Dimitri A Christakis, MD, MPH
On staff since April 1998
Academic Title: Professor
Research Title: Principal Investigator
Research Center: Center for Child Health, Behavior and Development
"What's very exciting to me is not my research alone but being part of a larger enterprise doing such important work. I'm surrounded by talented, energetic people attacking autism, fetal alcohol syndrome, depression, obesity. You name it, and we're buzzing here trying to make a difference in the lives of children in our community and around the world. And I think we are making a difference."
-
Dr. Dimitri A. Christakis is a principal investigator under the Center for Child Health, Behavior and Development at Seattle Children's Research Institute and the chief health officer for Special Olympics International. He is the author of more than 170 original research articles, a textbook of pediatrics, and co-authored a groundbreaking book, The Elephant in the Living Room: Make Television Work for Your Kids. He has appeared on CNN, NPR, Today, CBS News, ABC News, NBC News and was recently featured as a TEDx speaker.
In addition to his research, Christakis is a pediatrician at Seattle Children's Hospital in Seattle and a professor in the School of Medicine at University of Washington. He has devoted his career to investigating how early experiences impact children and to helping parents improve their children's early learning environments. He and his colleagues in the Christakis Lab have made a number of landmark findings, including discovering that young children who watch TV are more likely to develop attention problems and other health and behavioral issues.
-
Related Pages
-
The Christakis Lab studies how the early environment impacts childhood behavior and development, and develops strategies that help parents optimize their children's social, cognitive, and emotional development.
-
-
Other Publications
-
American Academy of Pediatrics. Policy
statement--sexuality, contraception, and the media.
20805150 Pediatrics, 2010 Sept. : 576-82 -
Christakis DAInfant media viewing: first, do no harm.
20839763 Pediatric annals, 2010 Sept. : 578-82 -
Christakis DAMaking research matter: promoting dissemination and sustainability.
20685191 Academic pediatrics, 2010 Sept. : 283-4 -
Moreno MA, Briner LR, Williams A, Brockman L, Walker L, Christakis DAA content analysis of displayed alcohol references on a social networking web site.
20638009 The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2010 Aug. : 168-75 -
Christakis DA, Rivara FPInfluence of experiences from birth to 5 years of age on emotional and psychological health.
20439803 Archives of pediatrics & adolescent medicine, 2010 May : 491-2 -
Thompson DA, Sibinga EM, Jennings JM, Bair-Merritt MH, Christakis DATelevision viewing by young Hispanic children: evidence of heterogeneity.
20124147 Archives of pediatrics & adolescent medicine, 2010 Feb. : 174-9 -
Tandon PS, Wright J, Zhou C, Rogers CB, Christakis DANutrition menu labeling may lead to lower-calorie restaurant meal choices for children.
20100765 Pediatrics, 2010 Feb. : 244-8 -
Christakis DA, Garrison MMPreschool-aged children's television viewing in child care settings.
19933733 Pediatrics, 2009 Dec. : 1627-32 -
Tarini BA, Lozano P, Christakis DAAfraid in the hospital: parental concern for errors during a child's hospitalization.
19653281 Journal of hospital medicine : an official publication of the Society of Hospital Medicine, 2009 Nov. : 521-7 -
From the American Academy of Pediatrics: Policy
statement--Media violence.
19841118 Pediatrics, 2009 Nov. : 1495-503 -
Moreno MA, Briner LR, Williams A, Walker L, Christakis DAReal use or "real cool": adolescents speak out about displayed alcohol references on social networking websites.
19766949 The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2009 Oct. : 420-2 -
Christakis DA, Moreno MATrapped in the net: will internet addiction become a 21st-century epidemic?
19805719 Archives of pediatrics & adolescent medicine, 2009 Oct. : 959-60 -
Perkins JA, Oliaei S, Garrison MM, Manning SC, Christakis DAAirway procedures and hemangiomas: treatment patterns and outcome in U.S. pediatric hospitals.
19592117 International journal of pediatric otorhinolaryngology, 2009 Sept. : 1302-7 -
Zimmerman FJ, Gilkerson J, Richards JA, Christakis DA, Xu D, Gray S, Yapanel UTeaching by listening: the importance of adult-child conversations to language development.
