QUARTER 3: July - September 2016 | USC-PRC Notes
"Promoting Health through Physical Activity"
Topics in this issue
NEWS YOU CAN USE:
Walkabouts Active Learning Platform
New #0to60 App Promotes Healthy Living
National Park Service Celebrates Centennial Anniversary
Robert Wood Johnson Foundation Culture of Health Prize: Call for Applications
Upcoming Events and Observances: October, November, December
WHAT’S HAPPENING IN WASHINGTON:
Federal Highway Administration Highlights Bicycle and Pedestrian Funding Opportunities
Advisory Committee Begins Work on the 2018 Physical Activity Guidelines for Americans
NIH Establishes New Research Program to Address Health Disparities of Chronic Disease
RESEARCH NOTES:
Special Series: The Lancet Physical Activity 2016
Physical Activity Outcomes in Afterschool Programs: A Group Randomized Controlled Trial
Neighborhood Environment Correlates of Physical Activity and Sedentary Behavior Among Latino Adults in Massachusetts
Source and Size of Emotional and Financial-Related Social Support Network on Physical Activity Behavior among Older Adults
Too Much Sitting and All-cause Mortality: Is There a Causal Link?
REPORTS, SURVEYS, GUIDELINES, RESOURCES:
Smart Growth America’s Foot Traffic Ahead: 2016
2015 Behavioral Risk Factor Surveillance System Data
Safe Routes to School by the Numbers
The State of Obesity 2016: Better Policies for a Healthier America
PROMOTING ACTIVE COMMUNITIES:
Five Questions about Complete Streets in Florida for Transportation Secretary Billy Hattaway
Say Hello to CrossBikes, Portland’s Latest Bikeway Innovation
Oklahoma City Mayor Helps Residents Lose 1 Million Pounds and Others are Encouraged to do the Same
Birmingham, Alabama Moves to Increase Trail Accessibility
50 Finalists Announced in the Healthiest Communities and Counties Challenge
UPCOMING CONFERENCES AND WORKSHOPS:
October, November, December
USC PREVENTION RESEARCH CENTER UPDATE:
Update from the USC PRC Core Research Project
USC hosts the Physical Activity and Public Health Courses for Practitioners and Researchers
Update from the National Physical Activity Plan
Update from the South Carolina Healthy Brain Research Network
Update from the South Carolina Cancer Prevention and Control Research Network II
NEWS YOU CAN USE:
Walkabouts Active Learning Platform
“Why just talk about it, when you can walk about it?” This is the slogan of a new platform called Walkabouts, aiming to promote active learning among American youth from Pre-K through the 2nd grade. Walkabouts, created by a company called ActivEd, focus on providing highly engaging supplementary lessons aligned with national and state education standards, using movement to enhance the classroom learning experience. The 7-10 minute web-delivered lessons can be used in a variety of ways and are designed to enable teachers to best meet the learning preferences of their students. Currently working to reach schools across the nation, Walkabouts advocate and ActivEd founder Dr. Julian Reed can be seen discussing the program here.
[Source: ActivEd Inc.]
New #0to60 App promotes Healthy Living
A new mobile app, #0to60, and mobile-ready website have been created in recognition of the 60th Anniversary of the President’s Council on Fitness, Sports and Nutrition. The app and mobile-ready website allow users to access tips and resources focused on physical activity and nutrition, empowering them to live healthy lifestyles. Some of these resources include: healthy lifestyle tips, the ability to share resources on social media, video workouts led by professional athletes, and recipes from celebrity chefs. Staff members at Let’s Move! partnered with First Lady Michelle Obama and television celebrity, Nick Offerman, producing a “History of Exercise” video to promote the campaign and new app. The #0to60 campaign is a collaboration between the National Foundation for Fitness, Sports, and Nutrition and the President’s Council on Fitness, Sports, and Nutrition.
[Source: 0to60fitness]
National Park Service Celebrates Centennial Anniversary
Totaling more than 400 across the country, national parks are natural, cultural, and historical landmarks covering over 84 million acres of land. The National Park Service is celebrating their centennial anniversary this year by offering the public various days of free admission. November 11th (Veteran’s Day), marks the final day of free admission for the year. The US National Park system promotes physical activity by providing resources and opportunities for hiking, biking, water sports, and other forms of outdoor recreation. The National Park Service encourages everyone to take part in this celebration, ushering in an additional 100 years of service.
