2015 Progress Report: Community Outreach and Translation Core

EPA Grant Number: R834513C004
Subproject: this is subproject number 004 , established and managed by the Center Director under grant R834513
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Center for the Health Assessment of Mothers and Children of Salinas - UC Berkeley School of Public Health: CHAMACOS Office, Berkeley, CA
Center Director: Eskenazi, Brenda
Title: Community Outreach and Translation Core
Investigators: Eskenazi, Brenda , Barlow, Janice , Bradman, Asa , Minkler, Meredith , Rosas, Lisa Goldman , Salvatore, Alicia L.
Institution: University of California - Berkeley , Stanford University , University of Oklahoma , ZERO Breast Cancer
EPA Project Officer: Louie, Nica
Project Period: August 1, 2009 through July 31, 2014 (Extended to July 31, 2016)
Project Period Covered by this Report: June 1, 2014 through May 31,2015
RFA: Children's Environmental Health and Disease Prevention Research Centers (with NIEHS) (2009) RFA Text |  Recipients Lists
Research Category: Children's Health , Health

Objective:

The COTC Core enables Center scientists and community partners to communicate study findings in a culturally appropriate manner, raise awareness of children’s environmental health within and beyond the Salinas Valley, and support policies that will improve the health of low-income Latino residents locally in Monterey County and throughout the state and nation. Because we achieved all major objectives in the first 5 years of Center funding and are operating in a no-cost extension year with reduced COTC staffing, we have limited our Center COTC activities in the past year to general community outreach. However, community outreach activities established under the Center have attracted outside funding, which has supported several other local environmental health projects that we report upon below.

Progress Summary:

1. To disseminate Center research findings to study participants, the Salinas Valley community, and other stakeholders.

Newsletter: We recently disseminated the 2015 CHAMACOS newsletter, La Semilla, to participants. The newsletter is in Spanish and English and is written at a level accessible to low-literacy readers. Our intent is to provide a means for parents and children to discuss the newsletter content. (Parents mostly speak Spanish and children mostly speak English). This issue of La Semilla featured a letter from Dr. Eskenazi, information on recent research findings, and an announcement recruiting new members to our Youth Community Council.

Electronic Newsletter: We sent out two e-newsletters from June 2014–May 2015 to more than 900 subscribers. The first newsletter was sent out in December before the holiday break to express our appreciation for the many research participants and collaborators who are essential to the success of our projects. The second newsletter was sent out in March 2015 to inform our subscribers of new changes to California’s Healthy Schools Act (HSA) and of a new resource developed by CERCH to help pest management professionals abide by the HSA and incorporate Integrated Pest Management Principles in their work.

Dissemination to larger community and targeted groups: We continued our efforts to share Center research findings with the Salinas Valley community through targeted meetings with community groups and key stakeholders, participation in community events, and media interviews about our work. We held 115 meetings with a wide range of groups, most of them in the Salinas Valley, to discuss recent Center findings and other environmental health issues. Center staff also attended several local health-related events such as health fairs and town hall meetings to discuss the Center’s research. Through these efforts, we made contact with 1,291 men, 2,883 women, and 1,405 children for a total of 5,579 people from June 1, 2014 to May 31, 2015.

Dissemination to the scientific community: A list of pertinent scientific publications is listed for each Core in its respective progress report, along with a list of presentations at professional and scientific meetings. We also have presented our findings at local meetings and universities. As a result of knowledge gained from this Center, Dr. Eskenazi has continued to provide consultation across the world in pesticide research and in the conduct of birth cohort studies – in Chile, Israel, Bangladesh, South Africa, Costa Rica, Spain, Ecuador, New Zealand – this year alone.

Website: On our website, www.cerch.org, we have developed an online resource center where specific audience groups can access information on environmental health hazards with tips on ways to protect themselves. These audiences include adults, families, parents of young children, teens, community groups, and health professionals. As new resources are developed by our center, they are posted to the ORC to facilitate rapid dissemination to these audience groups. From June 1, 2014 to May 31, 2015, www.cerch.org had 19,989 unduplicated visitors for a total of 49,101 page views.

