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The Rapid Risk Factor Surveillance System (RRFSS) began in 1999 as a pilot telephone survey of adults aged 18 years and older in Durham Region. The pilot project was a joint partnership between Health Canada, the Ontario Ministry of Health and Long-Term Care, Cancer Care Ontario and the Durham Region Health Department. The idea was to pilot test a risk factor survey based on the Behavioral Risk Factor Surveillance System (BRFSS) used in each state in the U.S.A.

The survey was administered by the Institute for Social Research (ISR) at York University on behalf of the partners. From June to October 1999, a random sample of approximately 200 Durham Region residents was surveyed each month. Respondents were asked about various lifestyle behaviours associated with cancer, heart disease and injuries, in particular behaviours such as smoking, sun safety, and fruit and vegetable consumption that are targeted by public health programs. The overall response rate was 69%.

Following the successful pilot project, the Durham Region Health Department decided to continue with RRFSS and was soon joined by the Haliburton, Kawartha, Pine Ridge District Health Unit and the Simcoe County District Health Unit. These three health units formed the RRFSS Working Group. In 2000, the RRFSS Working Group reviewed and revised the questionnaire.

The Ontario Ministry of Health and Long-Term Care funded the Durham Region Health Department and the RRFSS Working Group to document additional aspects of RRFSS in the context of all Ontario health units. The Central East Health Information Partnership (CEHIP) supported RRFSS by developing the prototype for the automated web-based reporting of RRFSS results.

By the end of 2000, 3 more health units had joined the RRFSS Working Group; Region of Peel Health Services, Middlesex-London Health Unit and Niagara Regional Public Health Department.

In January 2001, the next cycle of RRFSS began. Interest in RRFSS continued to grow and in 2007, there were 21 RRFSS-participating health units.

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The purpose of RRFSS is to provide timely data relevant to local public health needs. RRFSS is used to monitor key public health issues 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 risks for chronic diseases, infectious disease and injuries.


  • Two types: 'core' and 'optional' modules.
  • Core modules are asked by all RRFSS-participating health units.
  • Each health unit decides which optional modules to ask.


  • 20 minutes in length, on average.


  • Each health unit contracts directly with ISR for each cycle of RRFSS.


Success Stories....

 “RRFSS collected public opinion in support of tobacco bylaws. This data was critical at the municipal level as an indicator of public support for local policy. Successful establishment of local bylaws prior to provincial legislation. Cited positive support from RRFSS data for smoke free outdoor public places in backgrounders/rationale for outdoor smoke free spaces bylaws.” 

“The statistics gathered on fruit and vegetable consumption helped influence the decision to encourage schools to offer more than 5 different types of fr & veg servings in their school cafeterias.  This was prior to the provincial policy released by the Ministry of Education in 2008.”

“Analysis of the CPR and PAD module helped inform EMS services of public knowledge of these areas. The results of this analysis were presented to Council and helped inform EMS messaging to the public.”

“RRFSS also informed our physical activity strategy, in that CCHS provided information only on leisure time physical activity and RRFSS provided data on physical activity across all domains. Without RRFSS, we would not have a way to measure this.”

RRFSS Participating Health Units, RRFSS Environmental Scan, 2011

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