Jacqueline H Tran

California State University, Fullerton, Fullerton, CA, United States

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Publications (27)51.64 Total impact

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    ABSTRACT: Introduction: Community-based participatory research (CBPR) approaches are used to address health disparities via empowerment and capacity building among partners. Participants in the CBPR collaborative, Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART), were assessed for changes in perceived individual and organizational capacity. Objective: To better understand how the capacity and influence of community-based organizations involved in a CBPR collaborative change over time, and to explore factors that influence these changes at the individual and organizational levels. Methods: From 2005-2010, a longitudinal survey was administered at three time points to individuals working within partner organizations. Role/position within the organization and length of involvement in WINCART were examined to assess: organizational influence among cross-sector groups, skills development of staff, and organizational capacity of cancer control efforts. Data analysis examined changes in capacity. Results: Preliminary results indicate 53% (n=37) of respondents improved skills in cancer research and programming within one year, yet change from year 1 to year 5 only improved by 6% (n=87). Organizational influence on community cross-sectors and capacity of cancer control efforts within one year were 72.5% (n=73) and 87.9% (n=71), respectively; however, outcomes decreased at year 5. Further analyses will explore relationships between role/position within the organization and increased capacity, influence and skills development. Conclusions: Results suggest that CBPR can be effective in improving individual skills. However, further training and technical assistance is necessary to facilitate positive changes in organizational capacities. Implications for CBPR values of empowerment and capacity building will be discussed.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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    ABSTRACT: Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services.
    Journal of Health Care for the Poor and Underserved 02/2012; 23(1):398-413. DOI:10.1353/hpu.2012.0029 · 1.10 Impact Factor
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    Journal of Health Care for the Poor and Underserved 02/2012; · 1.10 Impact Factor
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    ABSTRACT: Background/Significance: There is growing recognition that community-based participatory research (CBPR) is a viable approach for addressing health disparities. The CDC REACH U.S. program supports coalitions engaged in CBPR to eliminate health disparities among underserved communities, and the ability for collaborators to function effectively is intrinsic to coalition goals. Methods: In Spring 2010, core questions for the REACH U.S. grantee partnership survey were collaboratively identified to assess partnership areas including trust, decision-making, and impact, in addition to socio-demographics and partnership information (e.g. coalition size). Descriptive statistics and means of Likert scaled items are computed, and psychometric characteristics of each measurement scale are analyzed. Cronbach's alphas assess the internal consistency of each construct. Results: Eight coalitions administered the survey; to date, 64 responses from 4 coalitions have been collected. Ninety-two percent of respondents were female, and 56% had been a coalition member for more than 2 years. Sixty-three percent believed that members' capacity to work well together in the past year had increased; 75% of individuals agreed or strongly agreed that they were satisfied with coalition progress in the past year. Subsequent analysis will include responses from additional coalitions, and psychometric properties of the measurement scales will be examined. Discussion/Conclusions: This partnership assessment will inform the extent that this survey can be used by community-academic coalitions to evaluate their health partnerships. Future administrations will add data and allow us to describe how scale constructs change over time.