2. To increase awareness about children’s environmental health among low-income Latino communities, clinicians, and service providers through widespread dissemination of innovative outreach and educational programs.

Outreach to childcare providers: We continue to provide education and outreach addressing environmental quality in child-care settings in the Salinas Valley and throughout California. In the Salinas Valley region, we collaborated with the Migrant Education Office in Watsonville, California, to conduct three trainings for child-care providers, reaching 53 directors and teachers. We also completed our California Department of Pesticide Regulation (DPR)-funded project to develop an integrated pesticide management (IPM) training course for licensed pest management professionals serving child care facilities and schools in California. This course provides required continuing education units for pest management professionals and involved close collaboration with child care professionals, the UC Cooperative Extension IPM program, DPR, and the Pest Control Operators of California, the lead trade organization for pest management professionals. A total of 647 pest management professionals completed the course, including 511 during nine in-person trainings and 136 using our on-line version. The online version will be operated permanently by the University of California (UC) IPM program and will become a long-term resource for California pest management professionals. Dr. Bradman also participates on the Science Advisory Board for the Children’s Environmental Health Network Eco Healthy Child Care (EHCC) program and has provided extensive review of their educational materials.

Outreach to social service organizations: Center staff continues to provide presentations to community groups in Monterey County on the following topics: Preventing Pesticide Exposure, CHAMACOS Findings Overview, Healthy Homes, Heat Illness Prevention, and Environmental Quality in Early Childcare Environments. Through these trainings and presentations, we have reached 3,158 individuals in the Salinas Valley this year.

Outreach to farmworkers: The greatest educational need we have identified in our community outreach work is accessible, quality training for farmworkers about the hazards of pesticide exposure and means to prevent exposure. To address this need, Clinica de Salud del Valle de Salinas (our main community partner) and California Department of Education, Migrant Education Program have worked to obtain an EPA Environmental Justice Small Grant. This grant, entitled "Proyecto La Semilla: Pesticide Safety Leadership Training for Farmworker Parents,"will allow our team’s primary health educator to train parent leaders in eight agricultural counties throughout California on how to educate other parents on pesticide safety using strategies and teaching materials developed and tested through our Center (i.e. a train-the-trainer program).

Outreach to growers and the agricultural industry and regulators: During the last year, we have continued to actively engage growers and the agricultural industry in the Salinas Valley, throughout California, and beyond. The Agricultural Commissioner, the Central Coast Grower Shipper Association, and the Monterey County Farm Bureau are active members of the CHAMACOS Community Advisory Board (CAB). We have also formed an Agricultural Council that includes the CAB industry representatives as well as the California Strawberry Commission and Jacobs Farms, an organic producer, as well as a Farmworker Council comprised of farmworker leaders. Last summer, we also met with Mr. Tom Nunes, President of the Nunes Company, one of the largest growers in the Salinas Valley, and a representative of the company will be participating in future Agriculture Council meetings. Due to limited funds, we have not met in-person as a group with the CAB or Councils this year but we have continued to communicate with the CAB and Councils at least on a semi-annual basis, including by phone and email. We have continued to share all methods and results and to provide pre-publication abstracts and draft manuscripts for review and input.

We also continue to meet regularly with those involved with pesticide regulation such as the Agricultural Commissioner and the California Department of Pesticide Regulation (DPR). We have had at least a dozen calls/meetings with the Monterey County Agricultural Commissioner this year and Drs. Bradman and Eskenazi gave a "grand rounds" presentation in Sacramento for DPR (January 2015). In addition, Dr. Eskenazi has provided review to DPR as a key member of the National Research Council of the National Academies' Committee to Review California’s Risk Assessment for Pesticides, which required meetings with DPR and EPA officials around pesticide regulation in the United States and, specifically, in California. This review was requested by the DPR in response to a California Department of Public Health (CDPH) report examining pesticide use near schools released in April 2014. This report received tremendous community, policy, and press attention in California and raised concerns about exposures to children. Dr. Bradman provided external peer review of the CDPH report and has been contacted on a regular basis by press and community members to comment on the report.

