OREGON STATE UNIVERSITY

college of public health and human sciences

California’s new mental health system helps people live independently

CORVALLIS, Ore. – A new analysis by Oregon State University researchers of California’s mental health system finds that comprehensive, community-based mental health programs are helping people with serious mental illness transition to independent living.

Published in the October issue of the American Journal of Public Health, this study has important implications for the way that states finance and deliver mental health programs, and speaks to the effectiveness of well-funded, comprehensive community programs.

In November of 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs, known as Full Service Partnerships (FSP). While community-based, these programs are different from usual mental health services programs in most states because they provides a more intensive level of care and a broader range of mental health services and supports, such as medication management, crisis intervention, case management and peer support.

It also provides services such as food, housing, respite care and treatment for co-occurring disorders, such as substance abuse.

“We found that these programs promoted independent living in the community among people who had serious mental illness but had not been served or underserved previously,” said Jangho Yoon, an assistant professor of health policy and health economist in OSU’s College of Public Health and Human Sciences and lead author of the study. “Overall, it reduced their chance of living on the street or being incarcerated in jails and prisons.”

The researchers looked at data from 43 of California’s 53 counties, resulting in a sample of 9,208 adults over the course of four years. They found that participants who stayed enrolled in the program continuously, without interruption, were 13.5 percent more likely to successfully transition to independent living.

However, they found that non-white patients were less likely to live independently, and more likely to end up in jail or homeless.

“Although FSPs represent the most well-funded comprehensive community-based programs in the country, they are still community programs and therefore program participation is voluntary,” Yoon said.  “My guess is that minorities may not benefit fully from these programs in their communities possibly due to greater stigma, and less family/social supports. But it needs further investigation.”

Patients with schizophrenia and bipolar disorders were also less likely to benefit from the community programs, because of the nature and severity of their mental health issues.

Yoon is an expert on health management policy, specifically policy around the area of mental health. He said other states haven’t followed California’s lead, in part because of the cost of such extensive programming. Yoon said some of the funding made possible by the federal Patient Protection and Affordable Care Act, which includes $460 million for community mental health services for states to use, may help other states to create similar programs.

“Nobody would disagree that the public mental health system has historically been under-funded in the U.S.,” he said. “The message for other states is clear: investment in well-funded, recovery-oriented, comprehensive community mental health programs clearly improves lives of people with serious mental illness, and may also save money from reduced dependency and incarcerations in this population.”

Tim Bruckner of the University of California, Irvine, and Timothy Brown of the University of California, Berkeley, contributed to this study, which was jointly funded by the California Department of Mental Health and the California Health Care Foundation.

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Jangho Yoon, 541-737-3839

Autistic children with better motor skills more adept at socializing

CORVALLIS, Ore. – In a new study looking at toddlers and preschoolers with autism, researchers found that children with better motor skills were more adept at socializing and communicating.

Published online today in the journal Research in Autism Spectrum Disorders, this study adds to the growing evidence of the important link between autism and motor skill deficits.

Lead author Megan MacDonald is an assistant professor in the College of Public Health and Human Sciences at Oregon State University. She is an expert on the movement skills of children with autism spectrum disorder.

Researchers tested 233 children ages 14 to 49 months diagnosed with autism.

“Even at this early age, we are already seeing motor skills mapping on to their social and communicative skills,” MacDonald said. “Motor skills are embedded in everything we do, and for too long they have been studied separately from social and communication skills in children with autism.”

Developing motor skills is crucial for children and can also help develop better social skills. MacDonald said in one study, 12-year-olds with autism were performing physically at the same level as a 6-year-old.

“So they do have some motor skills, and they kind of sneak through the system,” she said. “But we have to wonder about the social implications of a 12-year-old who is running like a much younger child. So that quality piece is missing, and the motor skill deficit gets bigger as they age.”

In MacDonald’s study, children who tested higher for motor skills were also better at “daily living skills,” such as talking, playing, walking, and requesting things from their parents.

“We can teach motor skills and intervene at young ages,” MacDonald said. “Motor skills and autism have been separated for too long. This gives us another avenue to consider for early interventions.”

