QUARTER 3: July - September 2022 | USC-PRC Notes

"Promoting Health through Physical Activity"

Topics in this issue

A LETTER FROM OUR DIRECTOR

UofSC PREVENTION RESEARCH CENTER UPDATES:

  • Update from the UofSC PRC Core Research Project
  • Update from the UofSC PRC Projects
  • Update from the South Carolina Cancer Prevention and Control Research Network

NEWS YOU CAN USE:

  • Applications Open for National Recreation Trail Designation
  • Podcast: Exercise for Post-Menopausal Women with Dr. NiCole Keith

UPCOMING EVENTS AND OBSERVANCES

  • October, November, December

WHAT’S HAPPENING IN WASHINGTON: 

  • Biden-Harris Administration to Help Rural Communities Grow Outdoor Recreation Economy
  • The Space Force is Scrapping the Annual Fitness Test in Favor of Wearable Trackers
  • White House Conference on Hunger, Nutrition, and Health

RESEARCH NOTES:

  • Physical Activity and Risk of Infection, Severity and Mortality of COVID-19: A Systematic Review and Non-Linear Dose–Response Meta-Analysis of Data from 1,853,610 Adults
  • Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis
  • Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns with All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study

REPORTS, SURVEYS, GUIDELINES, RESOURCES:

  • Making Strides: 2022 State Report Cards on Support for Walking, Bicycling, and Active Kids and Communities
  • Help Your Community Get Moving — with the Move Your Way Community Playbook
  • Report: Dangerous by Design 2022
  • New Brief on Physical Activity Equity from the Physical Activity Alliance

PROMOTING ACTIVE COMMUNITIES:

  • Urban Institute Park Equity Case Study: Washington, D.C.
  • Healthy Savannah Physical Activity Survey Results & Next Steps
  • Physical Activity Added to Basic Vital Signs at Hartford HealthCare
  • New Kinesiology Program Aims to Boost Middle School Girls’ Love of Physical Activity, Sports

UPCOMING CONFERENCES AND WORKSHOPS:

  • October, November, December

A LETTER FROM OUR DIRECTOR:

Happy (almost) Fall!

In this introduction, I want to share some observations about inclusivity…but with a slightly different twist. In July, I had the opportunity to do my first RAGBRAI (Register’s Annual Great Bicycle Ride Across Iowa). Over the course of seven days, I rode 462 miles (including one 105-mile day), stopping each day to camp in the designated overnight town before doing it all over again. This year, RAGBRAI had around 18,000 full-week registrants, and additional riders signed up for single or multiple days. It’s a BIG event!  And it’s been in existence for 49 years. Many people do RAGBRAI every year, and people come from all over the US and beyond to ride.

I’d like to write about the many reasons why I loved this event, but I’m going to focus just on inclusivity… Well, let me quickly mention that I loved doing the ride with my brother, thoroughly enjoyed the beauty of Iowa, and thought mixing pie with bike riding was a great idea. But back to inclusivity… When I started the ride, I saw lots of people who I was convinced could never ride 462 (or even 50) miles. Yes, that was judgey of me, but I’m being honest. After all, I trained a LOT for the ride, and wondered how some of these people who didn’t look very fit (some of whom said they didn’t train all that much) would do it. But over the course of the week, my perspective changed. I saw an incredible range of body sizes and shapes. I saw kids around 12 years old ride on their own bike. I saw families pulling kids behind. I saw riders in their 80s and 90s. I saw riders who appeared frail – some were hunched over, and others had gait challenges or couldn’t walk to the towns at night because of hip problems. I saw a rider who used only an arm-propelled recumbent bike. I saw everything! People traveled the miles all sorts of ways: road bikes, mountain bikes, hybrids, recumbent bikes, tandems, bikes for three, tricycles (for adults), ebikes, roller blades, and other contraptions I can’t even describe in words. I even saw a photo of someone who rode on a unicycle! Sara Wilco at RAGBRAIThere were plenty of traditional “cyclists” who traveled quickly in pace lines and barely stopped before getting to the overnight town. But some cyclists took the full day to get to the next town. Some cyclists walked their bikes up most of the hills (Iowa is not flat!). Some cyclists stopped a lot to rest and replenish. All of these riders were “cyclists!” Sure, some people didn’t finish on a given day or for the week. I don’t have data on how many don’t finish RAGBRAI, but people I didn’t think could do it, DID DO IT! Lots and lots of people.

