overnight delivery However, national health surveys cannot always address regional/local needs, usually have a limited number of questions, and are sometimes considered neither timely nor frequent enough [4]. Some national surveys may not have sufficient sample sizes to address the needs of smaller geographies. There are pockets of risk factor surveillance activities at the provincial/territorial and regional/local level to collect additional data from local surveys and administrative databases to provide sub-national estimates across Canada (Appendix). For example, in Saskatoon Health Region, supplementary health surveys are conducted periodically for purposes of public health surveillance, research and needs assessment, and reported to the community and to decision makers [5].

In Ontario, the Rapid Risk Factor Surveillance System (RRFSS) [6] was set up because some local health units felt the need to have a rapid and flexible information system to supplement data from national health surveys [4]. In British Columbia, a province-wide randomized telephone health and wellness survey (BC-HWS) was conducted to monitor the health behavior risk factors and general health at the local level [7]. In 2005, a federal/provincial/territorial report on “Enhancing Capacity for Surveillance of Chronic Disease Risk Factors and Determinants” recommended to “establish locally/regionally coordinated ongoing flexible public health data collection systems (such as the Rapid Risk Factor Surveillance System in Ontario)” [8]. The purpose of regional/local data is to “expand data sources to fill gaps in surveillance knowledge”.

In addition, the task group discussed the use of both a “roll-down” approach from national to local level (e.g. CCHS may use sufficient sample sizes to provide local area estimates), and a “roll-up” approach Cilengitide from local to national level (e.g. local surveys may together provide estimates at the national level). In order to further explore ways to enhance the capacity in collaborative regional/local level chronic disease risk factor surveillance, a Think Tank Forum was organized in Canada in 2008 which provided important insights and guidance on the issues relating to enhancing capacity for risk factor surveillance at the regional/local level. The Forum also established the Canadian Alliance for Regional Risk Factor Surveillance (CARRFS) [9] which has been in operation in Canada for four years. The objective of this paper is to report the findings of the Think Tank Forum, and to discuss progress made under each of the areas of recommendations. This is of importance for the operations of the CARRFS, and experts in other countries interested in building surveillance capacity at the local or county level.