[Source: National Park Foundation]
Robert Wood Johnson Foundation Culture of Health Prize: Call for Applications
The Robert Wood Johnson Foundation (RWJF) is seeking applications for the 2017 Culture of Health Prize, established to recognize and bring attention to communities that are working toward better health for all citizens. In recognition of the impact that communities can play in health promotion, the RWJF Culture of Health Prize will award $25,000 to winners. Applicants should be communities that prioritize citizen health, demonstrate strong community partnerships, and place an emphasis on those citizens in most need. RWJF will assess applicants on their ability to define health in broad terms, their dedication to creating sustainable change, and their ability to harness collective power of leaders and partners. In addition, RWJF will assess applicants’ commitment to measuring and sharing their progress with other communities. While communities can focus efforts on improving health in many areas, past winners such as Lawrence, Massachusetts, have successfully harnessed community input to expand physical activity opportunities by restoring bike paths, green spaces, and parks. Interested applicants can review stories about past award winners here and sign up to receive information and updates from RWJF. Applications for the 2017 Culture of Health Prize should be submitted by November 03, 2016.
[Source: Robert Wood Johnson Foundation]
UPCOMING EVENTS AND OBSERVANCES:
OCTOBER
Healthy Lung Month
October 1-31, 2016
National Breast Cancer Awareness Month
October 1-31, 2016
National Physical Therapy Month
October 1-31, 2016
International Walk to School Month
October 1-31, 2016
National Child Health Day
October 3, 2016
Walk to School Day
October 5, 2016
Walk to Work Day [Australia]
October 7, 2016
World Food Day
October 16, 2016
World Osteoporosis Day
October 20, 2016
NOVEMBER
National Diabetes Month
November 1-30, 2016
Pulmonary Hypertension Awareness Month
November 1-30, 2016
World Diabetes Day
November 14, 2016
National Family Health History Day
November 24, 2016
DECEMBER
None
WHAT’S HAPPENING IN WASHINGTON:
Federal Highway Administration Highlights Bicycle and Pedestrian Funding Opportunities
In August, the Federal Highway Administration (FHWA) published a resource that highlights potential sources of funding for bicycle and pedestrian projects under the U.S. Department of Transportation. This table provides stakeholders a consolidated view of opportunities to use transit, highway, and safety funds for a wide variety of projects encouraging the use of active transport. The Fixing America’s Surface Transportation (FAST) Act played a key role in this process and has brought attention to active transport by requiring federally-funded projects to consider access for modes of transportation beyond motorized vehicles.
Advisory Committee Begins Work on the 2018 Physical Activity Guidelines for Americans
The Advisory Committee for the 2018 Physical Activity Guidelines for Americans (PAG) held its first meeting in July to discuss progress toward the release of the new guidelines. The 2018 PAG will provide an update to the current 2008 version, which is a collection of science-based guidance for Americans over the age of six to improve health through increasing and sustaining physical activity. The committee includes physical activity researchers and experts from around the country who will provide direction using the strongest, most current scientific evidence available. Committee meetings are open to the public and to public comment, which can be submitted here. Archived webcast recordings of the first Advisory Committee meeting, and a list of Committee members, can be found online. The Advisory Committee for the 2018 PAG will meet again in fall 2016; sign up here to be notified of upcoming meetings. The 2018 PAG are a collaboration between the Office of Disease Prevention and Health Promotion, the Centers for Disease Control and Prevention, the National Institutes of Health, and the President’s Council on Fitness, Sports and Nutrition.
[Source: Office of Disease Prevention and Health Promotion]
NIH Establishes New Research Program to Address Health Disparities of Chronic Diseases
Due to the fact that chronic diseases disproportionately affect racial and ethnic minority groups, the National Institute on Minority Health and Health Disparities (NIMHD) has launched the Transdisciplinary Collaborative Centers (TCC) for Health Disparities Research on Chronic Disease Prevention. The TCC links organizations, academic institutions, health care systems, and state and local public health agencies. These groups will research the development, implementation, and dissemination of community-based, multilevel interventions addressing health disparities in real-world settings. Current activities at several of the established centers focus on applying community engaged health disparities research to increase physical activity and access to healthy foods. The NIMHD director hopes that the centers will conduct research to reduce disparities and advance population health.