Michael Zamora wrote a story for NPR about this year’s RAGBRAI. I’m sharing the link below. My favorite line in his description of RAGBRAI is this: “It’s not a race. Yet somehow everyone seems to win.” Yes, exactly! That was exactly how it felt. I’ve never seen so many happy and proud people before (myself included). Everyone did RAGBRAI their own way, and others, for the most part, cheered you along. My experience has raised questions like, “Why do ‘average people’ do an event like RAGBRAI – what motivates them?” and “How has this inclusive culture developed where people find sheer joy in riding 462 miles and feel welcomed and included and free to do their own thing?” How can we all create this type of inclusive culture in our sports and exercise programs and activities? How can we welcome in others who are different from us? These are questions I’ve been pondering, and I hope you will, too.

NPR article about this year’s RAGBRAI, by Michael Zamora

- Sara Wilcox

UofSC PREVENTION RESEARCH CENTER UPDATES:

Update from the UofSC PRC Core Research Project

The University of South Carolina Prevention Research Center is seeking applications from external agencies/organizations to work with us to house and deliver the Faith, Activity, and Nutrition (FAN) online training program through 2024, and potentially beyond.  The FAN Online Training integrates a Christian perspective on health and is designed to help churches create church environments that support physical activity and healthy eating through 8 interactive online lessons and 12 months of resources and support. Applications are due by October 10, 2022. Review the full Request for Application.

Earlier this month, we hosted the Physical Activity & Public Health Practitioner's Course on Community Interventions (led by Dr. Sara Wilcox). Course participants were 17 practitioners from 10 states. We also co-hosted the Physical Activity & Public Health Postgraduate Course on Research Directions and Strategies (led by Dr. Russ Pate). Course participants were 27 early career research fellows from 16 states, the District of Columbia, and two countries outside of the US. Overall, the courses provided a wonderful opportunity for all attendees to engage in meaningful conversations about the future of physical activity and public health research and practice. If you are interested in attending the course in the future, we will offer it again in September of 2023!

We are also excited to announce that two additional Special Interests Projects (SIPs) have been awarded to PRC-affiliate faculty, Dr. Shan Qiao and Dr. Jason Wang. Dr. Qiao’s project will focus on COVID-19 and Public Health Emergency Preparedness for Women, while Dr. Yang’s project is part of a collaborative Dementia Risk Reduction Network across three PRCs. More information on both projects is available below. Congratulations to Dr. Qiao and Dr. Yang!

Update from the UofSC PRC SIP Projects:

COVID-19 and Women SIP Project

Despite the aggregated burdens and challenges experienced by rural Black women during the COVID-19 pandemic, many of them may also have demonstrated strength and resilience to overcome challenges. Through mixed methodology and a community-based participatory approach, the CDC SIP project will collect multilevel data on challenges, responses, resilience, and lessons during the pandemic from Black women, community health workers, and community leaders in rural areas in South Carolina. The goal is to develop evidence-based recommendations for the development of public health emergency preparedness plans, which can promote the resilience of women, communities, and health facilities as well as optimize effective preparedness and response for rural Black women and their families during infectious disease outbreaks and other public health emergencies.

Dementia Risk Reduction SIP Project

Dr. Yang’s funded project is part of the Dementia Risk Reduction Research Network, which is established to implement promising, evidence-informed interventions and solutions to reduce risk for dementia and improve quality of life for individuals with symptoms of cognitive decline. Dr. Yang’s team will collaborate and interact closely with two other research teams (from University of Illinois at Chicago and Washington University in St. Louis.) across the funding period to achieve the Network goal. The intervention proposed by Dr. Yang will evaluate whether a multi-session mindful walking program shows promising signals for sustaining mental and cognitive health among African American older adults at risk for developing dementia. This project is unique as it integrates two modifiable factors – physical activity and mindfulness practice – both play a beneficial role in improving brain health. If successful, mindful walking activity may represent a promising and scalable strategy to promote healthy brain aging among older adults in greatest need. The reduced physical activity intensity of mindful walking can also reach older adults with mild mobility/physical barriers, who are often excluded from existing exercise programs.