MacDonald said some programs run by experts in adaptive physical education focus on both the motor skill development and communicative side. She said because autism spectrum disorder is a disability that impacts social skills so dramatically, the motor skill deficit tends to be pushed aside.

“We don’t quite understand how this link works, but we know it’s there,” she said. “We know that those children can sit up, walk, play and run seem to also have better communication skills.

This study was coauthored by Catherine Lord of Weill Cornell Medical College and Dale Ulrich of the University of Michigan. It was supported by the National Institutes of Health, the Simons Foundation, First Words and Blue Cross Blue Shield Foundation of Michigan.

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Megan MacDonald, 541-737-3273

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Megan MacDonald
Researcher Megan MacDonald practices important motor skills, like throwing a ball, with a child. (photo courtesy of OSU College of Public Health and Human Sciences)

OSU students to run across Oregon this summer promoting health and physical activity

CORVALLIS, Ore. – Oregon State University students and brothers Jeremiah and Isaiah Godby will spend their summer running across Oregon in an effort to encourage Oregonians to improve their health through better eating and exercise.

The “Health Extension Run 2014” was designed to inspire Oregonians to take charge of their health and educate community residents about the role the OSU College of Public Health and Human Sciences and OSU Extension Service offices in each county play in building healthy communities. The event coincides with the recent accreditation of the College of Public Health and Human Sciences.

The run begins July 7 on the Oregon State campus in Corvallis and is expected to finish Sept. 5 at OSU. The Godbys plan to run 1,675 miles through 30 Oregon counties, with stops in many communities along the route for public events such as health festivals and county fairs. OSU students, alumni and all other supporters are encouraged to run or walk with the brothers in their communities.

Jeremiah, 21, and Isaiah, 23, are exercise and sports science majors in the College of Public Health and Human Sciences. They said they are motivated to run in hopes that they can inspire others to get more exercise, eat better and make other health improvements.

Jeremiah Godby is an example of the difference exercise can make. After he decided to cut back on video-game playing and began running in high school, he lost 45 pounds.

“I feel so much better,” he said. “I just enjoy life more.”

He and his brother took up long-distance running as a form of advocacy and, after completing similar long runs in the past, volunteered for this summer’s Health Extension Run. 

“We just want to inspire people to live a balanced life,” said Isaiah Godby. “It’s not as complicated as people think. Walk an extra block or park your car further away in the parking lot.”

The run will kick off at 9:30 a.m. on July 7 with a short send-off ceremony on the steps of the Memorial Union quad on the Oregon State campus in Corvallis. The Godbys will then run around the OSU campus before heading north on Highway 99.

The brothers will run about 32 miles a day, traveling north from Corvallis to Astoria, down the Oregon Coast, across to Eugene and then south to Medford before heading east to Klamath Falls, where they’ll participate in the 100th anniversary celebration of the Klamath Basin Research & Extension Center. From Klamath Falls, they’ll run to Bend, Prineville, John Day, Burns and Ontario.

The Godbys also will spend a day in Boise, Idaho, where they’ll run through the city and participate in a Beavers alumni event. For more information or to register for that event, visit http://bit.ly/1rf1gOT.

From Boise, the runners will head back to Ontario, where they’ll head north to Baker City and LaGrande, then work their way back west through towns including Pendleton, Heppner, Condon, The Dalles and Hood River. They’ll be in Portland for a few days before running to Salem for the Oregon State Fair, then to Albany before wrapping in Corvallis on Sept. 5.

Find more information about events in the community at http://bit.ly/V9zK8a and follow along with the Godbys on their blog, http://bit.ly/1z65ue8.


Editor's note: Video b-roll is available to download for use with this news release: http://health.oregonstate.edu/broll/healthextensionrun.
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Isaiah Godby, 530-574-7420 or godbyi@onid.oregonstate.edu; Jeremiah Godby, 530-574-7421 or godbyj@onid.oregonstate.edu; Kathryn Stroppel, 541-737-6612 or Kathryn.Stroppel@oregonstate.edu

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Jeremiah, left, and Isaiah Godby

Health Extension Run 2014

OSU gains state’s first accredited school of public health

CORVALLIS, Ore. – Oregon State University’s College of Public Health and Human Sciences was granted accreditation today, making it the first school of public health in Oregon to earn that recognition.