[Source: National Institutes of Health]
RESEARCH NOTES:
Special Series: The Lancet Physical Activity 2016
Immediately prior to the 2016 Summer Olympics, The Lancet published a special series on physical activity, an update to the original 2012 series focusing on the same topic. The series represents an update to the field of physical activity research including advances in epidemiological research, intervention studies, global surveillance, and policy actions. The series provides information on scalable population-level interventions, the global economic burden of physical inactivity, and a meta-analysis of the combined impacts of physical activity and sedentary behaviors. Additional topics include global issues in physical activity promotion and community engagement as well as commentary, expert perspectives, original research, and executive updates to positions and papers published in the original 2012 series.
[Source: Series, July 2016. Physical Activity Series 2016: Progress and Challenges. The Lancet]
Physical Activity Outcomes in Afterschool Programs: A Group Randomized Controlled Trial
Afterschool programs are working to make 30 minutes of moderate-to-vigorous physical activity (MVPA) during program time the standard across the country. This study described the two-year impact of an intervention designed to assist afterschool programs in meeting the 30 min/day MVPA standard. The intervention, Strategies-To-Enhance-Practice (STEPs), focused on programming MVPA into daily afterschool program schedules, training staff and leaders, and providing continuous technical support. Over the course of this two-year group randomized controlled trial, the proportion of boys randomized to the immediate intervention who met the 30 min/day standard increased from 35.9% to 47%. Additionally, the proportion of girls in the delayed intervention who met the 30 min/day standard increased from 13.1% to 19.1%. This study indicates that daily physical activity improvements can be made over time, intervention effectiveness can vary by gender, and tailoring at the program level is required to meet the activity standard.
[Source: Beets MW. et al. 2016. Physical activity outcomes in afterschool programs: A group randomized controlled trial. Preventive Medicine]
Neighborhood Environment Correlates of Physical Activity and Sedentary Behavior Among Latino Adults in Massachusetts
Both physical and social environments are important in facilitating physical activity and reducing sedentary behavior among adults. This cross-sectional study of 602 Latino adults in Lawrence, Massachusetts examined attributes of the neighborhood environment including safety, walkability, social cohesion, and activities with neighbors to assess what elements may contribute to healthy lifestyle activities. Researchers found that neighborhood walkability was associated with an increased likelihood of meeting physical activity recommendations, but was not associated with sedentary behaviors. However, increased activities with neighbors was associated with higher odds of sedentary behaviors. This work demonstrates the importance of understanding the physical and social elements of neighborhood enviornments when assessing physical activity behaivors among diverse populations. Information presented in this article may be useful in developing future interventions and longitudinal studies examining the causal impact of neighborhood environments on health behavior.
[Source: Slifee VJ. et al. 2016. Neighborhood environment correlates of physical activity and sedentary behavior among Latino adults in Massachusetts. BCM Public Health]
Source and Size of Emotional and Financial-Related Social Support Network on Physical Activity Behavior among Older Adults
Using data from the National Health and Nutrition Examination Survey (NHANES), this study analyzed self-report data about the source and size of older adults’ social support networks and their relationships with physical activity. The study found that older adults with higher levels of emotional support, as well as friend and financial support, were more likely to meet physical activity guidelines. Furthermore, older adults whose friend network was larger were more likely to meet physical activity guidelines than those with a smaller friend network. Given that physical activity levels decrease with increasing age, these findings reemphasize the importance of positive social support networks for older adults to improve health and overall physical activity.
[Source: Loprinzi P.D. et al. 2016. Source and size of emotional and financial-related social support network on physical activity behavior among older adults. Journal of Physical Activity and Health]
Too Much Sitting and All-Cause Mortality: Is There a Causal Link?
Previous research has shown significant associations between sedentary behaviors and adverse health outcomes, but few studies have examined evidence for causality. Researchers in this study sought to determine a causal relationship between sedentary behavior and all-cause mortality. A literature review identified 8 eligible systematic reviews, totaling 17 studies, which assessed relationships between sedentary behaviors and all-cause mortality. Four criteria of causation - strength of association, consistency, temporality, and dose-response - were analyzed using a traffic light system (i.e., green, amber, red) to indicate cut points for levels of causality. Results indicated greatest evidence for the criteria of consistency and temporality, some evidence for strength of association, but no evidence for a dose-response relationship. The authors concluded that reasonable evidence for causality exists between sedentary behavior and all-cause mortality. According to the authors, public health initiatives and interventions will require innovative ways of encouraging people to engage in less sedentary behavior, which may differ from physical activity promotion.
