinical contexts. In January 2007, Dr. Morrison established the Health and Education Research Group at UNB. Mr. Warren O’Brian, Executive Director of the Communicable Disease and Addictions Prevention, BC Ministry of Healthy Living and Sport, British Columbia, Canada Email: Warren.OBriain@gov.bc.ca Warren has also chaired the development of BC's model core programs the Reduction of Harms Associated with Use of Substances and Mental Health Promotion/Prevention of Mental Disorders. Dr. Kathleen S. O’Connor, Director of Research and Education, KFL&A Public Health, Ontario, Canada Kate O’Connor is Director of Research and Education, and of the Public Health Research, Education and Development Program, at KFL&A Public Health. In addition to working on the evaluation of the RRFSS Website in 2007, she chaired a working group to evaluate RRFSS itself in 2006. Other research interests include maternal and child health and the prevention of disability. Ms. Joanna Oliver, Halton Region Health Department, Ontario, Canada Phone: 905-825-6000 x 7330 Email: joanna.oliver@halton.ca Joanna received her Master of Science Degree in Epidemiology in 1996 from Queen’s University. She begun her Epidemiology career as a Project Coordinator on the Ontario component of the national Enhanced Cancer Surveillance Study at OCTRF, now Cancer Care Ontario. Joanna was a special projects consultant with the Institutional Services Branch at the Ministry of Health and Long-Term Care and spent six years as an Epidemiologist and Health Planner with the former Grand River District Health Council. For the past 2.5 years, Joanna has been employed by the Halton Region Health Department as the Epidemiologist with primary responsibility for Infectious Disease Surveillance and providing support to the Health Protection Services Division. Joanna has been a member of APHEO since 1997. She joined the Executive in 2007 as the Secretary and Treasurer and took on the role of the President in January of 2008. Dr. Heather Orpana, Statistics Canada, Ontario, Canada Phone: 613-951-1650 Email: horpana@uottawa.ca Dr. Orpana is a Senior Researcher at Statistics Canada in the Health Information and Research Division. She is also an adjunct professor of psychology at the University of Ottawa. Her research interests are population mental health, healthy aging and longitudinal analysis.

Abstract Authors Bio Ms. Janet Philipps, Durham Region Health Department, Ontario, Canada Janet Phillips is an Epidemiologist at the Durham Region Health Department in Ontario. Prior to joining Durham Region last year, Janet worked for many years as a Health Information Analyst at Toronto Public Health. Janet has worked on a wide range of projects including establishing indicators to measure health inequalities and mapping the distribution of health-related risk factors and outcomes at the neighbourhood level. Janet is currently the Rapid Risk Factor Surveillance System (RRFSS) representative for Durham Region and has been involved in the development of new RRFSS survey content to monitor risk factors for chronic diseases, infectious disease and injury.

Ms. Erin Schillberg, Government of Manitoba, Manitoba Health and Healthy Living, Manitoba, Canada Phone: 204-788-2571 Email: Erin.Schillberg@gov.mb.ca Erin completed her Bachelor of Science with a major in Microbiology in 2006 and worked as a laboratory technician at the National Microbiology Lab conducting research on blood-borne pathogens. She is currently preparing to defend her thesis in order to complete her Masters of Science in Community Health Sciences at the University of Manitoba. Erin is an epidemiologist at Manitoba Health and Healthy Living and has an interest in population health and heath care utilization data and its application in evidence based decision making.

Ms. Laura Plett, Canadian Cancer Society, Manitoba, Canada Phone: 204-774-7483 Email: lplett@mb.cancer.ca Laura has worked with the CCS KEN since April 2008 as Director. Prior to this, she worked with CCS KEN on a contract basis for 9 months. Her background includes working with the Alberta Heart Health Project, public health nursing, and teaching adult learners. She received a Masters of Science in Health Promotion through the University of Alberta's Centre for Health Promotion Studies focusing on evaluation.

Ms. Jennifer Skinner, Haliburton Kawartha, Pine Ridge District Health Unit, Ontario, Canada Phone: 905-885-9100 x 252 Email: jskinner@hkpr.on.ca Jennifer Skinner grew up in Markham, Ontario and attended Harvard University where she obtained a Bachelor of Arts degree. She returned to Canada to obtain a Master’s of Science degree in Community Health and Epidemiology at Queen’s University. Jennifer currently works as an epidemiologist at the Haliburton, Kawartha, Pine Ridge District Health Unit.