    139st APHA Annual Meeting and Exposition 2011; 10/2011
  • Diane Gaspard · Jacqueline Tran
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    ABSTRACT: In the year 2000, several California REACH 2010 Program grantees, representing distinct communities and interventions, gathered to develop a strategy to build California's capacity to address health disparities among racial and ethnic communities. These grantees, funded under the CDC Racial and Ethnic Approaches to Community Health REACH 2010 Initiative, formed the California REACH Coalition. The planning process resulted in the organization of statewide conferences which highlighted racial and ethnic health disparities and presented strategies and lessons learned to healthcare providers, policymakers, and community-based organizations. Conferences were convened in 2000, 2003, 2004, 2006 and 2009. The conferences evolved to include workshops with plenary sessions designed to engage attendees in examination and discussion of health equity. The conferences provided forums for building community-academic partnerships, engaging additional community-based organizations as partners, supporting community education, increasing knowledge of public policy and resources; sharing community expertise in effective outreach methods, and disseminating best practices in community-based participatory research and the elimination of racial and ethnic health disparities. In order to continue and strengthen capacity building, the California REACH Coalition is making efforts to strategically link state efforts with other national groups such as the National REACH Coalition. The Coalition's lessons learned to promote capacity building will be shared.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
  • Jeff Dang · Jacqueline Tran
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    ABSTRACT: Objectives: We evaluated the effectiveness of a community based intervention aimed at increasing breast and cervical cancer screening in four Asian American and Pacific Islander (API) subgroups. Methods: Participants were recruited from community clinics, churches, and supermarkets throughout Southern and Northern California. The baseline sample consisted of 1733 foreign born Cambodians (n = 350), Laotians (n = 354), Thais (n = 741), and Tongans (n = 288). After baseline data were collected in the two communities, community based culturally and linguistically appropriate outreach, education and patient navigation was conducted in Southern California whereas the Northern California site served as the control group. Prospective follow up data were collected 1 year later. Multivariate analyses were performed on the complete, intent to treat, and imputed data to evaluate the impact of loss due to attrition on the results. Results: Among those who had never received a Pap test, mammography, and clinical breast exam at baseline, increases between groups were not found. However, ethnic group differences were found on the exposure to the intervention. Ethic group status and exposure to specific outreach and education components were found to impact the knowledge, attitudes, and beliefs regarding breast and cervical cancer screening. Conclusion: A culturally tailored intervention and awareness initiative can be used to promote positive perceptions of breast and cervical cancer screening among AAPI women. However, ethnic subgroup differences were evident in the AAPI women included in the study.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
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    ABSTRACT: We identified key elements required for a training curriculum for Southeast Asian community-based health navigators (CBHNs), who help low-income, immigrant Cambodian, Laotian, Thai, and Vietnamese women negotiate cultural and systemic barriers to breast cancer screening and care in the United States. We gathered the perspectives of 3 groups: CBHNs, community members, and their providers. We conducted 16 focus groups with 110 women representing different stages of the cancer care continuum and in-depth interviews with 15 providers and 10 navigators to identify the essential roles, skills, and interpersonal qualities that characterize successful CBHNs. The most important areas identified for training CBHNs were information (e.g., knowing pertinent medical information and how to navigate resources), logistics (transportation, interpretation), and affective interpersonal skills (understanding the language and cultural beliefs of patients, communicating with providers, establishing trust). CBHNs serve a crucial role in building trust and making screening practices culturally meaningful, accessible, usable, and acceptable. Future research should focus on developing training curricula, policies, resources, and funding to better maximize the expertise and services that CBHNs provide and to expand our findings to other underserved communities.
    American Journal of Public Health 11/2010; 101(1):87-93. DOI:10.2105/AJPH.2009.176743 · 4.23 Impact Factor
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    ABSTRACT: We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.21, 2.83), clinical breast exam (OR = 3.03; 95% CI = 1.82, 5.03), and a Pap smear (OR = 2.34; 95% CI = 1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women.
    Journal of Cancer Education 03/2010; 25(2):253-62. DOI:10.1007/s13187-010-0074-1 · 1.05 Impact Factor
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    ABSTRACT: Breast and cervical cancers are the second and fourth leading causes of cancer death among Asian and Pacific Islander women. Despite screening exams that can detect these cancers early and increase survival, racial and ethnic populations continue to be disproportionately affected. This study examined the sources of information and their impacts on cancer screening compliance among native Hawaiians in Orange County, California. A community-based participatory research approach was used to conceive, design, implement, and analyze data. A relatively small proportion of the study's native Hawaiian women were compliant with recommended breast and cervical cancer screenings, and their screening rates were below the national Healthy People 2010 standards. Knowledge of screening procedures, seeking advice from a doctor, and obtaining information from internet medical sites were associated with higher rates of compliance with cancer-screening procedures.
    Journal of Cancer Education 03/2010; 25(4):588-94. DOI:10.1007/s13187-010-0078-x · 1.05 Impact Factor
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    Jeff Dang · Jessica Lee · Jacqueline H Tran
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    ABSTRACT: Asian American Pacific Islander (AAPI) groups have low rates of breast and cervical cancer screening. This study examined knowledge, attitudes, and beliefs (KABs) regarding breast and cervical cancer on AAPI women. A cross-sectional survey of 1,808 AAPI women was included. Descriptive statistics and chi-square tests were provided and 55.3%, 68.6%, and 71.9% had received mammograms, clinical breast exam, and Pap smears, respectively. KABs on breast and cervical cancer varied between the four ethnic groups. Understanding the KABs toward cancer screening among AAPI women holds promise for identifying barriers to early detection and could aid in the creation of interventions.