[Source: Flint E. et al. 2016. Too much sitting and all-cause mortality: Is there a causal link? BMC Public Health]
REPORTS, SURVEYS, GUIDELINES, RESOURCES:
Smart Growth America’s Foot Traffic Ahead: 2016
Foot Traffic Ahead: 2016, a resource presented by Smart Growth America discusses the current state of walkable communities, trends pointing to future walkability, and associations between walkable urbanism and education in 30 metropolitan areas across the U.S. It also addresses the impact walkable urbanism has on the social equity and economy of these areas. The 30 metropolitan areas are ranked based on the current percentage of occupied and walkable urban office, retail, and multi-family rental space, compared to the amount of occupied square footage in the area. With data gathered by the George Washington University School of Business, this report states that cities with the highest levels of walkability are also the most educated, wealthy, and socially equitable. The top six metro areas with the most walkable urban space, in descending rank order, are New York City, Washington DC, Boston, Chicago, San Francisco, and Seattle.
[Source: Smart Growth America]
2015 Behavioral Risk Factor Surveillance System Data
The Centers for Disease Control and Prevention’s Division of Population Health has announced the release of the 2015 Behavioral Risk Factor Surveillance System (BRFSS) data. The BRFSS is a unique, state-based surveillance system active in all 50 states, the District of Columbia, Puerto Rico, and Guam. The survey collects information on health-risk behaviors including physical activity participation, clinical preventive health practices, and health care access from a representative sample of adults aged 18 years or older. The BRFSS provides flexible, timely, and ongoing data collection that allows for state-to-state and state-to-nation comparisons. It is also the largest ongoing telephone-based health surveillance system in the world, with more than 440,000 interviews conducted in 2015.
[Source: Centers for Disease Control and Prevention]
Safe Routes to School by the Numbers
Many low-income communities may lack adequate infrastructure to support children walking and biking to school. The Safe Routes to School National Partnership has released a report with information and tips for communities to ensure children have the opportunity to walk and bike to school safely. Data in the report include case studies from across the United States that provide examples for communities trying to improve their own environments. In addition, the report emphasizes ways that data can be used to guide fundraising, increase community awareness, and initiate violence prevention efforts. The authors highlight that this report may also benefit government agencies in creating effective policy. Data presented may also be used by universities, corporations, and other organizations support physically active communities.
[Source: Safe Routes to School National Partnership]
The State of Obesity 2016: Better Policies for a Healthier America
The Trust for America’s Health and the Robert Wood Johnson Foundation have released The State of Obesity 2016: Better Policies for a Healthier America, which provides an overview on national trends in obesity rates among children and adults. The 2016 report highlights the declining obesity rates among young children, steady trends among older children and teenagers, and a slowing growth in obesity rates among adults. Key components of the report emphasize the importance and success of community-based prevention programming, policy change, and recognition for organizations and communities working to reduce obesity among their most vulnerable populations. It also serves as a call to action for obesity prevention through physical activity and healthy eating. The authors provide several recommendations for obesity prevention including prioritizing active transportation, enhancing physical education and physical activity in schools, and increasing federal support for community programs.
[Source: The State of Obesity 2016]
PROMOTING ACTIVE COMMUNITIES:
Five Questions about Complete Streets in Florida for Transportation Secretary Billy Hattaway
In 2011 and 2014, four metropolitan areas in Florida - Orlando, Tampa, Jacksonville, and Miami - ranked among the five most dangerous places in the United States to be a pedestrian or bicyclist. In response to these rankings, Florida hired Transportation Secretary Billy Hattaway to lead the Florida Department of Transportation (FDOT) District 1. Secretary Hattaway’s main objective was to make Florida a more pedestrian and bicycle-friendly state. With assistance from Smart Growth America, Hattaway has worked to develop Florida's first-ever statewide strategic safety plan for walking and bicycling. To date, he has led efforts to train transportation planners and engineers in ways to design streets that support active transport. He has also revised the documents and guidelines used during road redesign and has appointed coordinators to direct planning efforts that will improve pedestrian safety. During his tenure, the FDOT has assigned a bike and pedestrian safety specialist to each district to work on the state’s existing safety problems.
