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Harlem H A R L E M

Health REPORT
Health
Promotion
Center
(HHPC)

2010 Pu t t i ng H ea l t h Pro m ot i o n i n to Ac t i o n t h ro ugh Co m m u n i t y Co l la bo ra t i o n

n Message from the Director

Harlem ... It’s time to make some noise!

T
here is a thief HHPC, along with many of our community
among us, steal- and public health partners, has begun a five-
ing something year initiative to screen Harlem residents for
more precious than sil- high blood pressure and then provide educa-
ver and gold–our health tion and linkages to care at local health cen-
and well-being. High ters, while also providing personalized educa-
blood pressure (hyper- tion and support to manage their condition.
tension) not only steals, As a community, we need to “make some noise”
but kills as well–target- in order to oust this “silent killer” from our midst.
ing elders and young For more information on controlling hypertension,
adults alike. This “silent visit our website (www.GetHealthyHarlem.org).
killer” fires no warning shots before it destroys key
vital organs such as the kidney, brain and heart. To particpate in our project, Support for
Hypertension Awareness, Reduction and
Research shows that people of color are more Education (SHARE), please contact Michelle
likely to have high blood pressure—and less Smith, Project Coordinator at mes2163@
likely to have it under control. While many columbia.edu or 646-284-9740. ❂
individuals have not been checked for high
blood pressure, those who do know that they
have “pressure” are not getting it under con- Alwyn T. Cohall, MD, is the Director of the Harlem Health Promotion Center

trol through a combination of healthy lifestyle


changes and, in some cases, medication.

n What’s Inside Innovative video


see page 6
HHPC collaborations 2
Healthy Monday Campaign
Message from the CAB chair 5
Healthy food access 2
Community Supported Agriculture (CSA) HHPC staff updates 5
Introductions
Community workshops 3
Promoting healthy relationships CAB updates 5
Newcomers and newsmakers
Publications 3
Peer-reviewed journal articles In the news 6
SEX::TECH Conference, Cells in Da Hood
Awards 4
My Life, My Decision
Staff, CAB and students
Student spotlight 7
Grants 4
Online health communications skills
Funding news
2010
Page 2

n HHPC Collaborations
HHPC helps start a CSA
in Northern Manhattan
Healthy Monday Campaign
HHPC has partnered with Commu-
nity Campus Partnerships for Health
HHPC partners with Healthy Monday to get Harlem healthy
(CCPH) and several other community

H
organizations in Washington Heights ealthy Monday (HM) is a na- University, in association with Johns
to start the Tierra Direct Community tional movement to get people Hopkins University Bloomberg School
Supported Agriculture (CSA) site at to start and stick with healthy of Public Health, and Syracuse Univer-
CCPH (178th Street and Fort Wash- behaviors that can help control chronic, sity Newhouse School of Public Com-
ington Avenue). preventable diseases like diabetes, munications. HM’s many campaigns
heart disease and hypertension. HM’s focus on reducing meat consumption
Every week from June 17 to Novem- goal is to reduce (Meatless Monday),
ber 4 this year, Tierra Direct CSA the impact of increasing physi-
members will pick up a variety of these diseases by cal activity (Move
delicious locally-grown, organic veg- offering a weekly it Monday) and
etables; attend cooking classes; go reminder to start smoking cessation
on a farm trip; meet their farmer; and stick with (Quit and Stay Quit
and engage in other educational healthy goals— Monday) to name
events to learn about healthy eating something that a few initiatives.
and the benefits of supporting local its collaboration
agriculture. with HHPC aims to HM’s recent collab-
bolster in Northern Manhattan. oration with HHPC is helping Northern
CSA is one way for communities with Manhattan residents learn more about
little access to healthy food to afford The idea for HM started in 2005, when getting healthy by adding HM messages
top-quality organic vegetables while advertising executive and marketer, Sid and activities into their lives. A related
also supporting local farmers. Lerner, compared the number of violent component encourages enhanced
deaths regularly reported by the media screening to identify and treat a variety
How does it work? A community with the number of deaths caused by of health conditions. This campaign
group works directly with a local diseases such as heart disease, stroke, is focusing on high school and college
farmer to purchase produce that cancer, and diabetes. He found that students and faith-based institutions.
the farmer delivers to their site there were actually more deaths caused Additionally, staff, parents and children
each week. by preventable, chronic diseases like involved in daycare, charter school, and
these than those caused by accidents, after-school programs will be engaged
To get matched up with a farmer and
violent crime and other causes. Lerner as well.
gain technical support, Tierra Direct
decided that lifestyle changes on a
worked with Just Food, a NYC-based The vision for the initiative will be
mass scale was needed to save lives.
non-profit organization that helps to turn Northern Manhattan into a
He began collaborating with academic
bring healthy, locally-grown food into “Healthy Monday” community where
institutions and organizations to cre-
communities here. Members pay the everyone becomes inspired by the
ate the spark needed to fuel this mass
farmer at the beginning of the season motto, “Monday–the day all health
movement.
for a “share” of produce so that the breaks loose!”
farmer can buy fertilizer, seeds, etc. HM began as a project of the Mailman
without taking out large interest-bear- School of Public Health at Columbia continued on pg. 8
ing loans.