Arthritis SIP Project

Recruitment continues through October for the UofSC Arthritis SIP project, Phone-Based Walk with Ease Program. The Walk With Ease Program is an evidence-based in-person program from the Arthritis Foundation that has now been converted into a phone delivered program. The 6-week Phone-Based Walk With Ease program consists of two telephone calls each week and is designed to help people with arthritis increase their walking. Recruitment will continue throughout the month of October to get ready for January 2023! If you’d like to participate or know somebody who may be interested, please contact us or visit our website at https://uofscwalkingstudy.com/ for more information. Our project coordinator, Krystal Cooper, can be reached by phone at 803-576-7836 or by email at uofscwalkingstudy@mailbox.sc.edu.

Update from the South Carolina Cancer Prevention and Control Research Network II

The South Carolina Cancer Prevention and Control Research Network is proud to announce that the Community Health Intervention Program (CHIP) call for mini-grant applications is now open! The current grant program will be focused on rural areas of South Carolina and partnership with rural clinics / Federally Qualified Heath Centers is strongly encouraged. To apply, please visit: https://uofsc.co1.qualtrics.com/jfe/form/SV_bskXIiMyg8kAdN4.

The 2020-2021 Community Health Intervention Program (CHIP) mini-grant recipients collaborated on a manuscript highlighting successes and lessons learned while implementing throughout a pandemic.

Mathias, W., Nichols, K.A., Golden-Wright, J., Fairman, C.M., Felder, T.M., Workman, L., Wickersham, K.E., Flicker, K.J., Sheng, J., Noblet, S.B., Arp Adams, S., Eberth, J.M., Heiney, S.P., Wilcox, S., Hebert, J.R., & Friedman, D.B. (2022 Sept 3 Epub). Implementation during a pandemic: Findings, successes, and lessons learned from community grantees. Journal of Cancer Education (DOI: 10.1007/s13187-022-02213-4).

Dr. Friedman is set to present on a National Cancer Institute webinar celebrating the last 20 years of the CPCRN network and highlighting tools and programs collaboratively developed and implemented, discuss current works in progress, and explore areas for research and practice growth in implementation science.

Friedman D., Leeman, J., Trinh-Shevrin, C., Wheeler, S., White, A., & Vinson, C.A. 20 Years of the Cancer Prevention and Control Research Network (CPCRN): Past, Present and Future. National Cancer Institute Implementation Science webinar. September 22, 2022.

NEWS YOU CAN USE:

Applications Open for National Recreation Trail Designation

The National Recreation Trails (NRT) Program recognizes scenic trails and greenways of local and regional significance throughout the United States. Each year, the NRT designation is awarded to eligible trails and greenways by the Secretary of the Interior. To receive the NRT designation, trails must be open for public use, have no gaps, and be designed and maintained according to best practices. Water trails are also eligible for consideration in the program. Any public or private trail manager may apply for the program designation. The deadline to apply is November 1, 2022.
[Source: American Trails]

Podcast: Exercise for Post-Menopausal Women with Dr. NiCole Keith

In a recent episode of BMJ Talk Medicine, Dr. NiCole Keith, President of the American College of Sports Medicine (ACSM) and Professor and Associate Dean at Indiana University, led a conversation about the importance of maintaining physical activity during menopause. In her talk, Dr. Keith discussed the different stages of menopause and emphasized the importance of physical activity during each stage. She also described how to create effective exercise prescriptions for women in menopause, including modifications that should be considered based on individual health and risk factors. Finally, Dr. Keith also acknowledged gender-based and community health disparities and discussed how to prioritize individual safety when prescribing exercise. The full episode of the podcast is available on SoundCloud.
[Source: BMJ Talk Medicine]

UPCOMING EVENTS AND OBSERVANCES:

OCTOBER

NOVEMBER

WHAT’S HAPPENING IN WASHINGTON:

Biden-Harris Administration to Help Rural Communities Grow Outdoor Recreation Economy