[Source: AARP]
Say Hello to CrossBikes, Portland’s Latest Bikeway Innovation
Portland, Oregon is already known as a pedestrian-friendly city. In an effort to make cycling even safer in the area, the Portland Bureau of Transportation (PBOT) has created crossbikes at selected intersections. The new crossings are similar to pedestrian crosswalks, but are painted green to distinguish them from traditional pedestrian crossings. Unlike crosswalks, motorists are not required to stop for cyclists at the new crossings. However, representatives for the PBOT are optimistic that the new crossbikes will lead to safer crossing by more clearly indicating to drivers that cyclists, pedestrians, and motorists share intersections. Currently, all of Portland’s crossbikes are located at intersections designated as neighborhood greenway streets, where active commuting is common. The PBOT has partnered with researchers from Portland State University to evaluate the new crossbikes to determine if they improve conditions for cyclists.
[Source: Bike Portland]
Oklahoma City Mayor Helps Residents Lose 1 Million Pounds and Others are Encouraged to do the Same
After being named America’s 2nd Fattest City in 2007 by Men’s Fitness magazine, Oklahoma City Mayor Mick Cornett took action to reverse his city’s unhealthy label. He created the website ThisCityIsGoingOnADiet.com, which provided fitness and lifestyle guidance to help local residents become more physically active, eat healthier, and lose weight. Mayor Cornett’s initiative to improve the health of his city has led to the loss of over 1 million pounds by local residents and has earned Oklahoma City a spot on the list of America’s fittest metropolitan areas from the 2016 American Fitness Index. To encourage other U.S. mayors to get their residents more focused on health and fitness, PHIT America has developed a 10-week health and wellness campaign designed to encourage community interaction through fitness and educational programs.
[Source: PHIT America]
Birmingham, Alabama Moves to Increase Trail Accessibility
The Birmingham, Alabama-based Lakeshore Foundation, an organization whose mission is to enable people with physical disabilities to lead healthy and active lives, has partnered with a Nevada design firm in a pilot project to map local trails. The project includes evaluating the length, elevation changes, path width, surface hardness, and grade of trails in the Birmingham area, and creating new informative trail signs. The signs will provide hikers with disabilities information needed to prepare for a hike, such as equipment required for particular trails and which trails are best suited for a person’s physical ability. While the focus of the project is to encourage trail use by individuals with disabilities, project coordinators hope that the trail signage will be helpful for all hikers. The project is supported by the Lakeshore Foundation, as well as grants from the federal government and the Curtis and Edith Munson Foundation.
[Source: WBHM]
50 Finalists Announced in the Healthiest Communities and Counties Challenge
The American Public Health Association, the National Association of Counties, and the Aetna Foundation have recognized 50 communities across the US as finalists in the Healthiest Communities and Counties Challenge. These communities will receive $10,000 seed grants to implement programming aimed at improving social determinants of health. While applicant communities could identify one of many possible health goals such as improving housing, increasing access to nutritious foods, or decreasing childhood asthma, many have chosen to focus on increasing physical activity. Strategies to accomplish this goal include increasing walkability, creating bike-friendly areas, and connecting families to outdoor activities, thus increasing physical activity opportunities. The finalists are eligible to apply for additional funding ranging from $25,000-$500,000. Funds will be awarded to communities demonstrating measurable change at the conclusion of the program. A complete list of winners and their program goals can be found here.
[Source: Healthiest Cities and Communities Challenge]
UPCOMING CONFERENCES AND WORKSHOPS:
October
Annual ASHA School Health Conference
October 6-8, 2016
Baltimore, MD
American Public Health Association Annual Meeting and Exposition
October 29-November 2, 2016
Denver, CO
November
European Public Health Association (EUPHA) Annual Conference
November 9-12, 2016
Vienna, Austria
Complete Streets Conference
November 15, 2016
Sacramento, CA
6th International Congress on Physical Activity and Public Health (ICPAPH)
November 16-19, 2016
Bangkok, Thailand
Gerontological Society of America (GSA) Annual Scientific Meeting
November 16-20, 2016
New Orleans, LA
International Council on Active Aging Conference
November 17-19, 2016
Orlando, FL
DECEMBER
None
USC PRC UPDATES:
USC Hosts Faith and Health Symposium
On September 6, 2016, the University of South Carolina hosted a symposium entitled “LiveWell @ Worship: How Faith-Based Initiatives Contribute to Community Health in Greenville, SC.” Sixty-eight people attended the symposium and represented diverse sectors including academia, public health, faith-based settings, and other health-related settings. Speakers included Rev. Sean Dogan and Ms. Peggy Baxter from Long Branch Baptist Church (Greenville, SC) and Ms. Sally Wills, Executive Director of LiveWell Greenville. A link to the video of the symposium is available here.