    Journal of Cancer Education 03/2010; 25(4):595-601. DOI:10.1007/s13187-010-0082-1 · 1.05 Impact Factor
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    ABSTRACT: We examined trends in smoking prevalence from 2002 through 2006 in 4 Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) intervention. Annual survey data from 2002 through 2006 were gathered in 4 REACH Asian communities. Trends in the age-standardized prevalence of current smoking for men in 2 Vietnamese communities, 1 Cambodian community, and 1 Asian American/Pacific Islander (API) community were examined and compared with nationwide US and state-specific data from the Behavioral Risk Factor Surveillance System. Prevalence of current smoking decreased dramatically among men in REACH communities. The reduction rate was significantly greater than that observed in the general US or API male population, and it was greater than reduction rates observed in the states in which REACH communities were located. There was little change in the quit ratio of men at the state and national levels, but there was a significant increase in quit ratios in the REACH communities, indicating increases in the proportions of smokers who had quit smoking. Smoking prevalence decreased in Asian communities served by the REACH project, and these decreases were larger than nationwide decreases in smoking prevalence observed for the same period. However, disparities in smoking prevalence remain a concern among Cambodian men and non-English-speaking Vietnamese men; these subgroups continue to smoke at a higher rate than do men nationwide.
    American Journal of Public Health 03/2010; 100(5):853-60. DOI:10.2105/AJPH.2009.176834 · 4.23 Impact Factor
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    ABSTRACT: The Pacific Islander (PI) community suffers disproportionately from illnesses and diseases, including diabetes, heart disease and cancer. While there are tremendous health needs within the PI community, there are few health care providers from the community that exist to help address these particular needs. Many efforts have focused on health care workforce diversity to reduce and eliminate health disparities, but few have examined the issues faced in the health care work force pipeline. Understanding educational attainment among PI young adults is pivotal in speaking to a diverse health care workforce where health disparities among Pacific Islanders (PIs) may be addressed. This paper provides an in-depth, qualitative assessment of the various environmental, structural, socio-economic, and social challenges that prevent PIs from attaining higher education; it also discusses the various needs of PI young adults as they relate to psychosocial support, retention and recruitment, and health career knowledge and access. This paper represents a local, Southern California, assessment of PI young adults regarding educational access barriers. We examine how these barriers impact efforts to address health disparities and look at opportunities for health and health-related professionals to reduce and care for the high burden of illnesses and diseases in PI communities.
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    ABSTRACT: Objective: We describe the development of a community and academic research partnership, share reflections on processes for collaborations, and identify key factors for establishing strong and effective relationships to foster high-quality research. Background: A community-based participatory research (CBPR) effort evaluating a community-based patient navigation program assisting Chamorro women to access breast cancer services in Southern California served as the foundation for the development of the community-academic partnership. Methods: Using a CBPR approach focusing on active involvement of community members, organizational representatives, and academic researchers in all aspects of research process, faculty from a research university and a local community-based organization were brought together to build a partnership. Community and academic partners engaged in a series of meetings where dialogue focused on developing and nurturing trust and shared values, respect for community knowledge, and establishing community-defined and prioritized needs and goals. Partners have also focused on defining and developing explicit structures and policies to implement an equal partnership. Results: Experiences and lessons learned are shared, reflecting the processes of relationship building, and planning and implementing preliminary research steps. Lessons Learned: Adequate time for relationship-building, open and honest communication, flexibility, and ongoing examination of assumptions are keys to developing successful CBPR partnerships.