The accreditation, from the Council on Education for Public Health, means OSU has the only accredited school of public health between San Francisco and Seattle. The distinction elevates the College of Public Health and Human Sciences’ visibility and stature, increases its ability to attract and retain committed students and world-class faculty, and helps the college continue its mission of education, research and outreach, OSU officials say. The recognition also allows the college to support a qualified work force in Oregon and beyond.

The college is a leader in efforts to redesign and integrate the public health curriculum. Harvard and Columbia University are among the handful of other accredited schools in the United States using this approach. At Oregon State, faculty members already work across disciplines in public health and the human sciences.

“Integration is where the future of public health is headed,” said Tammy Bray, dean of the College of Public Health and Human Sciences. “We believe a life-span, interdisciplinary approach will make the greatest impact on society’s most complex public health issues, which don’t come in discipline-shaped blocks.”

Helping Oregonians become healthier at all stages of life, with an emphasis on prevention and outreach, is a central focus of the college.

“Our faculty in OSU Extension, including programs in 4-H and Family and Community Health, have worked with their neighbors in every county in Oregon for 100 years to create local solutions to their health challenges,” Bray said. “Of the nation’s 50-plus schools of public health, we’re the only one with that level of community outreach built in.”

Bray said receiving accreditation means that experts in the field of public health agree that the College of Public Health and Human Sciences is of high quality; has the curriculum, faculty and resources needed to continue meeting high standards; and produces graduates that have the knowledge and skills to succeed in their fields.

The council awarded the College of Public Health and Human Sciences a five-year accreditation, the maximum granted. The decision follows an extensive and rigorous review of the college’s academic programs that took more than four years to complete. The college’s accreditation will be up for review and renewal in 2019.

“This accreditation establishes our role as a credible leader in public health in Oregon and beyond,” Bray said. “It comes at a time when a spotlight is on the public’s health like never before, and we are uniquely positioned to work with our communities in creating healthy environments that enhance lifelong health and well-being.”

This year, the college extended its reach beyond state and national borders by launching the new Center for Global Health, which joins three existing research centers – the Hallie E. Ford Center for Healthy Children and Families; the Moore Family Center for Whole Grain Foods, Nutrition and Preventive Health; and the Center for Healthy Aging Research.

The college serves more than 3,500 undergraduate and 300 graduate students, and its alumni go on to work in a variety of positions in high-demand health care settings, including federal and state health agencies, hospitals and clinics, community organizations, county health departments, non-governmental organizations and many more.

“Public health is an increasingly relevant and vital profession. At OSU, enrollment in our public health programs is up 116 percent over the last five years, a trend that’s still on the rise,” Bray said.

“That’s a good thing for the public, because more than three times the number of current public health graduates is needed to meet the health needs of the future,” she said. “Our graduates will be well prepared to work collaboratively to solve current and emerging public health challenges not only in Oregon but across the globe.”


About the Council on Education for Public Health: The council is an independent agency recognized by the U.S. Department of Education to accredit schools of public health and public health programs that prepare students for careers in public health. The primary professional degree in these programs is the Master of Public Health.

Editor's Note: Video b-roll is available to download for use with this news release: http://health.oregonstate.edu/broll/accreditation

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Tammy Bray, 541-737-3256, tammy.bray@oregonstate.edu

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College of Public Health and Human Sciences Dean Tammy Bray

Dean Tammy Bray

Norm Hord (left) is the Celia Strickland and G. Kenneth Austin III Endowed Professor in the College of Public Health and Human Sciences.
Norm Hord

OSU seeks participants for new health promotion program

CORVALLIS, Ore. – Researchers who are organizing Physical Activity Centered Education, a new health promotion program aimed at people with physical mobility issues, are seeking participants from the Corvallis area.