USC Hosts the Physical Activity and Public Health Courses for Practitioners and Researchers
Earlier this month, the University of South Carolina hosted the Physical Activity and Public Health Courses in Columbia, SC. The courses consisted of an 8-day Postgraduate Course on Research Directions and Strategies and a 6-day Practitioner’s Course on Community Interventions. There were 39 Research Course participants and 13 Practitioners. The long-term goal of the courses is to improve the public’s health by increasing the number of public health researchers and practitioners who have expertise in the relationship between physical activity and health in populations. 2016 marked the 20th year of successful training for professionals in the field. The next course will be held in 2018. More details on the Physical Activity and Public Health Courses can be found here.
Update from the National Physical Activity Plan
Earlier this month, the National Physical Activity Plan Alliance announced the release of the Secular Change in Physical Education Attendance Among U.S. High School Student Report. The report, which can be downloaded here, traces the changes in physical education attendance over time in order to compare the current exposure of physical education among American high school student to that of previous generations.
Key findings show that daily physical education attendance dropped 16.2% in four years (from 41.6% in 1991 to 25.4% in 1995)—attendance rates have stabilized since then. Despite this stabilization attendance remains below recommended guidelines. One-half of US high school students do not attend physical education classes, and attendance in P.E. classes decreases steadily as a student moves from 9th to 12th grade. The report concludes that policies and programs should be adopted that prioritize physical education in order to maximize its benefits. The US National Physical Activity Plan provides strategies and tactics that can increase participation in school-based physical education programs.
Update from the South Carolina Healthy Brain Research Network
The South Carolina Healthy Brain Research Network (SC-HBRN) is excited to announce a new partnership with Leeza’s Care Connection. Leeza’s Care Connection is an organization dedicated to the caregiver experience and aims to “reset the caregiving conversation and prepare caregivers for an ever-changing life by providing innovative self-care and wellness programs and resources.” Leeza’s Care Connection is new to the Columbia, SC community and joins several other organizations that collaborate through the SC-HBRN partners group to implement actions in The Public Health Road Map for State and National Partnerships.
In addition, SC-HBRN Scholars Weizhou Tang and Kate Olscamp each received $1,000 travel scholarships from the national Alzheimer’s Association to attend the upcoming Gerontological Society of America conference in New Orleans. These awards will allow Kate to attend the national HBRN grantee meeting being held before the conference, and for Weizhou to share her recent HBRN research through a poster presentation.
Update from the South Carolina Cancer Prevention and Control Research Network II
Documentary filmmaking approaches incorporating community engagement and awareness raising strategies may be a promising approach to evaluate community-based participatory research. A documentary film was designed to promote the SC-CPCRN farmers’ market as well as evaluate and disseminate the intervention. The purpose of this study was both to evaluate the viewers’ satisfaction with the film and to assess whether the film affected viewers’ awareness regarding food access issues and healthy foods in a food-desert community with high rates of obesity. The coalition model of filmmaking, a model consistent with a community-based participatory research (CBPR) approach, and personal stories, community profiles, and expert interviews were used to develop a documentary film (Planting Healthy Roots). The evaluation demonstrated high levels of approval and satisfaction with the film and CBPR essence of the film. The documentary film aligned with a CBPR approach to document, evaluate, and disseminate research processes and outcomes. Watch the documentary film, “Planting Healthy Roots,” here.
Brandt HM, Freedman DA, Friedman DB, Choi SK, Seel JS, Guest MA, Khang L. (2016). Planting healthy roots: using documentary film to evaluate and disseminate community-based participatory research. Family Community Health (DOI: 10.1097/FCH.0000000000000120).
Writers: Nathan Peters, Caroline Dunn, and John Bernhart
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This publication was supported by Cooperative Agreement Number U48-DP-001936 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.
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