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    ABSTRACT: Community health workers (CHWs) developed and implemented this project, the first community-based participatory research study to investigate how CHWs help to navigate patients from four Southeast Asian (SEA) communities in Southern California throughout the entire breast cancer care continuum. Our collaborative goal was to identify how CHWs address cultural differences and systemic barriers to effectively support immigrant, low-income SEA women (Cambodian, Laotian, Thai and Vietnamese) to obtain breast health care services. Four CHWs conducted 16 focus groups with 110 SEA women representing different stages of the care continuum. We will present findings from these focus groups to cover three specific aims: 1) Explain how CHWs enable SEA women to seek breast health services, 2) Describe the roles, skills, and personal qualities of SEA community health navigators, and 3) Identify the essential topics and elements for a CHW breast health navigation training curriculum. Focus group participants described CHWs as navigators who assist clients to access and utilize breast health services by serving various roles: 1) assisting with making appointments, 2) filling out forms/ paperwork at appointments, 3) assisting with financial assistance and benefits programs, 4) translation and interpretation, 5) transportation, 6) logistical navigation and 7) emotional support. CHWs did not just help to steer clients through the health care appointment and health care system; they also helped clients to navigate community resources so that health services were readily accessible. Respondents felt all of these roles and skills were important topics to cover in a training curriculum for community breast health navigators.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    ABSTRACT: Our project is the first community-based participatory research study to investigate how community health workers and breast health navigators helped to guide patients from four Southeast Asian communities in Southern California throughout the entire cancer care continuum. Our collaborative goal was to identify how community health navigators address cultural differences and systemic barriers to effectively navigate low-income Southeast Asian (SEA) women (Cambodian, Laotian, Thai and Vietnamese) to obtain breast health care services from initial screening exams throughout diagnosis, treatment, and recovery. We explored our research questions by studying the perspectives of three groups: community health navigators, Southeast Asian women/patients, and their providers. We conducted focus groups with 110 SEA women representing different stages of the care continuum; and qualitative, semi-structured, in-depth interviews with 15 providers and 10 community health navigators to achieve three research aims: 1) Identify how health navigation services enable SEA women to seek breast health services, 2) Describe the roles, skills, and personal qualities of community health navigators, and 3) Identify the essential elements needed to develop a navigation training curriculum. We focus on study findings from provider interviews in defining the role of community health navigators, analyze how community health navigators bridge access to health care, and discuss health systems and policy recommendations to institutionalize community health navigation. Most hospitals or private offices did not have navigator training programs in place. Finding resources to better support trained community health navigators would be an important contribution to improve the quality of health care, especially for underserved populations.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    ABSTRACT: Southeast Asian (SEA) women have the lowest rates of breast cancer screening among all women. Our project is the first community-based participatory research study to investigate how community health navigators (CHNs) support patients from four SEA communities in Southern California to obtain breast health services. Our collaborative goal was to identify how CHNs address cultural differences and systemic barriers to navigate immigrant, low-income Cambodian, Laotian, Thai and Vietnamese women journeying through the vast and complex ocean of cancer care services. We gathered the perspectives of three groups: community health navigators, SEA women/patients, and their providers. Our team conducted 16 focus groups with 110 SEA women representing different stages of the care continuum; and qualitative, semi-structured, in-depth interviews with 15 providers and 10 community navigators to achieve three research aims: 1) Explain how community navigators enable SEA women to seek breast health services, 2) Describe the roles, skills, and personal qualities of community health navigators, and 3) Identify the essential elements needed to develop a navigation training curriculum. Findings indicate that the important focus areas for a health navigation training curriculum include informational (e.g. knowing pertinent medical information and procedures and how to navigate resources); logistical (providing transportation, interpretation); and interpersonal aspects (understanding the language/cultural beliefs of patients, communicating with providers, knowing navigator roles). From all three group perspectives, community health navigators appear to be the crucial links who help to establish trusting relationships that are key in making healthy practices culturally meaningful, accessible, usable, and acceptable for underserved communities.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    ABSTRACT: We determined hepatitis B virus (HBV) testing and vaccination levels and factors associated with testing and vaccination among Vietnamese- and Cambodian-Americans. We also examined factors associated with healthcare professional (HCP)-patient discussions about HBV. We analyzed 2006 Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data from four US communities. We used logistic regression to identify variables associated with HBV vaccination, testing, and HCP-patient discussions about HBV. Of the 2,049 Vietnamese- and Cambodian-American respondents, 60% reported being tested for HBV, 35% reported being vaccinated against hepatitis B, and 36% indicated that they had discussed HBV with a HCP. Cambodian-Americans were less likely than Vietnamese-Americans to have been tested for HBV, while respondents with at least a high school diploma were more likely to have been tested for HBV. Respondents born in the US, younger individuals, and respondents with at least some college education were more likely to have been vaccinated against hepatitis B. HBV testing and vaccination remain suboptimal among members of these populations. Culturally sensitive efforts that target Vietnamese- and Cambodian-Americans for HBV testing and vaccination are needed to identify chronic carriers of HBV, prevent new infections, and provide appropriate medical management. HCPs that serve these populations should be encouraged to discuss HBV with their patients.