19564318 Pediatrics, 2009 July : 342-9 -
Christakis DA, Gilkerson J, Richards JA, Zimmerman FJ, Garrison MM, Xu D, Gray S, Yapanel UAudible television and decreased adult words, infant vocalizations, and conversational turns: a population-based study.
19487612 Archives of pediatrics & adolescent medicine, 2009 June : 554-8 -
Blume HK, Garrison MM, Christakis DANeonatal seizures: treatment and treatment variability in 31 United States pediatric hospitals.
19182150 Journal of child neurology, 2009 Feb. : 148-54 -
Moreno MA, Vanderstoep A, Parks MR, Zimmerman FJ, Kurth A, Christakis DAReducing at-risk adolescents' display of risk behavior on a social networking web site: a randomized controlled pilot intervention trial.
19124701 Archives of pediatrics & adolescent medicine, 2009 Jan. : 35-41 -
Moreno MA, Parks MR, Zimmerman FJ, Brito TE, Christakis DADisplay of health risk behaviors on MySpace by adolescents: prevalence and associations.
19124700 Archives of pediatrics & adolescent medicine, 2009 Jan. : 27-34 -
Christakis DAThe effects of infant media usage: what do we know and what should we learn?
18793294 Acta paediatrica (Oslo, Norway : 1992), 2009 Jan. : 8-16 -
Galbraith AA, Semura JI, McAninch-Dake RJ, Anderson N, Christakis DALanguage disparities and timely care for children in managed care Medicaid.
18611093 The American journal of managed care, 2008 July : 417-26 -
Tieder JS, Cowan CA, Garrison MM, Christakis DAVariation in inpatient resource utilization and management of apparent life-threatening events.
18410764 The Journal of pediatrics, 2008 May : 629-35, 635.e1-2 -
Thompson DA, Flores G, Ebel BE, Christakis DAComida en venta: after-school advertising on Spanish-language television in the United States.
18346518 The Journal of pediatrics, 2008 April : 576-81 -
Cooper WO, Ray WA, Arbogast PG, Garrison M, Dudley JA, Christakis DAHealth plan notification and feedback to providers is associated with increased filling of preventer medications for children with asthma enrolled in Medicaid.
18346500 The Journal of pediatrics, 2008 April : 481-8 -
Bowman SM, Zimmerman FJ, Christakis DA, Sharar SRThe role of hospital profit status in pediatric spleen injury management.
18388849 Medical care, 2008 March : 331-8 -
Zerr DM, Englund JA, Robertson AS, Marcuse EK, Garrison MM, Christakis DAHospital-based influenza vaccination of children: an opportunity to prevent subsequent hospitalization.
18245426 Pediatrics, 2008 Feb. : 345-8 -
Moreno MA, Fost NC, Christakis DAResearch ethics in the MySpace era.
18166570 Pediatrics, 2008 Jan. : 157-61 -
Tarini BA, Christakis DA, Lozano PToward family-centered inpatient medical care: the role of parents as participants in medical decisions.
18035155 The Journal of pediatrics, 2007 Dec. : 690-5, 695.e1 -
Rivara FP, Christakis DAThe march of science.
18056569 Archives of pediatrics & adolescent medicine, 2007 Dec. : 1214-5 -
Christakis DA, Zimmerman FJViolent television viewing during preschool is associated with antisocial behavior during school age.
17974736 Pediatrics, 2007 Nov. : 993-9 -
Zimmerman FJ, Christakis DAAssociations between content types of early media exposure and subsequent attentional problems.
17974735 Pediatrics, 2007 Nov. : 986-92 -
Zimmerman FJ, Christakis DA, Meltzoff ANAssociations between media viewing and language development in children under age 2 years.
17889070 The Journal of pediatrics, 2007 Oct. : 364-8 -
Mendoza JA, Zimmerman FJ, Christakis DATelevision viewing, computer use, obesity, and adiposity in US preschool children.
17894878 The international journal of behavioral nutrition and physical activity, 2007 Sep 25 : 44 -
Rivara FP, Cummings P, Ringold S, Bergman AB, Joffe A, Christakis DAA comparison of reviewers selected by editors and reviewers suggested by authors.