Dr. Bradman also participates on the Board of Trustees for The Organic Center, a nonprofit organization addressing scientific concerns about organic agriculture and food. In April 2015, Dr. Bradman presented our CHAMACOS research at the Organic Trade Organization Policy Conference, including findings that sulfur use was associated with poorer lung function among CHAMACOS children. Because sulfur is heavily used as a fungicide in both conventional and organic agriculture, these findings will be of interest to both sectors. Finally, Dr. Bradman, Harley, and Eskenazi were funded through the UC Berkeley-Chile Seed Grant program to travel to Chile, and meet with agricultural officials, researchers, and health officials. Dr. Bradman toured greenhouse operations with growers and reviewed strategies to reduce worker pesticide exposures, and presented CHAMACOS research findings to a large audience at the Catholic University in Talca, including growers and agricultural officials. These meetings and presentations were widely covered in the local press.

3. To build the capacity of Salinas Valley youth to promote healthy environmental policies in their community.

The goal of the Youth Community Council (YCC) is to build youth capacity in environmental health and to engage youth in promoting healthy environmental policies in Salinas. During this no-cost extension year, we have successfully garnered support of the YCC through funding from the California Breast Cancer Research Program and the Monterey County Health Department. The HERMOSA project (Harley, PI, California Breast Cancer Research Program) was initiated in 2012 to study the levels of exposure of Latina youth to endocrine disrupting chemicals (EDC) used in cosmetics and personal care products. Over the summer of 2013, members of the YCC and research staff conducted an intervention study to investigate whether using low-chemical cosmetics could lower EDCs in these girls. The study was conducted with community-based participatory approaches to involve youth members in each phase of the research project from the development of the study, to conducting the study, to disseminating results. In Summer 2014, the YCC members disseminated the results of the study to participants and community members. They presented on radio, television, at health fairs, and developed content for the Center’s website (www.cerch.org/hermosastudy). The YCC members created health education materials for their peers about chemicals in make-up and distributed this material at various meetings. They also developed recipes for Do-it-Yourself remedies for personal care products, such as using egg whites to stiffen your hair instead of mouse or gels with chemicals. On July 26, 2014, the youth put on a community forum for participants of the HERMOSA study where they gave overall results of the study as well as individual results to the participants. Through this process youth members had to become well-versed in the environmental health topic and be confident enough to share this information with their peers. In addition, members of the YCC visited the State capital to educate lawmakers about the results of their study (see below).

In addition to their work on the walkability report (in previous Progress Reports) and the HERMOSA Study, YCC members have worked on other projects with the Monterey County Health Department. This spring they initiated the Healthy Retail Project, which is a direct development of the YCC’s Photovoice project conducted in Summer 2011. The Photovoice project highlighted the lack of access to healthy food in Salinas corner stores as well as the high rates of obesity in the population. We have been funded by the Monterey County Health Department to survey local store-owners and customers in Salinas about their willingness to provide and purchase healthier foods. This grant provides stipends for YCC members to collect these data and to prepare a report for Monterey County, under our supervision. Our projects that have engaged youth in the research have become an effective model to train future researchers in the community and provide meaningful summer employment for low-income high school students. In addition, we write letters of recommendation for our YCC members as they apply to universities and we help to review their applications. This year, four members of our YCC have been accepted to the University of California, and most others will be attending colleges as the first generation in their families to attend.

4. To educate policy makers at the local, state, and national levels about Center research findings and children’s environmental health priorities.

Our research was shared at the national level when our Center provided comments to the proposed changes to the Worker Protection Standard (WPS). The WPS was introduced in 1992 and was designed to protect farmworkers from pesticides. New changes in the WPS have been proposed to make the regulation more effective. We submitted comments to the EPA that included CHAMACOS research findings. Insights from exposure and health outcome studies by CHAMACOS can help EPA staff develop regulations that will prevent exposure to pesticides and protect the health of farmworkers and their families.