The Environmental Protection Agency (EPA), in partnership with the U.S. Department of Agriculture Forest Service, the Appalachian Regional Commission, and the Northern Border Regional Commission, has announced the 2022 partner communities for the Recreation Economy for Rural Communities (RERC) Program. The RERC program funds projects located in 25 small and rural communities across the country. The program specifically aims to assist communities who are working to grow their outdoor recreation economy or to revitalize their main streets. The partner community projects include initiatives like multi-use trail development, plans for pedestrian and bike connectivity to main streets and recreation opportunities, and improving local parks. Future calls for applications will be posted to the EPA website.
[Source: American Trails]

The Space Force is Scrapping the Annual Fitness Test in Favor of Wearable Trackers

The U.S. Space Force is making strides in eliminating annual fitness testing by 2023. The Space Force, which currently requires its members (Guardians), to participate in yearly fitness assessments based on those of Air Force PT standards, including timed push-ups, pull-ups, and a timed 1.5 mile run. The Space Force is currently evaluating the use of wearable fitness trackers and rings (e.g., Garmin watches and Oura rings) to replace the annual fitness assessments with overall health surveillance throughout the year, using these devices and a virtual community of peers. The thought behind making this novel change is prioritizing the overall health of servicemen and women through constant feedback on physical health, mental health, and encouraging healthy habits around eating and sleeping. Though the physical expectations will not change with the new system, the hope is that with a new approach, members of the Space Force will take more responsibility for creating healthy and balanced habits and will be credited for making daily health and fitness a priority.
[Source: NPR]

White House Conference on Hunger, Nutrition, and Health

The Biden-Harris Administration recently hosted the second White House Conference on Hunger, Nutrition, and Health. The conference has not been hosted since its inaugural occurrence in 1969. The event, which was held live and virtually, brought together community leaders and advocates for improved food access, food security, and physical activity opportunities. The Administration also plans to release a recommended national strategy on nutrition and physical activity to drive federal policy in these areas. The Biden Administration’s stated goal for the conference and subsequent national strategy is to “end hunger and increase healthy eating and physical activity by 2030, so that fewer Americans experience diet-related diseases like diabetes, obesity, and hypertension.” Individuals are requested to share stories and ideas for improving nutrition, physical activity, and health through an open form on the conference website.
[Source: Department of Health and Human Services]

RESEARCH NOTES:

Physical Activity and Risk of Infection, Severity and Mortality of COVID-19: A Systematic Review and Non-Linear Dose–Response Meta-Analysis of Data from 1,853,610 Adults

Regular physical activity is known to be associated with numerous health benefits, including protection against severe respiratory infections and risk factors for severe COVID-19, such as obesity and type 2 diabetes. However, it is not well-understood how habitual physical activity affects COVID-19 outcomes. Researchers in this review sought to quantify the association between physical activity and risk of COVID-19 infection, hospitalization, severe illness, and death in adults. Their review included 16 studies of either self-reported or accelerometer-measured physical activity and subsequent COVID-19 outcomes among 1,853,610 adults. Overall, individuals who engaged in regular physical activity had a lower risk of COVID-19 infection, hospitalization, severe illness, and death than those who were inactive. Further, the researchers identified a negative dose-response relationship between physical activity metabolic equivalent minutes per week and risk of severe COVID-19 illness and death. These results indicate that physical activity is protective against severe COVID-19 outcomes, and should be broadly promoted as a public health initiative.
[Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, Garcia-Hermoso A. Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose-response meta-analysis of data from 1 853 610 adults. Br J Sports Med. 2022 Aug 22]

Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis

Physical activity is a key intervention in the prevention and management of chronic diseases, such as cardiovascular disease and cancer. Much of the research to date has examined the association between moderate-to-vigorous physical activity and chronic disease, and little is known about the dose-response relationship between resistance training and chronic disease outcomes. In this meta-analysis and systematic review, the authors evaluated 10 studies to assess the benefits of resistance training on reducing mortality risk among the general adult population. All studies measured resistance training through questionnaires and self-reporting. The authors found that resistance training was positively associated with reduced risk of the three measured mortality types, all-cause (15%), cardiovascular disease (19%), and cancer-specific mortality (14%), when compared to no resistance training. Their results also suggested a nonlinear association between resistance training and mortality risk, though more in-depth study is needed. Ultimately, the systematic review and analysis supports current evidence that participating in resistance training provides reduced mortality risk, particularly from chronic disease.
[Prathiyankara Shailendra, Katherine L. Baldock, L.S. Katrina Li, Jason A. Bennie, Terry Boyle,Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American Journal of Preventive Medicine, Volume 63, Issue 2, 2022.]

Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns with All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study

It is not well-understood whether there are benefits to concentrating recommended physical activity on fewer days per week versus spreading activity sessions throughout the week. In this prospective cohort study including 350,978 U.S. adults, the authors examined the association of physical activity patterns of three groups (the “weekend warrior,” regularly active, and inactive adults) with all-cause mortality, cardiovascular disease (CVD), and cancer-specific mortality. The researchers used responses from the 1997-2013 National Health Interview Survey (NHIS) and follow-up data of up to 10.5 years or until an established death date. Participants were categorized as physically active (≥150 min/wk of moderate or ≥75 min/wk of vigorous activity) or physically inactive (<150 minutes per week [min/wk] of MVPA). Physically active participants were then split into sub-groups of PA patterns for comparison, where “weekend warriors” were categorized as regularly active adults who completed their activity on 1-2 days per week. Among weekend warriors and regularly active adults with the same amount of total MVPA, there was no difference in all-cause or cause specific mortality. Both weekend warriors and regularly active adults had significantly lower odds of all-cause mortality and cause-specific mortality than their inactive counterparts.
[dos Santos, M., Ferrari, G., Lee, D. H., Rey-López, J. P., Aune, D., Liao, B., Huang, W., Nie, J., Wang, Y., Giovannucci, E., & Rezende, L. F. M. (2022). Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns with All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study. JAMA Internal Medicine, 182(8), 840–848.]

REPORTS, SURVEYS, GUIDELINES, RESOURCES:

Making Strides: 2022 State Report Cards on Support for Walking, Bicycling, and Active Kids and Communities

Safe Routes Partnership has released report cards that grade states on how effective they are in supporting walking, bicycling, and active communities. The report cards provide a snapshot of how each state supports policies in four key areas: Complete Streets and active transportation policy and planning; Federal and state funding for active transportation; Safe Routes funding and support; and active neighborhoods and schools. The report cards detail each key area and the possible points associated with them. Overall, states are graded with scores ranging up to 200 points and categorized into one of the following groups: Lacing Up, Warming Up, Making Strides, and Building Speed. The full report, additional resources about the state report cards, and a recorded webinar about the state report cards are available online.
[Source: Safe Routes Partnership]

Help Your Community Get Moving — with the Move Your Way Community Playbook

The U.S. Department of Health & Human Services Office of Disease Prevention & Health Promotion has published a Community Playbook to help organizations implement strategies from Move Your Way. The Move Your Way campaign was developed following the release of the 2018 National Physical Activity Guidelines and is designed to help communities promote physical activity among individuals of all ages. The new Playbook is an implementation guide and offers tips on how communities may plan for, implement, and evaluate their Move Your Way campaign. The Playbook was developed following the pilot implementation of Move Your Way in 10 communities across the country. Both the Playbook and the Move Your Way materials are free and publicly accessible online.
[Source: Office of Disease Prevention & Health Promotion] 

Report: Dangerous by Design 2022

Smart Growth America has released Dangerous by Design 2022, a new report that details where pedestrian and cyclist fatalities occur, and which individuals are most affected. The report uses federal traffic data through 2020 and data from the Governor’s Highway Safety Association through 2021. Despite decreases in driving in 2020 due to the COVID-19 pandemic, pedestrian fatalities increased overall by 4.5%. Preliminary data also suggest that pedestrian fatalities increased between 11-13% from 2020-2021. While all individuals are imperiled by dangerous street design, older adults, people of color, and individuals who live in low-income areas are disproportionately affected by traffic fatalities. Among the 20 most dangerous metro areas for pedestrians across the country, seven were located in Florida, four were located in California, and three were located in South Carolina. Smart Growth America is calling for better street designs and pedestrian infrastructure nationally to protect all individuals. The full report is available online, along with an accompanying webinar that discusses the results.
[Source: Smart Growth America]