continued on pg. 8

More HHPC support for CSA!


HHPC Community Advisory Board (CAB) member, Debra Jack-
son, is one of the volunteers to start the Grace CSA at a West
139th Street church in Harlem.

“Grace CSA is in a residential area that has no major grocery


stores within a quarter mile radius,” says Jackson. “Having a
farmer come to our site with fresh vegetables is a real bonus.”
The Goshen, NY farm where the Tierra Direct
vegetables come from To learn more, contact gracechurchcsa@yahoo.com.
2010
Page 3

n Community Workshops
MHT workshop
Project STAY on the move feedback
“Gotham Professional Arts Acad-
Promoting healthy relationships emy in Brooklyn invited the Project
STAY Mobile Health Team (MHT) to

T
his past February marked the School of Public Health: Kirby Bumpus, participate in our Respect for All
first observance of Teen Dating Maria Papadimitriou and Jolene Lalas. Day. We wanted to focus on respect
Violence Awareness and Preven- for self and others, our community,
tion Month. The New York State Office “The MHT mission is to provide educa-
and our right to be respected by
for the Prevention of Domestic Violence tion, prevention, testing and treatment
others. The MHT presented on STI
started a campaign to encourage teens to young people for STIs and HIV in
prevention and gave students the
to recognize abusive behavior and to NYC,” says Renee Cohall, LCSW-R,
opportunity to be tested. I know
learn more about it. ACSW, who oversees the MHT. “We
that many kids who would other-
offered these workshops as a way to
wise go untested got tested. I also
As part of this address the urgen-
know that many students who have
effort, Project cy of teen dating
questions about sexual decision-
STAY’s* Mobile violence which is
making, pregnancy, STIs, and vari-
Health Team a silent epidemic.
ous other topics were able to ask
(MHT) provided According to
those questions in a private and
workshops focused Break the Cycle,
safe environment with a qualified
on teen dating a leading non-
counselor. This could potentially
violence, homopho- profit organization
save a young person’s life. The
bia, and sexual addressing teen
work that Project STAY does is so
health to high dating violence,
important.”
school students at one in three teens
the Gotham Profes- MHT Health Educator, Julen Harris, presents to will experience Shelby Mitchell, Social Worker,
Facing History High School students
sional Arts Acad- abuse in a dating Gotham Professional Arts Academy
emy in Brooklyn relationship and in Brooklyn
and Urban Assembly High School for more than two thirds of them will never
Performing Arts in Harlem (see box at report it to anyone.”
right on school staff response). These
workshops were facilitated by three For more information on teen dating
MHT health educators, all graduate stu- violence go to breakthecycle.org. ❂
dents at Columbia University’s Mailman

*Project STAY is HHPC’s service arm and is funded by the New York State Department of Health and the
Robin Hood Foundation.