In Spring 2015, three YCC representatives and research staff visited the capital to educate policymakers about the importance of environmental research and about the HERMOSA Project, how it was conducted, and what the study found. The group met with the staff of four state legislators and of the governor of California. The YCC representatives described our work at the Center and the HERMOSA Study and expressed their concern about chemicals in personal care products. Specifically, they met with Assemblymember Lorena Gonzalez as well as with staffers from the offices of Assembly members Tony Thurmond, David Chiu, Lorena Gonzalez and Senator Mark Leno. They also met with two staffers from the Governor's office (Martha Guzman-Aceves, Deputy Legislative Secretary, Environment and Donna Campbell, Deputy Legislative Secretary, Health and Human Services).

Project-Generated Resources
In the past year, our Center’s COTC infrastructure has attracted new funding that increases the breadth and scope of our training and outreach efforts. Two funding sources continue the model established by the Walkability Survey and the HERMOSA Study (described above and in previous progress reports), in which our Youth Community Counsel serves as a public health research team during summer break from high school, working with the training, supervision, and guidance of UC Berkeley/Clinica de Salud del Valle de Salinas CHAMACOS staff to execute projects from design through data collection, analysis, and reporting. New funding sources which build upon this model are as follows:

     a. The Healthy Retail Project, funded by the Monterey County Department of Public Health: In 2014, the local health department selected the CHAMACOS YCC from among other local applicants to administer a Healthy Retail Project in Salinas in summer 2015 (currently underway). The Healthy Retail Project is a small intervention project intended to encourage local corner store owners to make healthy changes to their stores. The project consists of enrolling owners of local corner stores, conducting a baseline interview with owners regarding their thoughts on the role of food stores in promoting public health, completing an observation checklist about the baseline health quality of the store (e.g., presence, quality, and variety of fresh produce and whole grain products; presence of tobacco and alcohol advertising, etc), and completing brief surveys with approximately 50 customers of each corner store regarding their current shopping habits, items they’d like to see at the store, and their support of potential healthy changes to the store. On the basis of baseline and customer information, we will provide a fact sheet for each store with information on its customer base and store-specific suggestions for achievable, healthy changes that are likely to appeal to the customer base; the fact sheet constitutes the intervention. Once store owners have received their fact sheets, they will be interviewed again regarding their reaction to the fact sheet and their willingness to attempt healthy changes (either the ones we have suggested or ones they have thought of on their own). For owners who are willing to attempt changes, we will offer the voluntary assistance of YCC members in procuring health promotion materials from the health department, rearranging store displays to highlight healthier products, etc. Owners who attempt changes will be interviewed a third and final time to gather initial feedback on how the changes are being received by customers. YCC members will summarize all data collected in a final report to the Monterey County Department of Public Health detailing the baseline health quality of local corner stores and attitudes of owners towards health promotion, the degree to which local residents who shop at these stores feel they have access to healthy foods they need or want, and the willingness of store owners to make healthy changes, and/or the supports they would require to make these changes.

     b. The Peer-to-Peer Project, funded by the California Breast Cancer Research Program (CBCRP): In 2015, we have been awarded funding to plan and execute a teen pesticide exposure study to be carried out in summer 2016. We will enroll 100 14-15 year old female volunteers from the CHAMACOS Study. Girls will wear novel, silicone-based personal exposure sampling bracelets for 7 days, wear GPS loggers to track their movements relative to agricultural fields, and provide house dust samples. We will apply geographic information systems (GIS) modelling tools to California’s comprehensive Pesticide Use Reporting (PUR) database (which records the active ingredient, volume, date, time, and location of all agricultural pesticide applications) to characterize pesticide use around each girl’s home and personal environs, and to evaluate associations of nearby use of carcinogenic and endocrine disrupting pesticides with levels in homes (house dust) and personal exposures (silicone bracelet). Local teen leaders from the YCC will be involved in all stages of the research, including design, implementation, data analysis, interpretation, and presentation of results. We will work with the YCC to develop a locally appropriate curriculum using publically available pesticide use maps to educate community members about pesticide exposure. (Note that this project is the corollary to a maternal pesticide exposure study we have proposed to conduct as part of our Center grant renewal. The value of including mothers is that we would include farm workers in our maternal sample, which would allow us to better differentiate the contributions of occupational versus ambient exposures to overall exposure levels. We also anticipate that current maternal exposure patterns will be more reflective of maternal prenatal exposure patterns than will current teen exposure patterns, which is an important consideration given our Center grant’s aim of extrapolating prenatal PUR-based pesticide exposure levels for all members of the CHAMACOS cohort.)