    Journal of Community Health 03/2009; 34(3):173-80. DOI:10.1007/s10900-008-9141-5 · 1.28 Impact Factor
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    ABSTRACT: Colorectal cancer is among the leading causes of cancer deaths for Pacific Islander on both the US mainland and their home island. Embracing the foundational values of community based participatory research (CBPR), WINCART (Weaving an Islander Network for Cancer Awareness, Research and Training) is a collaborative between 5 universities and 8 community based organizations serving Pacific Islanders in Southern California. WINCART conducted a culturally tailored, community driven educational campaign to improve colorectal cancer (CRC) detection through raising awareness about CRC and encouraging active participation in individual health and cancer prevention. The campaign promotes two key messages in a culturally meaningful way: 1) there are ways you can prevent CRC' and 2) talk with your primary care provider about CRC screening.' Materials utilize peripheral, linguistic, constituent involving, and sociocultural strategies to communicate the health message, namely various multimedia -a public service announcement, a CRC informational flip chart, and a bookmark that reinforces CRC knowledge and prevention behavior. A pre-, post-, and follow-up survey was developed to test the efficacy of the CRC educational campaign. A working group- comprised of community leaders from five Pacific Islander communities (Chamorro, Marshallese, Native Hawaiian, Samoan, and Tongan) - was directly involved in the development, planning and implementation stages of the educational campaign to ensure ownership and a joint and equitable process. Although the working group functioned as a cohesive unit with the same overall objective, each community had its own unique contribution in identifying culturally appropriate mechanisms to outreach and educate community members on CRC.
    136st APHA Annual Meeting and Exposition 2008; 10/2008
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    Sora Park Tanjasiri · Jacqueline H Tran
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    ABSTRACT: Addressing cancer health disparities constitutes a national priority in this country, with funding for Pacific Islander efforts initiated 7 years ago by the National Cancer Institute. In 2005, the Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART) was launched in Southern California by a collaboration of community and university organizations to build upon past efforts to decrease cancer health disparities for Chamorros, Native Hawaiians, Marshallese, Samoans and Tongans. To assess community organizational capacity to participate in collaborative cancer control for Pacific Islanders, a strengths, weaknesses, opportunities, and threats (SWOT) analysis was undertaken. Two staff members per community organization (CBO) performed the SWOT analyses, with grids analyzed for commonalities and differences between all organizations. Staff informants provided many examples of what they perceived as organizational strengths and weaknesses with regards to promoting cancer control for their respective Pacific Islander populations. CBO strengths included strong leadership and extensive community experience. Challenges included limited resources, lack of staff skills in some areas, and difficulty in recruiting volunteers. In addition, many external opportunities and threats to cancer control promotion were identified. Results from the SWOT analyses have been used to identify topics for community organizational trainings and supports within WINCART, with the goals of increasing their participation in the development and implementation of collaborative, community-university driven efforts to decrease cancer disparities for Pacific Islanders in Southern California.
    Cancer Detection and Prevention 02/2008; 32 Suppl 1:S37-40. DOI:10.1016/j.cdp.2007.12.005 · 2.52 Impact Factor
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    ABSTRACT: Community-based participatory research (CPBR) represents a growing research approach for addressing health disparities disfavoring members of racial/ethnic minorities and other underserved populations in the U.S. While such endeavors are often guided by explicit principles regarding the relationships between communities and universities, few studies have reported on the development or strength of such relationships. This paper describes the methods and preliminary results of a cross-sectional analysis of the ties between community and university organizations in a CBPR network to address cancer disparities between Pacific Islanders in Southern California and the general population. These analyses afford a means of representing the collaborative relationships and may enhance tracking improvements in CBPR links for cancer education, research, and training. Such tracking will help concerned parties understand how academic and community groups collaborate and coordinate their efforts to reach shared and overlapping goals.
    Journal of Health Care for the Poor and Underserved 12/2007; 18(4 Suppl):184-96. DOI:10.1353/hpu.2007.0116 · 1.10 Impact Factor