17643779 The Journal of pediatrics, 2007 Aug. : 202-5 -
Davis RL, Wright J, Chalmers F, Levenson L, Brown JC, Lozano P, Christakis DAA cluster randomized clinical trial to improve prescribing patterns in ambulatory pediatrics.
17525793 PLoS clinical trials, 2007 May 18 : e25 -
Zimmerman FJ, Christakis DA, Meltzoff ANTelevision and DVD/video viewing in children younger than 2 years.
17485624 Archives of pediatrics & adolescent medicine, 2007 May : 473-9 -
Mendoza JA, Drewnowski A, Christakis DADietary energy density is associated with obesity and the metabolic syndrome in U.S. adults.
17229942 Diabetes care, 2007 April : 974-9 -
Thompson DA, Lozano P, Christakis DAParent use of touchscreen computer kiosks for child health promotion in community settings.
17332194 Pediatrics, 2007 March : 427-34 -
Tarini BA, Garrison MM, Christakis DAInstitutional variation in ordering complete blood counts for children hospitalized with bronchiolitis.
17427246 Journal of hospital medicine : an official publication of the Society of Hospital Medicine, 2007 March : 69-73 -
Christakis DAWhat to do about the new and growing digital divide?
17283309 Archives of pediatrics & adolescent medicine, 2007 Feb. : 204-5 -
Thompson DA, Christakis DAThe association of maternal mental distress with television viewing in children under 3 years old.
17261480 Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2007 Jan. : 32-7 -
Thakkar RR, Garrison MM, Christakis DAA systematic review for the effects of television viewing by infants and preschoolers.
17079575 Pediatrics, 2006 Nov. : 2025-31 -
Christakis DA, Zimmerman FJ, Rivara FP, Ebel BImproving pediatric prevention via the internet: a randomized, controlled trial.
16951011 Pediatrics, 2006 Sept. : 1157-66 -
Tarini BA, Christakis DA, Welch HGState newborn screening in the tandem mass spectrometry era: more tests, more false-positive results.
16882794 Pediatrics, 2006 Aug. : 448-56 -
Christakis DA, Rivara FPPublication ethics: editors' perspectives.
16829242 The Journal of pediatrics, 2006 July : S39-42 -
Christakis DA, Zimmerman FJViewing television before age 3 is not the same as viewing television at age 5.
16818597 Pediatrics, 2006 July : 435; author reply 435-6 -
Christakis DA, Zimmerman FJEarly television viewing is associated with protesting turning off the television at age 6.
16926802 MedGenMed : Medscape general medicine, 2006 Jun 1 : 63 -
Tarini BA, Carroll AE, Sox CM, Christakis DASystematic review of the relationship between early introduction of solid foods to infants and the development of allergic disease.
16651493 Archives of pediatrics & adolescent medicine, 2006 May : 502-7 -
Sox CM, Koepsell TD, Doctor JN, Christakis DAPediatricians' clinical decision making: results of 2 randomized controlled trials of test performance characteristics.
16651490 Archives of pediatrics & adolescent medicine, 2006 May : 487-92 -
Mendoza JA, Drewnowski A, Cheadle A, Christakis DADietary energy density is associated with selected predictors of obesity in U.S. Children.
16614423 The Journal of nutrition, 2006 May : 1318-22 -
Christakis DAThe hidden and potent effects of television advertising.
16615175 JAMA : the journal of the American Medical Association, 2006 Apr 12 : 1698-9 -
Christakis DA, Zimmerman FJMedia as a public health issue.
16585492 Archives of pediatrics & adolescent medicine, 2006 April : 445-6 -
Hollingworth W, Ebel BE, McCarty CA, Garrison MM, Christakis DA, Rivara FPPrevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.
16562413 Journal of studies on alcohol, 2006 March : 300-8 -
Cohen AL, Christakis DAPrimary language of parent is associated with disparities in pediatric preventive care.
16492438 The Journal of pediatrics, 2006 Feb. : 254-8 -
Garrison MM, Jeffries H, Christakis DARisk of death for children with down syndrome and sepsis.