Ms. Harleen Sahota, Association of Public Health Epidemiologists, Ontario, Canada Phone: 905-668-4113 x 3159 Email: harleen.sahota@region.durham.on.ca Harleen Sahota is an epidemiologist working on the Core Indicators for Public Health in Ontario project as Core Indicators Project Manager for the Association of Public Health Epidemiologists in Ontario. Her position is funded by a Chronic Disease and Risk Factor Surveillance grant from the Public Health Agency of Canada. Harleen is a graduate of the Community Health and Epidemiology program (MHSc) from the University of Toronto and has a Bachelors degree in Health Studies from the University of Waterloo. Harleen has also worked as an analyst with CIHI.

Dr. David Strong, Alberta Health Services-Calgary Health Region, Alberta, Canada Phone: 403-943-0272 Email: david.strong@albertahealthservices.ca Dr. David Strong MD MHSc FRCPC Dr. Strong is a Deputy Medical Health Officer for Alberta Health Services, Calgary Health Region. He joined the region in 2003 and his primary area of responsibility is surveillance. Prior to joining the CHR he had worked with First Nations and Inuit Health Branch of Health Canada for six years. Dr. Strong’s most recent work has included establishing a Public Health Observatory in the Calgary Health Region, and co-founding the Canadian Network of Public Health Observatories (CaNPHO). The network is comprised of health authorities and allied academic and non-academic centers that produce local level knowledge for decision making.

Ms. Ruth Sanderson, Region of Waterloo Public Health, Ontario, Canada Phone: 519-883-2004 x 5829 Email: sruth@region.waterloo.on.ca Ruth Sanderson has over a decade of experience in local public health epidemiology and thrives on the range of projects that this work has involved. She has worked in rural, northern and urban regions of Ontario, and currently works as an Epidemiologist with the Region of Waterloo Public Health. She is the Chair of the Steering Group for the Rapid Risk Factor Surveillance System Ms. Rachel Savage, Ontario Agency for health Protection and Promotion, Ontario, Canada Phone: 647-260-7403 Email: rachel.savage@oahpp.ca Rachel Savage is an epidemiologist with the newly formed Ontario Agency for Health Protection and Promotion. She was a member of RRFSS from 2006 to 2008 and has continued her involvement in RRFSS as the Agency supports provincial expansion.

Dr. Liping Zhang, Winnipeg Regional Health Authority, Manitoba, Canada Phone: 204-926-7145 Email: lzhang@wrha.mb.ca Liping has been working as Senior data analyst in Research & Evaluation unit, Division of Research & Applied Learning , Winnipeg Regional Health Authority since 2006. Liping got Medical Doctor degree in China in 1986 and master degree in 1991. She got her second degree in computer science in 2001. Her research has predominantly focused on Public Health, in particular local population health status and risk determinants analysis. She designed database and did statistical analysis for WRHA mental health program to research mortality rate due to suicide and related risk factors. Liping also designed database and did data analysis for French-speaking program to survey disparity in Francophone and health service barrier. More recently Liping’s work has focused on Community Health Assessment. Liping has been involved directly with the searching data source, validating data, and data analysis. Dr. Lynne Warda, University of Manitoba, Manitoba, Canada Phone: 204-253-5980 Email: lwarda@mfs.net Dr. Lynne Warda is a Pediatric Emergency Physician at the Children's Hospital in Winnipeg, Medical Director of IMPACT, the injury prevention centre of Children's Hospital, and Associate Professor of Pediatrics and Child Health at the University of Manitoba. Recent research includes: development of an injury prevention-related risk indicator surveillance system using handheld technology; development and of a PDA-based hospital safety audit system; multi-method studies examining the roles of family supervision and peer and sibling involvement in child and adolescent injury; observational studies of PFD use and parental supervision at Manitoba waterfronts; observational studies of bicycle helmet and protective equipment use for cycling, inline skating and non-powered scooters; and evaluation of a child passenger safety program in three Manitoba First Nations communities.

Dr. Bin Zhang, New Brunswick Cancer Network, New Brunswick, Canada Phone: 506-444-3696 Email: bin.zhang@gnb.ca Dr. Zhang has conducted or been involved in various epidemiological studies for more than ten years. He obtained his Master of Science and Ph.D. in Epidemiology and Biostatistics from McGill University. Dr. Zhang worked as a biostatistician in the NB Provincial Epidemiology Services starting from September 2005 and independently conducted the 2007 NB Student Drug Use Survey using two-stage cluster sampling approach. In the past several years, he was responsible for two years of the NDSS national data submission, which was led by the Public Health Agency of Canada. In February 2008, he was transferred to NBCN due to the department organization. Currently, he is leading the project of the 2002¡V2006 NB provincial cancer report. His research interests have been in the areas of pharmacoepidemiology, environmental pollution, human health, particularly in cancer epidemiology and etiology related to environmental hormone disruptors, genetic susceptibility, geneenvironmental interaction, as well as the development.

