Table A5.
Enabling components for integrated surveillance systems in Circumpolar Arctic and Subarctic regions as described or recommended by the literature.
| Component | Definition | Example of Linkages to Surveillance Attributes and/or Activities | |
|---|---|---|---|
| Structural | Decision-making and accountability structures | Procedures for guiding decision-making related to surveillance information, and structures for holding decision-makers accountable for their actions | In the case of surveillance information that Germain [87] used to inform early-warnings of avalanche risks in Quebec, bottom-up approaches, in this context, were largely ineffective. Instead, top-down approaches from the municipal and provincial government were recommended. |
| Enabling regulatory, policy, and funding environments | Resources, personnel, and other forms of support that provide or enhance enabling environments for surveillance activities | The International Circumpolar Surveillance system, as described by Parkinson [63] allowed for the collection and sharing of uniform laboratory and epidemiologic data between Arctic countries, and assisted in the development of coordinated prevention and control strategies. | |
| Existing surveillance systems and/or data | Use of existing surveillance systems and data that focus on environment and/or health issues of interest | Pacyna et al. [103] described how assessment tools developed for the EU ArcRisk project were enhanced through use of existing databases, models, and monitoring systems from the Arctic Monitoring and Assessment Program. | |
| Technologies and tools | Technological tools for capturing surveillance data, such as remote-sensing, Geographic Information Systems, and satellite imagery | Satellite imagery was one of many useful tools described by Laidler et al. [70] that Inuit in Iqaluit, Nunavut draw upon and used alongside experiential knowledge in monitoring sea ice dynamics. | |
| Processual | Capacity to adapt or adjust surveillance activities | Capacity to adapt the processes and approaches to certain surveillance activities to allow for a system to be more responsive to changing environmental conditions as well as the needs of stakeholders and/or end-users | The iterative development of metrics, a survey instrument, and a protocol for collecting sentinel surveillance data on the health effects of climate change in Alaska by Driscoll et al. [84,85] led to targeted climate change adaptation strategies that were both locally-determined and data-driven. |
| Involving distinct knowledge systems and disciplines | Capacity to involve multiple distinct knowledge systems and sources—such as local and Indigenous knowledge, and/or multiple disciplinary perspectives—in various stages of developing, implementing, and/or using surveillance systems | Tremblay et al. [89] explained how bringing together Indigenous and Western knowledge systems surrounding sea ice dynamics and climate change in Nunavik informed adaptation strategies for accessing land and resources that were grounded in more holistic understandings of environmental changes that respected Indigenous perspectives and worldviews. | |
| Involving multiple sources and types of surveillance data | Use of multiple approaches to surveillance data collection and analysis (e.g., qualitative and quantitative) appropriate for the specific purpose(s) and use(s) of a surveillance system | In a Northern environmental impact assessment described by Bronson and Noble [122], quantitative data from mail-out surveys were supplemented with qualitative data from semi-structured interviews with stakeholders to provide additional data and understandings for identifying and monitoring human health determinants. | |
| Relational | Capacity to recognize and meet stakeholder needs | Ability to involve stakeholders in decision-making processes related to the development and implementation of integrated surveillance systems | The main goals of the Nunavik Trichinellosis Prevention Program described by Larrat et al. [92] were to prevent human trichinellosis and indirectly participate in the public health mission of ensuring health by increasing food diversity and positively impacting economic, social, and cultural role of the walrus hunt. |
| Communication strategies | Clear, consistent communication procedures and channels that allow for stakeholders to voice potential ideas or concerns in a timely manner | Communication about resource development projects was recommended by Banfield and Jardine [66] to be kept at the forefront in all consultations, decision-making processes, and long-term monitoring efforts to facilitate relevant public health promotion through ongoing information-sharing, reporting of on-site monitoring activities, and educational initiatives. | |
| Strategies for managing collaborations involving multiple stakeholders | Efforts to encourage and sustain respectful and mutually-supportive collaboration among stakeholders involved in various stages of surveillance system development and implementation. | Collaboration among stakeholders helped to develop the community-based monitoring program described by Brook et al. [109] that provided more locally-relevant and useful information, ensured higher levels of support from all those involved, as well as functioned as a form of peer-review throughout the development process. | |
| Strategies for engaging specific, key stakeholders | Efforts to identify and reach out to key individuals and groups to identify and address common goals as well as potential challenges related to integrated surveillance | Driscoll et al. [84] discussed how consultations with village and tribal administrators, community members, as well as with an international team of climate change researchers helped the research team identify categories of exposure to the environmental effects of climate change, measurable health outcomes, as well terminology to use in a survey tool as part of a community-based sentinel surveillance system in Alaska. | |
| Training and educational opportunities | Provision of training or educational opportunities to key individuals and groups that strengthen or enhance approaches for collection, analyses, and interpretation of environment and health data | Hueffer et al. [61] recommended that additional resources and training were needed to ensure adequate numbers of trained staff were available to address the emerging public and wildlife health impacts posed by climate change in Alaska, and enhance the capacity to monitor those potentially climate-sensitive infections that are most likely to have a large public health impact. |
Note: Corresponding examples of each component with linkages to surveillance attributes and activities are provided, as identified in the 85 articles included for review.