16356424 The Journal of pediatrics, 2005 Dec. : 748-52 -
Garrison MM, Jeffries H, Christakis DARisk of death for children with down syndrome and sepsis.
16356424 The Journal of pediatrics, 2005 Dec. : 748-52 -
Bowman SM, Zimmerman FJ, Christakis DA, Sharar SR, Martin DPHospital characteristics associated with the management of pediatric splenic injuries.
16304075 JAMA : the journal of the American Medical Association, 2005 Nov 23 : 2611-7 -
Bowman SM, Zimmerman FJ, Christakis DA, Sharar SR, Martin DPHospital characteristics associated with the management of pediatric splenic injuries.
16304075 JAMA : the journal of the American Medical Association, 2005 Nov 23 : 2611-7 -
Galbraith AA, Grossman DC, Koepsell TD, Heagerty PJ, Christakis DAMedicaid acceptance and availability of timely follow-up for newborns with Medicaid.
16264002 Pediatrics, 2005 Nov. : 1148-54 -
Galbraith AA, Grossman DC, Koepsell TD, Heagerty PJ, Christakis DAMedicaid acceptance and availability of timely follow-up for newborns with Medicaid.
16264002 Pediatrics, 2005 Nov. : 1148-54 -
Thompson DA, Christakis DAThe association between television viewing and irregular sleep schedules among children less than 3 years of age.
16199693 Pediatrics, 2005 Oct. : 851-6 -
Sox CM, Christakis DAPediatricians' screening urinalysis practices.
16182676 The Journal of pediatrics, 2005 Sept. : 362-5 -
Christakis DA, Wright JA, Taylor JA, Zimmerman FJAssociation between parental satisfaction and antibiotic prescription for children with cough and cold symptoms.
16148842 The Pediatric infectious disease journal, 2005 Sept. : 774-7 -
McCarty CA, Zimmerman FJ, Digiuseppe DL, Christakis DAParental emotional support and subsequent internalizing and externalizing problems among children.
16100499 Journal of developmental and behavioral pediatrics : JDBP, 2005 Aug. : 267-75 -
Zimmerman FJ, Christakis DAChildren's television viewing and cognitive outcomes: a longitudinal analysis of national data.
15996993 Archives of pediatrics & adolescent medicine, 2005 July : 619-25 -
Fishman PA, Ebel BE, Garrison MM, Christakis DA, Wiehe SE, Rivara FPCigarette tax increase and media campaign cost of reducing smoking-related deaths.
15958247 American journal of preventive medicine, 2005 July : 19-26 -
Zerr DM, Blume HK, Berg AT, Del Beccaro MA, Gospe SM Jr, Allpress AL, Christakis DANonfebrile illness seizures: a unique seizure category?
15946338 Epilepsia, 2005 June : 952-5 -
Cohen AL, Rivara FP, Davis R, Christakis DACompliance with guidelines for the medical care of first urinary tract infections in infants: a population-based study.
15930206 Pediatrics, 2005 June : 1474-8 -
Christakis DA, Cowan CA, Garrison MM, Molteni R, Marcuse E, Zerr DMVariation in inpatient diagnostic testing and management of bronchiolitis.
15805359 Pediatrics, 2005 April : 878-84 -
Zimmerman FJ, Glew GM, Christakis DA, Katon WEarly cognitive stimulation, emotional support, and television watching as predictors of subsequent bullying among grade-school children.
15809395 Archives of pediatrics & adolescent medicine, 2005 April : 384-8 -
Zerr DM, Garrison MM, Allpress AL, Heath J, Christakis DAInfection control policies and hospital-associated infections among surgical patients: variability and associations in a multicenter pediatric setting.
15805339 Pediatrics, 2005 April : e387-92 -
Carroll AE, Zimmerman FJ, Rivara FP, Ebel BE, Christakis DAPerceptions about computers and the internet in a pediatric clinic population.
15780015 Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2005 March : 122-6 -
Wiehe SE, Garrison MM, Christakis DA, Ebel BE, Rivara FPA systematic review of school-based smoking prevention trials with long-term follow-up.