Megan MacDonald, assistant professor in exercise and sport science at Oregon State University, is creating the program based on a successful model developed at a medical facility in Texas.

The program is aimed at people ages 18 and older who have limited mobility – defined as having difficulty walking one block, or using an assistive device such as a walker, cane or wheelchair.

Participants must be able to communicate in English, attend the program once a week for 90 minutes during an eight-week period, and will receive up to $75 for taking part. It will take place in the Movement Studies in Disabilities Lab in the Women’s Building on the OSU campus.

This is part of a research project on how a health promotion program can influence the physical activity of people with a mobility disability. It helps people learn social and behavioral skills to become healthier, such as setting goals, rewarding themselves for making their goals, and how to overcome barriers to being healthy and active.

To learn more information on qualifications for the program and to sign up to participate, email health.disability@oregonstate.edu or call 541-737-6928.

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Megan MacDonald, 541-737-6928; megan.macdonald@oregonstate.edu

OSU Ballroom Dance Company to perform showcase in Corvallis

CORVALLIS, Ore. – The Oregon State University Ballroom Dance Company will perform May 30 and 31 at Corvallis High School.

The company’s showcase, “Swingin’ Ballroom,” will feature two pieces with country western flair. Other numbers include a West Coast Swing interpretation of the movie “Men in Black” and a Lindy hop, as well as dances featuring salsa, fox trot, cha cha, tango and more.

The 42-member company is comprised of the original Cool Shoes Dance Troupe and an additional team, New Shoes. The company is sponsored by the Physical Activity Course Program in OSU’S College of Public Health and Human Sciences.

The OSU Ballroom Dance Company, under the direction of Cathy Dark and Mark Baker, has toured throughout the Pacific Northwest. This spring, Cool Shoes toured southern Oregon and San Francisco, receiving numerous accolades for their performances.

The performances begin at 7:30 p.m. in the Corvallis High School Auditorium, 1400 N.W. Buchanan Ave. Tickets are $10 for general admission or $8 for students and seniors, and can be purchased at the door the nights of the performances.

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Cathy Dark, 541-737-5929 or cathy.dark@oregonstate.edu

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Cool Shoes Ballroom Dance Troupe

 

Cool Shoes Cool Shoes

Study: Targeted funding can help address inequities in early child care programs

CORVALLIS, Ore. – The quality of early child care and education programs is influenced both by funding and by the characteristics of the communities in which the programs operate, new research from Oregon State University shows.

The findings indicate that law- and policy-makers may need to consider the demographics of communities when making funding decisions about early childhood programs, said Bridget Hatfield, an assistant professor in OSU’s College of Public Health and Human Sciences.

That’s especially important now because many states, including Oregon, are adopting or revising quality ratings systems that tie funding to program quality, Hatfield said.

Her findings were published recently in “Early Childhood Research Quarterly.” Co-authors were Joanna K. Lower of Lower & Company, Deborah J. Cassidy of the University of North Carolina at Greensboro and Richard A. Faldowski of the University of North Carolina at Chapel Hill. Lower received funding for the research from the Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Hatfield received funding for the research from the Institute of Education Sciences at the University of Virginia.

Hatfield studied about 7,000 licensed early child care and education programs in North Carolina, which has one of the nation’s oldest quality rating and improvement systems for early child care and education programs. These systems are used by many states to determine how much government funding an early child care and education program receives.

Oregon and many other states are in the midst of implementing a quality rating system.

Hatfield found that children from low-income communities have less access to high-quality early child care and preschool, even though they are likely to gain more benefits from it.

“There are a lot of barriers to high-quality education in disadvantaged communities,” she said. “Hiring teachers with bachelor’s degrees, providing appropriate school supplies and play equipment – you need money to do all those things.”

Her research also showed that additional government funding can provide a significant boost to the quality of programs in disadvantaged communities. Those programs make bigger quality improvements when they receive extra funding than programs that are in more affluent communities, Hatfield found.

“Just because a program is in a disadvantaged community doesn’t mean it can’t attain high quality,” she said. “The extra money helps the programs in disadvantaged communities close the gap.”