n Publications
Cohall AT, Dini S, Nye A, Dye B, Neu N, Hyden C. HIV Testing Preferences Among
Young Men of Color Who Have Sex With Men. American Journal of Public Health. MHT fast facts
In press. Published ahead of print on January 14, 2010.
Each year:
Cohall AT, Nye A, Moon-Howard J, Kukafka R, Dye B, Vaughan RD, Northridge
M. Computer Use, Internet Access, and Online Searching for Health Information • MHT provides 1,500 youth with
among Harlem Adults. American Journal of Health Promotion. In Press. sexual health information and risk-
reduction workshops
Johnson R, Nshom M, Nye A, Cohall A. There’s always Plan B: Adolescent knowl- • 700 youth attending MHT workshops
edge, attitudes and intention to use emergency contraception. Contraception. 81 voluntarily request additional coun-
(2010); 128–132. seling and screening for sexually-
transmitted infections and HIV
Khan S, Ancker J, Li J, Kaufman D, Hutchinson C, Cohall A, Kukafka R.
GetHealthyHarlem.org: Developing a Web Platform for Health Promotion and
Wellness Driven by and for the Harlem Community. AMIA Annu Symp Proc 2009;
2009:317-321. Published online 2009 November 14.
continued on pg. 7
2010
Page 4

n Awards
posters were presented at the 11th An- over 30 years of experience in the film
nual Community-Campus Partnerships and television industry and is currently
for Health Conference May 12-15, 2010 the Executive Producer of Light/Action
in Portland, Oregon, where they were Productions.
granted a Third Place “viewers choice”
award based on the votes of conference n Several of HHPC’s collaborating
participants. Columbia University’s Mailman School
of Public Health graduate students
won Awards of Excellence for their
Master’s theses: Melody Hsiou, “The
Genetic Information Nondiscrimination
Nye (at left) with Dean Linda P. Fried
Act,” Policy Review Article (SMS Thesis
n Andrea Nye, HHPC’s Director of Pro- Award Recipient); Laura Shulman,
grams and Evaluation, is one of seven “Incorporating Risk Reduction Counsel-
recipients of Columbia University’s ing as a Standard of Care in Obstetrics-
2010 Mailman School of Public Health Gynecology Offices,” Research Proposal
annual Staff Award for Excellence. (Honorable Mention); Colleen Kapsi-
These awards are made possible by a malis, “Going Against the Grain: An
generous gift from an anonymous do- Watkins-Bryant (at left) and Hanif Shabazz Intervention to Increase Screening of
nor to recognize outstanding Mailman Celiac Disease in the United States,”
School employees who demonstrate the n Hanif Shabazz, HHPC Community Intervention Proposal (Notable for Ex-
highest standards of excellence and Advisory Board (CAB) member, received cellence); Jennifer Pehr, “Barriers and
extraordinary performance. the third “Trail Blazer Award” based on Facilitators to Pregnant and Parenting
his work in the film industry. The award Teens’ Ability to Access Educational Op-
n Carly Hutchinson, Director of Com- was presented by the Harriet Tubman portunities in New York City,” Research
munications and Community Relations, Humanitarian Achievement Awards Report, (Notable for Excellence); Dana
Michelle Smith, Project Coordinator, Jubilee, Inc. after being nominated by Smiles, “Integrating Traditional Medi-
Andrea Nye, Director of Programs Goldie Watkins-Bryant, also an HHPC cine and Western Biomedical Practices
and Evaluation, and Dr. Alwyn Cohall, CAB member. Mr. Shabazz’s work for HIV Treatment in Southwest Burkina
HHPC Director, were authors on two includes the award-winning educational Faso: Exploring the Potential for a
award-winning posters focusing on the film My Life, My Decision, a film cre- Multi-faceted and Culturally Relevant
development of the GetHealthyHarlem. ated for HHPC to educate youth about Intervention Planning Model,” Research
org website and the use of graduate emergency contraception and acknowl- Proposal (Notable for Excellence). ❂
students to build organizational capac- edged at the Tribeca Film Festival on
ity and promote service learning. The March 27th, 2010. Mr. Shabazz has

n Grants

n The 2009 Columbia Community continued funding from the Robin Hood (SHARE), utilizes web and print-based
Service Grant was awarded to Project Foundation. The MHT is an outreach educational materials, guided instruc-
STAY’s Joanna Pudil and Alexandra program that engages behaviorally tion and support from a qualified
Christopher to create a documentary high-risk youth in sexual health educa- health professional to help participants
film about the stories of five HIV+ tion through group workshops, indi- reduce blood pressure. Harlem resi-
youth, with the goal of changing the vidualized and tailored counseling, and dents have higher rates of hypertension
face of HIV while simultaneously STI/HIV testing and follow-up care. than the American population generally,
serving as a therapeutic tool for the and hypertension can lead to a variety
adolescents involved. The film will be n With renewed funding from the of serious health problems, includ-
completed by October 2010. Additional Centers for Disease Control and Preven- ing stroke, kidney and heart diseases,
funding will allow five more client pro- tion, HHPC is developing a program to which affect Harlem residents at alarm-
files to be created in 2011. reduce high blood pressure in Harlem ing rates. ❂
over the next four years. The proj-
n In the spring of 2010, Project STAY’s ect, called Support for Hypertension
Mobile Health Team (MHT) received Awareness, Reduction and Education
2010
Page 5