Workshop Presenters Bio Charles Burchill, MSc, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada Phone: (204)789-3429 fax(204)789-3910 E-mail: Charles_Burchill@cpe.umanitoba.ca Charles Burchill graduated with a MSc from the University of Manitoba in 1990. He joined the Manitoba Centre for Health Policy, University of Manitoba, in 1991 and has been working as a data analyst since that time. Primarily his work involves database support and statistical analysis but he also provides a significant amount of GIS support within the centre. Most of the GIS work involves building base maps for using in population health, geocoding and goreferecing existing data. Lynn Ann Duffley, School-based Risk Factor Survey in New Brunswick, New Brunswick, CA Phone: 506.447.3173 E-mail: duffley@unb.ca Lynn Ann has worked for 27 years in health promotion and policy. In August 2007, she joined UNB’s Health and Education Research Group as a research associate on secondment from the Canadian Cancer Society (CCS). As Director of Wellness Initiatives, her graduate work in surveillance and knowledge translation focuses on health attitudes and behaviours of students & parents. She is interested in knowledge translation as a means to move evidence into policy and practice; with has a strong commitment to tobacco control. Her work experience includes 14 years with the CCS working on public issues & communications; and 8 years with the Heart & Stroke Foundation promoting heart health. In 2005, Lynn Ann received the National Award of Merit from the Non-Smoker’s Rights Association for her contribution to protecting and improving public health. She is serving her 2nd term as the National President of the Canadian Council for Tobacco Control. Tannis Erickson, Health Systems Analysis Manager, Interlake Regional Health Authority Phone: 204.642.4552 E-mail: terickson@irha.mb.ca Tannis is a Health Systems Analysis Manager with the Interlake Regional Health Authority in Manitoba. In this capacity she has helped spearhead the province’s efforts at developing and administering the Manitoba Youth Health Survey. Tannis is a member of the province’s innovative Need to Know Team that operates under the aegis of the Manitoba Center for Health Policy at the University of Manitoba. In addition,Tannis is active at all levels of public health in the province of Manitoba. Jane Griffith, PhD, CancerCare Manitoba, Manitoba, Canada Phone: 204.787.2178 E-mail: Jane.Griffith@cancercare.mb.ca Dr. Griffith is an epidemiologist with CancerCare Manitoba. She is also a member of the Faculty of Medicine in the Department of Community Health Sciences at the University of Manitoba. Her current research is focused on behavioural and environmental risk factors for chronic diseases including cancer and diabetes. She is also involved in enhancing local risk factor surveillance by working on developing collaborations with aboriginal organizations, regional health authorities, government departments, non-government organizations, universities, school systems and communities, to support the collection of regional level data for local planning. She is keenly interested in using local risk factor surveillance to inform effective prevention practices.The epidemiology of chronic diseases and Aboriginal and youth health are strong areas of interest for her. She has been instrumental in the development and administration of the Manitoba Youth Health Survey in Manitoba public schools.