Hatfield studied family child care homes, where child care is provided in a private home, as well as child care centers and preschool programs, including federal programs such as Head Start.

The research shows that quality of child care can vary based on funding, but other factors also affect program quality, Hatfield said. For example, in other research projects, she is studying the interactions between teachers and children in the classroom. That kind of research will help child care program leaders determine how best to spend money they receive to improve their programs.

“If we give people more money, what’s the best way to spend it?” she said. “Do we buy more puzzles for the children or train the teachers to better use the puzzles they have?”

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Bridget Hatfield, 541-737-6438, Bridget.hatfield@oregonstate.edu

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Bridget Hatfield

Bridget Hatfield

Changes in processing, handling could reduce commercial fishing injuries, research shows

CORVALLIS, Ore. – Handling frozen fish caused nearly half of all injuries aboard commercial freezer-trawlers and about a quarter of the injuries on freezer-longliner vessels operating off the coast of Alaska, new research from Oregon State University shows.

Many of those injuries and others aboard the two types of vessels could be prevented with the right interventions, and the research methods used in the study could help identify and reduce injuries and fatalities in other types of commercial fishing, said researcher Devin Lucas. His findings were published in the “American Journal of Industrial Medicine.”

“We’ve drilled down to such a detailed level in the injury data that we can actually address specific hazards and develop prevention strategies,” said Lucas, who recently received his Ph.D. in public health from OSU’s College of Public Health and Human Sciences and works for the National Institute for Occupational Safety and Health (NIOSH) in the Alaska Pacific office.  

Lucas’ study is the first scientific assessment of the risk of fishing on freezer-trawlers and freezer-longliners. In both types of vessels, the processing of fish is handled on-board. The vessels had reputations for being among the most dangerous in commercial fishing in part because of a few incidents that resulted in multiple fatalities.

However, an analysis of 12 years of injury data showed that fishing on the freezer vessels was less risky than many other types of commercial fishing, which is one of the most dangerous occupations in the United States, Lucas said. The rate of injury on freezer-trawlers was about the same as the national average for commercial fishing, while the rate aboard freezer-longliners was about half of the national average.

“The reality is that many fisheries elsewhere in the U.S., including Oregon Dungeness crabbing, are much more dangerous,” Lucas said.

His review of injury data indicated that the majority of injuries in the freezer-trawler fleet occurred in the factories and freezer holds, while the most common injuries in the freezer-longliner fleet occurred on deck while working the fishing gear. Injuries from processing and handling fish were also common on the longliners, the research showed.

Study co-author Laurel Kincl, an assistant professor of environmental and occupational health and safety in the College of Public Health and Human Sciences, said the methods used in the research, including describing and categorizing the types of injuries, can now be applied to other commercial fishing industries to identify safety issues and pinpoint areas for prevention.

“Not all commercial fishing is the same,” Kincl said. “You have different equipment, different processes.”

Kincl said researchers are hoping to build from this research and explore other fishing-related injuries and prevention strategies. The Dungeness crab industry is one area that may be explored and another is land-based fish-processing, she said.

Additional authors of the study were Viktor E. Bovbjerg and Adam J. Branscum, associate professors in the College of Public Health and Human Sciences at OSU and Jennifer M. Lincoln of NIOSH. The research was supported by OSU and NIOSH.

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Devin Lucas, 907-271-2386, dlucas@cdc.gov

Laurel Kincl, 541-737-1445, Laurel.kincl@oregonstate.edu

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Devin Lucas

Researcher Devin Lucas

Mistrust, discrimination influence Latino health care satisfaction

CORVALLIS, Ore. – Mistrust of the medical community and perceived discrimination by health care providers can affect how satisfied young adult Latinos in rural Oregon are with their health care, new research from Oregon State University shows.

Health care satisfaction, or the lack of, could influence health outcomes for patients, affect participation in health care programs under the new Affordable Care Act, and contribute to disparities in health care access for Latinos, said lead researcher Daniel López-Cevallos, associate director of research for the Center for Latino/a Studies and Engagement at OSU

“Health care reform is about people getting insurance so they have access to services, but mistrust may lead people to delay care,” López-Cevallos said.

