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Background: The Rapid Risk Factor Surveillance System (RRFSS) is an ongoing population health survey conducted by a collaborating group of Ontario public health units. This formative evaluation examined the process effectiveness, collaboration, utility and cost-effectiveness of RRFSS during its first year of operation., Methods: An Evaluation Framework was developed with reference to guidelines for evaluation of surveillance systems developed by the World Health Organization and the U.S. Centers for Disease Control and Prevention. The study focussed on evaluable performance areas in a young surveillance system and on information needed to inform stakeholder decisions about future participation and improvement. Data were collected through surveys and interviews of key informants in participating health units, non-participating health units, the survey research house, and the provincial health ministry., Results: Findings documented early use and dissemination of RRFSS data in health units after less than a year of surveillance system operation, stakeholder perceptions overall of data impact and value, and satisfaction with system functioning. Challenges to effectiveness were documented concerning data analysis, barriers to data use, and sustainability. Performance improvement strategies were identified for survey implementation and supports, data use, system participation, and reduced costs., Conclusion: In its first year, RRFSS was an effective collaborative method to collect population data for public health program planning and evaluation. The evaluation provided valuable information on use, functioning, effectiveness, strategic issues and areas for improvement in a young surveillance system, created opportunities for stakeholder input into evaluation and planning, and provided a baseline for future evaluations.

Objective: To describe family caregivers' experiences with palliative care services in rural communities., Design: Qualitative study., Setting: Manitoulin Island, Ont., Participants: Thirteen family caregivers of 12 deceased patients who had received palliative care services., Method: Twenty-five family caregivers were recruited by mail and local newspaper. Eight were excluded because they lived off the Island or were too recently bereaved; one declined an interview; and three were excluded by researchers. Initial contact was by telephone; those retained (13 people) were interviewed at home. Interviews were conducted by the same researcher using a semistructured interview guide. All interviews were audiotaped and transcribed, and content was analyzed., Main Findings: Three interwoven themes were identified: access to services, quality of services, and support and caring. Hospital and community-based services were accessed with ease at the local level; difficulties were noted when accessing services in tertiary care centres. Participants were generally grateful for and pleased with services received. Two areas of concern raised by participants were communication and pain and symptom control. Participants suggested to the Ministry of Health ways to improve rural palliative care services. More public funding for in-home palliative care services was identified as a priority., Conclusion: Participants thought good services and supportive care at the local level made up for difficulties in accessing and using palliative services in tertiary care centres. Community spirit and culture were seen as making situations more bearable.

This article describes a health promotion project for teens in a rural francophone community in Northern Ontario. A planning committee of two community health nurses and eight teenagers developed, implemented and evaluated the project. Based on teen interest generated in the community, the committee planned a youth snowmobile day to help identify and define the teenagers' particular health needs. The aim was to facilitate youth participation at every step of the project, from needs assessment to follow-up, and encourage them to explore, with their peers, ways to improve their health. A qualitative research approach was used to study and document the event. A total of 48 girls and boys in the 13-19 age group took part. Stopovers were held at various inns for group discussions on predetermined topics. Study results indicate that when power is shared with teenagers, important lessons are learned by both parties. In such a partnership, nurses need to use more than the educational approach to interventions. Their role as community development facilitators is highlighted, as well as their need to develop novel and unique approaches for dealing with teenagers.