n HHPC Staff Updates n Message from the CAB Chair


Introductions The Upper
Manhattan
Yuan (Vivian) Katie K.Tang, Mental Health
Zhang, M.S., MA, CHES, Center, where
Data Manager Mobile Health I am Executive
is responsible Team Outreach Director, has
for maintaining Coordinator hosted a very
HHPC databases is responsible successful health
and analyzing for coordinating fair for nearly a
data for a variety and implement- decade. The fair offers screenings for
ing Project STAY’s Mobile Health Team blood pressure, diabetes, depression,
of on-going research projects. She is
(MHT) outreach events. She interacts cholesterol, HIV and other conditions,
also a skilled web programmer and is
with outreach agencies and helps train and provides important linkages to
helping to update and revise both the student educators. Ms. Tang received
Project STAY website and the center- health care. Last year we screened
her MA in Health Education from Teach-
wide HHPC website. Ms. Zhang received over 250 attendees, of which 50
ers College, Columbia University.
her MS in Applied Statistics from Co- percent required follow-up. Like many
lumbia University. kkt2115@columbia.edu health fairs in Northern Manhattan,
we are often attendees’ only point of
yz2212@columbia.edu contact with health services–from
accessing screenings to learning
about available resources, like where
to find a doctor or obtain healthcare
n CAB Updates coverage if they are uninsured.
As HHPC launches its Support
HHPC’s newest CAB members for Hypertension Awareness, Reduc-
tion and Education (SHARE) Project
Welcome to HHPC’s newest CAB mem-
this Fall, it is a great time for you to
bers: Verna Fitzpatrick (not pictured),
let HHPC know about health fairs and
MS, Administrator, Northern Manhattan
other community events where HHPC
Rehabilitation and Nursing Center;
could recruit for this project. SHARE
Donna R. Williams (back row second),
will offer some participants a chance
DDS, FIND, Owner, President, Morning-
to get intensive support in making
side Dental Care, PC; Olajide Williams,
important lifestyle changes
MD (back row last), Assistant Professor
to reduce and manage their high
of Clinical Neurology, Columbia Univer-
blood pressure.
sity; Assistant Attending, Department
of Neurology, Columbia University, A key learning from my work on
Harlem Hospital Center. health fairs has shown that providing
screenings is not enough—helping
Harlem residents manage their health
CAB members in the news has to be our goal. ❂

Congratulations to the science behind the disease, and the William S. Witherspoon, Jr., LCSW is the Executive
Director of the Upper Manhattan Mental Health
one of our newest importance of acting quickly. Center, Inc.
CAB members, Dr.
Olajide Williams, on Each chapter describes a patient’s
the publication of experience with stroke. The lessons
his first book, Stroke drawn from each story can inspire and
Diaries: A Guide for educate stroke survivors, family mem-
Survivors and their bers, medical professionals and the About HHPC
Families. community at large. HHPC is a collaboration of community, aca-
demic, and public health stakeholders that uses
A series of thought- This intimate look at stroke in our research, education, and service delivery to
ful narratives fol- community highlights the need for improve the health and well-being of the Harlem
lowed by authorial comments, the book and importance of stroke education community.
describes stroke signs and symptoms, in Harlem. HHPC is one of 37 Prevention Research Centers
funded by the Centers for Disease Control and
Prevention and administered by Columbia Univer-
sity’s Mailman School of Public Health. For more
information, visit healthyharlem.org.
2010
Page 6

n In the News
My Life, My Decision:
Shown in Tribeca
HHPC launches first of “Cells
On Saturday, March 27, 2010 the
video, “My Life, My Decision” was
in Da Hood” video series
featured at the Teen Health & Well-