Findings of the research were published recently in “The Journal of Rural Health.”  The article was co-authored by S. Marie Harvey, associate dean and professor of public health, and Jocelyn T. Warren, assistant research professor in the College of Public Health and Human Sciences. Harvey received funding from the Centers for Disease Control and Prevention for the research.

Researchers surveyed 387 young adult Latinos, 18 to 25, living in rural Oregon. Patient satisfaction information was collected as part of a larger study about health issues among young, rural Latinos. Participants were not asked about their immigration status; more than half, about 58 percent, were born outside the U.S. and the average length of U.S. residency was 13.8 years.

The majority of participants, about 73 percent, reported being moderately or very satisfied with their health care. Among those who were not satisfied, medical mistrust and perceived discrimination were identified as factors. Other factors including age and health insurance did not affect satisfaction, the study showed.

The research suggests a need to improve “cultural competency” among health care providers, from the doctors to the receptionists to the lab technicians, so Latinos are treated with respect and dignity, the researchers said. A bilingual/bicultural workforce may be more effective in addressing health issues affecting a patient.

“Trust is huge; it allows patients to disclose concerns and be honest,” Harvey said. “In a previous study we conducted, young adult Latino men reported that ‘confianza,’ a term that encompasses trust, respect, level of communication and confidentiality, affected their access to and use of health care services.  

Efforts to enroll Latinos in health care programs under the Affordable Care Act won’t be successful if patients don’t feel comfortable at their doctor’s office, López-Cevallos said.

“These are young, healthy adults,” he said. “We want them in our health insurance pools to help average the risk and keep costs down. This is an opportunity, but we have a lot of work to do.”

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S. Marie Harvey, 541-737-3824, Marie.harvey@oregonstate.edu

Daniel López-Cevallos, 541-737-3850, Daniel.lopez-cevallos@oregonstate.edu

Behavior problems in preschool and child care centers may be an issue of genes

BEND, Ore. – A new study suggests that some children may be genetically predisposed to developing behavioral problems in child care and preschool settings.

Previous research has found that some children develop behavior problems at child care centers and preschools, despite the benefit of academic gains. It was never known, however, why some youngsters struggle in these settings and others flourish. The new study indicates that some children may be acting out due to poor self-control and temperament problems that they inherited from their parents.

The study’s lead author Shannon Lipscomb, an assistant professor of human development and family sciences at Oregon State University-Cascades, said the findings point to the reason that some children develop problem behavior at care centers, despite the best efforts of teachers and caregivers. The results are published online today in the International Journal of Behavioral Development.

“Assuming that findings like this are replicated, we can stop worrying so much that all children will develop behavior problems at center-based care facilities, because it has been a concern,” she said. “But some children (with this genetic predisposition) may be better able to manage their behavior in a different setting, in a home or smaller group size.”

Researchers from Oregon State University and other institutions collected data in 10 states from 233 families linked through adoption and obtained genetic data from birth parents as well as the children. They found that birth parents who had high rates of negative emotion and self-control, based on a self-reported temperament scale, were more likely to have children who struggled with behavioral issues such as lack of self-control and anger, in child care centers. They controlled for adoptive parent’s characteristics, and still found a modest effect based on the genetic link.

“We aren’t recommending that children are genetically tested, but parents and caregivers can assess a child’s needs and help them get to a setting that might be more appropriate,” Lipscomb said. “This study helps us to explain why some children struggle so much with large peer groups and heightened social interactions. It may not be a problem with a teacher or parent, but that they are struggling on a biological level.”`

Lipscomb is in OSU’s College of Public Health and Human Sciences. She is an expert on early childhood development and school readiness, and is particularly interested in adult influences on young children.

Researchers from the University of Oregon, Pennsylvania State University, University of Pittsburgh, University of California, Riverside, Yale Child Study Center, and Oregon Social Learning Center contributed to this study, which was supported by grants from the National Institutes of Health.

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Shannon Lipscomb, 541-322-3137