New Brief on Physical Activity Equity from the Physical Activity Alliance

The Physical Activity Alliance, in partnership with the FrameWorks Institute, recently published a strategic brief titled, “Framing Guidance: Equitable Physical Activity.” The report contains a set of recommendations on how individuals who work in the physical activity sector can use more equitable language when talking about physical activity. This includes acknowledging how structural and environmental factors, like racism and inequitable neighborhood development, affect individual capacity to be physically active. The report also offers a set of narrative templates that may help practitioners address inequities in physical activity in various settings, such as employer-sponsored wellness programs or access to sport programs. The full report is available online.
[Source: Physical Activity Alliance]

PROMOTING ACTIVE COMMUNITIES:

Urban Institute Park Equity Case Study: Washington, D.C.

The Urban Institute, a nonprofit research organization, recently published a case study on park equity in Washington, D.C. The study focuses on the renovation of Stead Park, which is located in the densely-populated Dupont Circle neighborhood. The park’s evolution across recent decades, from dirt field to grassy lawn plus playground and splash pad, tracks with the influx of young families to Dupont but has neglected to serve the needs of older residents. The report authors note that while most D.C. residents live within 10-minutes walking distance of a park, the distribution of usable green space is not always equitable in predominantly Black or low-income neighborhoods. The report advocates for neighborhood surveys to understand how parks are used (or how residents would like to use them) to inform renovations. In the case of Stead Park, a proposed renovation will include a community center with programming for older residents of the neighborhood. In addition to the case study, the Institute has also published a report on investing in equitable urban parks.
[Source: Urban Institute]

Healthy Savannah Physical Activity Survey Results & Next Steps

Healthy Savannah, a nonprofit focused on providing equitable opportunities for physical activity and healthy eating in Savannah, GA, recently revealed the results of a year-long survey focused on community physical activity. Residents who took part in the survey indicated that they would like better access to physical activity infrastructure and health services. The nonprofit hopes to mitigate these concerns through the construction of the Tide to Town trail, a protected trail network that will connect 75% of Savannah’s neighborhoods. Further, residents reported that they were less physically active in 2021 than in previous years. This prompted Healthy Savannah to plan weekly walks on trails throughout Chatham County. The nonprofit will also use the survey results to inform future physical activity programming, with the intent of reaching as many Chatham County residents as possible.
[Source: Savannah Business Journal]

Physical Activity Added to Basic Vital Signs at Hartford HealthCare

The Hartford, Connecticut-based health system, Hartford HealthCare, has added physical activity as a part of routine vital sign assessment at preventive care appointments. All patients will be asked to report on how many days per week they take part in exercise, and for how many minutes per day. The health system is the first in New England, and one of very few nationally, to add physical activity measures to vital sign assessment. Research directors at Hartford acknowledged the importance of collecting physical activity data to facilitate conversations between patients and providers on the importance of physical activity. The health system hopes that the new metric will help patients track and improve their physical activity levels.
[Source: Hartford HealthCare]

New Kinesiology Program Aims to Boost Middle School Girls’ Love of Physical Activity, Sports

A grant-funded outreach program targeting barriers to middle school girls’ physical activity is under development through the University of Wisconsin-Madison. The program aims to provide local sixth grade girls with workouts, activities, and instruction to encourage physical activity within this population. The creator of the program and academic program manager at UW-Madison department of Kinesiology, Morgan Shields stated, “I wanted to reach out to the gals who stopped playing sports, or never started, and create a space for them to just learn and try stuff out in a safe environment with really strong mentors and theory-based information.” Over 200 girls from two local middle schools, targeted in part for their high proportion of students enrolled in free and reduced lunch-programs, were surveyed to gain insight into what kind of activities they enjoyed that helped shape the workouts and activities within the program. Shields' aim is to apply for continued funding in the future to expand the program to include sports equipment and transportation for the girls. The program is set to be piloted in Madison area schools beginning next fall. 
[Source: Interactive Health Technologies]

UPCOMING CONFERENCES AND WORKSHOPS:

October

November

December

Writers: Kelsey Day and Jasmin Parker-Brown

To submit an item, please e-mail the USC PRC at uscprc@mailbox.sc.edu.

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This publication was supported by Cooperative Agreement Number U48DP006401 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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