Verlé Harrop, PhD, Atlantic Health Sciences Corporation, New Brunswick, Canada Phone: 506.648.7944 Fax 506.648.6173 Email harve@reg2.health.nb.ca Dr. Harrop is Senior Researcher, Applied Health Research, Atlantic Health Sciences Corporation (now Health Region B) in Saint John, New Brunswick. She holds an interdisciplinary PhD in medical informatics from MIT (2002). Her abiding research interest is the intersection between needs assessments and the determinants of health. Dr. Harrop is noted for her ground-breaking work with the Bell Island Needs Assessment, NL (2006), and the Campobello Island Needs Assessment, NB, (2008). She has drawn praise for her work preparing Health Region 2 Health Status Report, NB (2008). Broadly stated, Dr. Harrop is committed to the research, development and deployment of generic e-tools and einfrastructures enabling real and virtual individuals, communities and corporations to proactively engage, manage, and monitor acute interventions, chronic disease, prevention, health and wellness. Alton Hollett, Assistant Deputy Minister, Economics and Statistics Branch, Government of Newfoundland and Labrador, Dep. of Finance Newfoundland, Canada Email: ahollett@gov.nl.ca Alton Hollett is the Assistant Deputy Minister, Economics & Statistics Branch, for the Department of Finance. In this capacity, he is responsible for the Government of Newfoundland and Labrador’s (NL) central statistics agency and economic research and analysis functions and services. Mr. Hollett has led the development of the Community Accounts (CA), a web-based interactive data platform.The Community Accounts won the National IPAC Award for Knowledge Management and the Provincial Government’s Award of Excellence. Since the public release of the Community Accounts (2001), Mr. Hollett has worked steadfastly to communicate its purpose and potential to international and national audiences. Most recently, he co-presented with Dr. Douglas May at the OECD World Forum in Istanbul,Turkey (2007). Mr. Hollett has also spearheaded the adoption/application of the Community Accounts in other provinces and territories. He is a tireless advocate of evidencebased policy and program development. Steve Manske, EdD, School Health Action, Planning and Evaluation System (SHAPES) University of Waterloo, Ontario, Canada Phone: 519.888.4518 Fax: 519.886.6424 E-mail: manske@healthy.uwaterloo.ca Dr. Steve Manske is a Scientist for the Centre for Behavioural Research and Program Evaluation (CBRPE) and a Research Assistant Professor in Applied Health Sciences at the University of Waterloo. CBRPE is supported by the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society, and located at the University of Waterloo. He trained at the University of Toronto (EdD in Adult Education) and University of Waterloo (MSc in Health Behaviour). Dr. Manske focuses on youth studies and heads the development and implementation of the School Health Action, Planning and Evaluation System or SHAPES. SHAPES can collect health behaviour data from all students in a school, which can then be used to create a computer-generated “health profile” of the school. Data can also be aggregated regionally, provincially or national to identify trends and evaluate initiatives. SHAPES is currently used to aid intervention planning, evaluation, surveillance, and research (and integration of these activities) across Canada.

Doug May, PhD, Department of Economics, Memorial University of Newfoundland Newfoundland, Canada Phone: 709.737.8274 Email: dmay@mun.ca Dr. May is Professor of Economics at Memorial University with cross-appointments in the Faculty of Business Adm. and the Division of Community Health in the Faculty of Medicine. He holds a PhD from the University of York in England.Over the past decade Dr. May has worked closely with the Newfoundland and Labrador Statistics Agency and units of Memorial University as the conceptual architect of the Community Accounts, a web-based interactive data platform, and its associated accounts. Among his current research interests are the estimation of population health models and the determinants of the quality of life. Part of his research efforts is devoted to designing surveys to collect better data. Of particular interest is the relationship between labour market activities and health status. Bill Morrison, EdD, University of New Brunswick Executive Director Health and Education Research Group, New Brunswick, Canada E-mail: wmorriso@unb.ca Dr. Bill Morrison is Executive Director Health and Education Research Group. As a psychologist and academic, Dr. Morrison has been actively involved in projects focusing on health research, program evaluation, and the implementation of community based rehabilitation services for high-risk children and their families. Over the past ten years he has received funding from CIHR, Health Canada, the National Crime Prevention Center and the Department of Wellness, Culture and Sport to complete a range of research initiatives related to tobacco control, crime prevention, student and workplace wellness and knowledge translation of health research in educational and clinical contexts. In January 2007, Dr. Morison established the Health and Education Research Group at UNB. Lara Murphy, Comprehensive Community Information System, Public Health Services Saskatoon Health Region, Saskatchewan, Canada Email: lara.murphy@saskatoonhealthregion.ca Lara Murphy is an epidemiologist with the Saskatoon Health Region and the project coordinator for the Comprehensive Community Information System (CCIS). The Comprehensive Community Information System is an innovative undertaking that has been much lauded across Canada. The CCIS is envisioned as a network of databases across agencies and sectors containing information that can be used at a population level. It is seen as a partnership across sectors where all members contribute to and access data appropriate to their needs. Cristina Ugolini, Public Health Observatory Public Health Services, Saskatoon Health Region, Saskatchewan, Canada Phone: 306.655.4480 Email: Cristina.Ugolini@saskatoonhealthregion.ca Cristina is Manager of Saskatoon Health Region's newly formed Public Health Observatory. She has worked in Saskatoon Health Region since 2002 and played a key role in leading the Region's 2007-2010 Strategic Plan. Her policy experience is extensive and she has contributed to health care policy development as a member of both the Saskatchewan Commission on Medicare (2000) and the Commission on the Future of Health Care in Canada (2001/ 02). She holds a Master's Degree in Public Administration.