I
ness Film Festival at the Tribeca n the past few years, HHPC has be- According to HHPC’s Director, Dr. Alwyn
Cinemas. The festival was sponsored gun making use of digital media to Cohall, this population is at a greater
by the Young Women of Color HIV/ educate young people 14-24 years risk for contracting sexually transmitted
AIDS Coalition, in partnership with of age about sexual health. Reaching infections (STIs).
HEAT (Health & Education Alterna- youth networks through this medium
has become easier with widespread ac- This prototype for the video series has
tives for Teens). The festival’s goal
cess to the Internet and mobile technol- been evaluated in eight focus groups by
was to raise awareness about HIV/
ogies. The cen- 50 teens who par-
AIDS, and to empower adolescents
ter’s latest digital ticipate in several
to find out their HIV status. Katie
media project NYC community-
Tang, Mobile Health Team (MHT)
targeting urban based organiza-
Outreach Coordinator, and Hanif
teens and young tions who part-
Shabazz, HHPC CAB member and
adults is “Cells in ner with HHPC.
producer, both attended the event
Da Hood,” a se- “Based on this
and participated on the guest panel
ries of five-minute research,” says
to address participants’ questions
computer ani- Kirby Bumpus,
regarding the film’s production and
mated vignettes an MPH graduate
potential collaboration with HHPC’s
depicting phone of the Columbia
MHT. ❂
text conversations Phone texting promotes sexual health Mailman School
between young of Public Health,
people. The topic of conversation: who oversaw the focus group process
Sexual health issues such as condom for HHPC, “the video has been updated
utilization and sexually transmitted and dramatically improved.”
infection (STI) testing. The goal of each
Focus groups showed that “Cells in Da
vignette is to provide clear information
Hood” appealed to many of the youth
about sexual health, including dispel-
who participated. “One youth com-
ling myths and fears, as well as how to
mented, at first I thought the video was
access HHPC’s Project STAY services.
whack, but as I watched it, I became
As culturally-and age-appropriate interested and it turned out to be funny
sexual health promotional materials and informative.” Another young viewer
are not readily available for adoles- said, “The video was motivating, it
cents and young adults, the “Cells in seems easy to get to the [Project STAY]
Da Hood” video series has an edge on clinic and get things done.” ❂
reaching urban teens and young adults.

San Francisco SEX::TECH Conference highlights


sexual health innovation
HHPC was one of the featured innova- HHPC’s “Cells in Da Hood” video was
tors presenting at the Sex::Tech Confer- featured in the “Innovation” session
ence in February 2010. This conference category entitled “Bridging the Digital
explored available tools and methods Divide: Reaching Urban Youth.” This
for reaching youth with culturally ap- session focused on three “exemplary”
propriate STD/HIV prevention and sex programs that used social media, digi-
education interventions. Technology tal video and mobile social networks to
developers, accidental techies, educa- reach youth at risk.
tors, researchers, youth, public health
professionals, and activists were among For more information on this innovative
the participants. conference see sextech.org
2010
Page 7

n Student Spotlight

Students gain real-life skills


A
ttaining practical skills to ef- developing promotional materials and
fectively engage in community- social marketing programs, how to
based public health, social work, create accessible, culturally-relevant
pharmacy, biomedical informatics, online content, how to engage commu-
nutrition, community health education nity members and conduct qualitative
or direct medical service interven- research, as well as how to develop
tions is a keen challenge for graduate methods for evaluating research data.
students whose coursework often pro- Some are currently assisting with the
vides theoretical background, but little roll-out of a new research project using Touro College of Pharmacy Students
opportunity to apply this knowledge the website to disseminate information
the theories and methods they learn
in practical ways. This is the first in a about hypertension reduction.
in the classroom while also making a
series of articles on how students can
gain valuable experience at the Harlem Outcomes: Everybody wins difference in the community. Students
Student collaborations have had trans- who intern at HHPC show a high level
Health Promotion Center (HHPC).
formative effects for HHPC, “With the of commitment that extends beyond
Working on a community help of nearly 30 students over the the typical practicum experience.”
past four years,” says Carly Hutchin-
health website HHPC has also provided some students
son, Director of Communications and
HHPC’s groundbreaking website, with a whole new perspective on their
Community Relations at HHPC, “we
GetHealthyHarlem.org (GHH), was careers.
have been able to populate the website
developed through a five-year grant
with hundreds of plain-language health “Working on GetHealthyHarlem.org
funded by the Centers for Disease
education articles, blogs, and event helped me build important skills in
Control and Prevention and in partner-
postings that have been shaped by a health literacy, community engage-
ship with Columbia’s Department of
continuous dialogue with community ment, and effective team work. I now
Biomedical Informatics. Developing a
members, organizational partners and want to work in health communica-
website that offers both social network-
local health experts.” tions, “says Laura Shulman, an MPH
ing capabilities as well as hundreds of
original community-focused articles graduate of Columbia’s Mailman
The perspective is also positive for
has been a huge undertaking that could School of Public Health.
those in academia who place students
not have been accomplished without in internships or community service
student involvement. To find out more about student op-
experiences. “HHPC’s work is central portunities with GetHealthyHarlem.org,
to the School of Public Health,” says contact Carly Hutchinson at clh47@
HHPC’s rigorous hands-on, skills-
Ian Lapp, Associate Dean of Academic columbia.edu. ❂
building program allows students from
Affairs and Education at Columbia’s
diverse fields (public health, health
Mailman School of Public Health. “We
informatics, nutrition, health promo-
believe deeply in this center as it has
tion, journalism, public relations and
had a profound effect on many stu-
pharmacy) to learn firsthand about
dents. At HHPC students get to apply