     Our Center’s COTC infrastructure has also attracted funding which will increase the reach of our health education efforts. Specifically, in late 2014, EPA awarded funding to our community partner, Clinica de Salud del Valle de Salinas and the California Deaprtment of Education Migrant Education Program, which will allow the project’s primary health educator, Jose Camacho, to hold workshops in eight California counties with large migrant farmwormker populations (i.e. Imperial, Fresno, Kern, Merced, Monterey, San Benito, San Joaquin, Santa Clara). These "train-the-trainer" style workshops will educate local parent leaders on delivering pesticide education material. The presentations will be modelled on our effective and popular CHAMACOS "Protecting Children from Pesticides" presentation, modules of which include "why and where pesticides are used," "how they come in contact with people’s bodies," "why children are more vulnerable," "short-term health effects," "long-term health effects," "your rights as farmworkers," etc. The creation of these presentations were funded under the Center grant.

     In addition to generating new funding sources, our COTC has continued to generate and distribute new resources, many of which are available through our website (www.cerch.org). New materials released in 2014/2015 include resources for safer cosmetics designed by YCC members under CBCRP HERMOSA Project funding, and the continuing education course for pest management professionals described above: Providing IPM Services in Schools and Child Care Settings (http://www.ipm.ucdavis.edu/training/school-and-child-care-ipm.html).

Significance
The COTC core of our Center has focused on communicating study findings in a culturally-appropriate manner, raising awareness of children’s environmental health within and beyond the Salinas Valley, and supporting policies to improve the health of low-income Latino residents locally in Monterey County and throughout the state and nation. These core foci are well-aligned with EPA’s commitment to combat environmental injustice and mitigate health risks which are environmental in origin, many of which disproportionately affect poor and socially marginalized communities like immigrant farmworkers. In the past year, our community outreach efforts have reached over 4,100 local adults and 1,400 local children, providing basic environmental health education paired with tips on how to minimize exposure to potential environmental toxicants. Our Center’s main community partner has recently been granted EPA funding which will allow our team’s premier health educator to train educators in Monterey County and seven other California counties with large farmworker populations on how to deliver our most popular presentation, "Protecting Children from Pesticides."

As CHAMACOS children have matured to pre-teens over the course of the current Center funding cycle, our COTC has increasing focused on youth both as recipients of environmental education and as agents of environmental justice. The foremost achievement of our COTC under this phase of Center funding has been to establish a dynamic Youth Community Council (YCC) which we believe embodies EPA’s goal of empowering disadvantaged communities to better characterize environmental health problems and create solutions. Our initial focus on educating high-school age Salinas youth – many from immigrant farmworker families – to recognize and understand locally-relevant environmental health problems took on new form and new energy when we decided to train these youth in environmental epidemiology and empower them to investigate issues of concern and interest to them. The youth researcher model we have developed has proven a magnet for additional project funding. In the past year, supported by both Center/EPA and outside funding, YCC researchers have created teen-friendly resources to help local youth minimize exposure to endocrine-disrupting chemicals in personal care products (based on their successful implementation of an intervention study with this aim in 2013), have designed and begun to implement a Healthy Retail intervention project whose aim is to encourage owners of local corner stores to adopt healthy changes, and have helped attract funding to conduct an intensive teen pesticide exposure study in 2016 which will use silicone bracelets as a novel exposure marker. The opportunity to work hand-in-hand with Center scientists and research staff through each stage of various environmental health research studies has armed YCC youth with a set of applied research skills which few students gain even at college level, and has prompted many to consider or actually pursue science majors in college. Opportunities for community-wide environmental health education have also arisen organically from YCC work. These have included TV, radio, and newspaper coverage of YCC research activities, as well as chances for YCC youth to enhance science education and pique the interest of fellow students by presenting their work in high school and middle school science classes.

In short, through fruitful alliances and continual realignment of our work to the needs and interests of the community we serve, our COTC has allowed us to fulfill our initial commitment to give back more to the community that we take from it, and has helped us establish ourselves as a reliable source of environmental health information that is relevant and accessible to immigrant farmworker communities as well as the broader population.