15737770 The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2005 March : 162-9 -
Carroll AE, Rivara FP, Ebel B, Zimmerman FJ, Christakis DAHousehold computer and Internet access: The digital divide in a pediatric clinic population.
16779012 AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2005 : 111-5 -
Galbraith AA, Semura J, McAninch-Dake B, Anderson N, Christakis DAEmergency department use and perceived delay in accessing illness care among children with Medicaid.
15548103 Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2004 Nov. : 509-13 -
Christakis DA, Ebel BE, Rivara FP, Zimmerman FJTelevision, video, and computer game usage in children under 11 years of age.
15520768 The Journal of pediatrics, 2004 Nov. : 652-6 -
Taylor JA, Brownstein D, Christakis DA, Blackburn S, Strandjord TP, Klein EJ, Shafii JUse of incident reports by physicians and nurses to document medical errors in pediatric patients.
15342846 Pediatrics, 2004 Sept. : 729-35 -
Rivara FP, Christakis DA, Cummings PDuplicate publication.
15351761 Archives of pediatrics & adolescent medicine, 2004 Sept. : 926 -
McCarty CA, Ebel BE, Garrison MM, DiGiuseppe DL, Christakis DA, Rivara FPContinuity of binge and harmful drinking from late adolescence to early adulthood.
15342844 Pediatrics, 2004 Sept. : 714-9 -
Rivara FP, Ebel BE, Garrison MM, Christakis DA, Wiehe SE, Levy DTPrevention of smoking-related deaths in the United States.
15261898 American journal of preventive medicine, 2004 Aug. : 118-25 -
Garrison MM, Richardson LP, Christakis DA, Connell FMental illness hospitalizations of youth in Washington State.
15289251 Archives of pediatrics & adolescent medicine, 2004 Aug. : 781-5 -
Christakis DA, Wright JACan continuity of care be improved? Results from a randomized pilot study.
15264940 Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2004 July : 336-9 -
Rivara FP, Garrison MM, Ebel B, McCarty CA, Christakis DAMortality attributable to harmful drinking in the United States, 2000.
15376828 Journal of studies on alcohol, 2004 July : 530-6 -
Richardson LP, DiGiuseppe D, Christakis DA, McCauley E, Katon WQuality of care for medicaid-covered youth treated with antidepressant therapy.
15123492 Archives of general psychiatry, 2004 May : 475-80 -
Zimmerman FJ, Christakis DA, Vander Stoep ATinker, tailor, soldier, patient: work attributes and depression disparities among young adults.
15020006 Social science & medicine (1982), 2004 May : 1889-901 -
Christakis DA, Zimmerman FJ, DiGiuseppe DL, McCarty CAEarly television exposure and subsequent attentional problems in children.
15060216 Pediatrics, 2004 April : 708-13 -
Carroll AE, Tarczy-Hornoch P, O'Reilly E, Christakis DAThe effect of point-of-care personal digital assistant use on resident documentation discrepancies.
14993533 Pediatrics, 2004 March : 450-4 -
Carroll AE, Christakis DAPediatricians' use of and attitudes about personal digital assistants.
14754932 Pediatrics, 2004 Feb. : 238-42 -
Garrison MM, Christakis DA, Ebel BE, Wiehe SE, Rivara FPSmoking cessation interventions for adolescents: a systematic review.
14580641 American journal of preventive medicine, 2003 Nov. : 363-7 -
Christakis DA, Garrison MM, Ebel BE, Wiehe SE, Rivara FPPediatric smoking prevention interventions delivered by care providers: a systematic review.
14580640 American journal of preventive medicine, 2003 Nov. : 358-62 -
Richardson LP, DiGiuseppe D, Garrison M, Christakis DADepression in Medicaid-covered youth: differences by race and ethnicity.
14557159 Archives of pediatrics & adolescent medicine, 2003 Oct. : 984-9 -
Christakis DAContinuity of care: process or outcome?
15043373 Annals of family medicine, 2003 Sept. : 131-3 -
Sox CM, Cooper WO, Koepsell TD, DiGiuseppe DL, Christakis DAProvision of pneumococcal prophylaxis for publicly insured children with sickle cell disease.