Publications, continued from pg. 3

Cohall AT, Dini S, Nye A, Dye B, Neu American Journal of Health Promotion. Web Platform for Health Promotion and
N, Hyden C. HIV Testing Preferences In Press. Wellness Driven by and for the Harlem
Among Young Men of Color Who Have Community. AMIA Annu Symp Proc
Sex With Men. American Journal of Johnson R, Nshom M, Nye A, Cohall 2009; 2009:317-321. Published online
Public Health. In press. Published A. There’s always Plan B: Adolescent 2009 November 14.
ahead of print on January 14, 2010. knowledge, attitudes and intention to
use emergency contraception. Contra- Kukafka R, Khan S, Kaufman D, Mark
Cohall AT, Nye A, Moon-Howard J, ception. 81 (2010); 128–132. J. An Evidence-based Decision Aid to
Kukafka R, Dye B, Vaughan RD, North- Help Patients Set Priorities for Select-
ridge M. Computer Use, Internet Ac- Khan S, Ancker J, Li J, Kaufman D, ing Among Multiple Health Behaviors.
cess, and Online Searching for Health Hutchinson C, Cohall A, Kukafka R. AMIA Annu Symp Proc. 2009; 2009:
Information among Harlem Adults. GetHealthyHarlem.org: Developing a
continued on pg. 8
2010
Page 8

CSA, continued from pg. 2

What does it cost and what ing season. To learn more a little higher to “subsi- Community Partnerships for
do you get? An average about CSAs in New York City dize” the shares of other Health (646-697-2274) or
unsubsidized share usu- and find one in your neigh- members who meet certain Tierradirectcsa@gmail.com.
ally costs about $400 per borhood go to http://www. income criteria. It also has a
season/$20 per week. Each justfood.org/csaloc/search. payment plan for subsidized More information about
member gets eight to 12 shareholders. Next year, CSAs: Vist Justfood.org and
types of vegetables each Can CSA be affordable Tierra Direct will also accept GetHealthyHarlem.org. ❂
week. Members choose their to very low-income Food Stamps.
own portions of vegetables. members?
Shares are sold in the winter More information about Tier-
Tierra Direct offers two
and spring for each grow- ra Direct: Contact Columbia
different share prices—one

Publications, continued from pg. 3 Healthy Monday, continued from pg. 2

343–347. Published online Enable Patients to Initiate To learn more about HM, www.GetHealthyHarlem.org
2009 November 14. Tailored Lifestyle Conversa- visit their site at www. or contact Michael Hernan-
tions with Providers at the healthymonday.org or see dez at 917-841-6617. ❂
Li J, Khan S, Mark J, Nivar- Point of Care. AMIA Annu
thi P, Misra R, Chan C, Symp Proc. 2009; 2009:
Kaufman D, Kukafka R. TLC: 364–368. Published online
An Informatics Approach to 2009 November 14. ❂

H A R L E M

Health REPORT
Harlem Health Promotion Center
215 West 125th Street, First Floor, Suite B, New York, NY 10027
646 284-9777 phone • 646 284-9729 fax

This publication was supported by Cooperative Agreement Number U48-DP-00030 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily
represent the official views of the Centers for Disease Control and Prevention.