Future Activities:

All of the primary activities described above will continue in the next year. We will continue active engagement with our Youth Community Council, including ongoing activities as part of the Healthy Retail and new Peer-to Peer Study. We will continue targeted outreach to community groups, and respond to invitations for presentations. Targeted outreach will focus on farmworkers, teachers, and child care providers. We will maintain ongoing contact with our Community Advisory Board and Agriculture and Farmworker Councils.


Journal Articles on this Report : 5 Displayed | Download in RIS Format

Other subproject views: All 334 publications 8 publications in selected types All 8 journal articles
Other center views: All 666 publications 138 publications in selected types All 137 journal articles
Type Citation Sub Project Document Sources
Journal Article Guerrero J, Madrigal DS, Minkler M. What is…?: a research ethics Jeopardy™ game to help community partners understand human subjects protections and their importance. Progress in Community Health Partnerships: Research, Education, and Action 2014;8(3):405-411. R834513 (2014)
R834513 (2015)
R834513 (Final)
R834513C004 (2013)
R834513C004 (2014)
R834513C004 (2015)
  • Abstract from PubMed
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  • Other: ResearchGate-Abstract
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  • Journal Article Harley KG, Kogut K, Madrigal DS, Cardenas M, Vera IA, Meza-Alfaro G, She J, Gavin Q, Zahedi R, Bradman A, Eskenazi B, Parra KL. Reducing phthalate, paraben, and phenol exposure from personal care products in adolescent girls: findings from the HERMOSA Intervention Study. Environmental Health Perspectives 2016;124(10):1600-1607. R834513 (Final)
    R834513C002 (2015)
    R834513C004 (2015)
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  • Journal Article Madrigal DS, Salvatore A, Casillas G, Casillas C, Vera I, Eskenazi B, Minkler M. Health in my community: conducting and evaluating PhotoVoice as a tool to promote environmental health and leadership among Latino/a youth. Progress in Community Health Partnerships: Research, Education, and Action 2014;8(3):317-329. R834513 (2014)
    R834513 (2015)
    R834513 (Final)
    R834513C004 (2013)
    R834513C004 (2014)
    R834513C004 (2015)
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  • Journal Article Rosas LG, Trujillo C, Camacho J, Madrigal D, Bradman A, Eskenazi B. Acceptability of health information technology aimed at environmental health education in a prenatal clinic. Patient Education and Counseling 2014;97(2):244-247. R834513 (2014)
    R834513 (2015)
    R834513 (Final)
    R834513C004 (2014)
    R834513C004 (2015)
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  • Abstract: Patient Education & Counseling-Abstract
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  • Other: ScienceDirect-Abstract
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  • Journal Article Salvatore AL, Castorina R, Camacho J, Morga N, Lopez J, Nishioka M, Barr DB, Eskenazi B, Bradman A. Home-based community health worker intervention to reduce pesticide exposures to farmworkers’ children: a randomized-controlled trial. Journal of Exposure Science & Environmental Epidemiology 2015;25(6):608-615. R834513 (2014)
    R834513 (2015)
    R834513 (Final)
    R834513C002 (2014)
    R834513C002 (2015)
    R834513C004 (2015)
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  • Supplemental Keywords:

    Community outreach and translation, community-based research, environmental justice

    Relevant Websites:

    http://cerch.org/ Exit

    http://cerch.org/research-programs/child-care/ Exit

    http://cerch.org/research-programs/child-care/greencleaningtoolkit Exit

    Progress and Final Reports:

    Original Abstract
  • 2010
  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • 2014 Progress Report
  • Final

  • Main Center Abstract and Reports:

    R834513    Center for the Health Assessment of Mothers and Children of Salinas - UC Berkeley School of Public Health: CHAMACOS Office, Berkeley, CA

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R834513C001 CHAMACOS Cohort Project: Pesticides and PBDE on Neurobehavior and Puberty
    R834513C002 Project B: Exposure Project: Mn, DDT/E and PBDE Exposure to Farmworker Children
    R834513C003 Epigenetics Project
    R834513C004 Community Outreach and Translation Core