12941678 JAMA : the journal of the American Medical Association, 2003 Aug 27 : 1057-61 -
Li ST, DiGiuseppe DL, Christakis DAAntiemetic use for acute gastroenteritis in children.
12742884 Archives of pediatrics & adolescent medicine, 2003 May : 475-9 -
Carroll AE, Tarczy-Hornoch P, O'Reilly E, Christakis DAResident documentation discrepancies in a neonatal intensive care unit.
12728074 Pediatrics, 2003 May : 976-80 -
Christakis DA, Wright JA, Zimmerman FJ, Bassett AL, Connell FAContinuity of care is associated with well-coordinated care.
12643780 Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2003 March : 82-6 -
DiGiuseppe DL, Christakis DAContinuity of care for children in foster care.
12612273 Pediatrics, 2003 March : e208-13 -
Saha S, Saint S, Christakis DAImpact factor: a valid measure of journal quality?
12572533 Journal of the Medical Library Association : JMLA, 2003 Jan. : 42-6 -
Neff JM, Valentine J, Park A, Hicks-Thomson J, Christakis DA, Muldoon J, Churchill STrends in pediatric hospitalizations of children in washington state by insurance and chronic condition status, 1991-1998.
12090839 Archives of pediatrics & adolescent medicine, 2002 July : 703-9 -
Feudtner C, Christakis DA, Zimmerman FJ, Muldoon JH, Neff JM, Koepsell TDCharacteristics of deaths occurring in children's hospitals: implications for supportive care services.
11986451 Pediatrics, 2002 May : 887-93 -
Christakis DA, Wright JA, Zimmerman FJ, Bassett AL, Connell FAContinuity of care is associated with high-quality careby parental report.
11927727 Pediatrics, 2002 April : e54 -
Van Niel CW, Feudtner C, Garrison MM, Christakis DALactobacillus therapy for acute infectious diarrhea in children: a meta-analysis.
11927715 Pediatrics, 2002 April : 678-84 -
Feudtner C, Silveira MJ, Christakis DAWhere do children with complex chronic conditions die? Patterns in Washington State, 1980-1998.
11927711 Pediatrics, 2002 April : 656-60 -
Gallaher MM, Christakis DA, Connell FAHealth care use by children diagnosed as having developmental delay.
11876668 Archives of pediatrics & adolescent medicine, 2002 March : 246-51 -
Carroll AE, Garrison MM, Christakis DAA systematic review of nonpharmacological and nonsurgical therapies for gastroesophageal reflux in infants.
11814369 Archives of pediatrics & adolescent medicine, 2002 Feb. : 109-13
-
American Academy of Pediatrics. Policy
statement--sexuality, contraception, and the media.
Overview
- Board Certification(s)
-
Pediatrics
- Medical/Professional School
-
University of Pennsylvania School of Medicine, Philadelphia, PA
University of Washington School of Medicine, Seattle, WA - Residency
-
University of Washington School of Medicine, Seattle, WA
- Research Description
-
The first years of children's lives are critically important for children's lifelong development. Consider that a newborn's brain triples in size in the first two years after birth. This immense growth happens in direct response to the environment that that infant experiences. Consider further that as many as half of children from lower income families start kindergarten without the basic skills they need to learn and that educational gap puts them at a disadvantage throughout school.
Dr. Christakis, is a Professor of Pediatrics, Director of the Child Health Institute at the University of Washington, and a pediatrician at Children's Hospital in Seattle. Dr. Christakis is the author of over 100 original research articles and a textbook of pediatrics. He is also the author of "The Elephant in the Living Room: Make Television Work for Your Kids" (September 2006; Rodale). Dr. Christakis is an international expert on children and media. His research focuses on the effects of media on child health and development and has been featured on Anderson Cooper 360, the Today Show, ABC, NBC, and CBS news as well as all major national newspapers.
His research to date has included:
TV viewing in the first three years of life can lead to problems with language development as well as attention and cognitive development at school age.
Playing with blocks can improve language acquisition for children ages 1.5 to 2.5 years of age.
Watching violent cartoons during preschool ages is associated with aggression at ages 7-10 whereas watching educational programming is not.
His current research includes:
Helping parents make better media choices for their preschoolers and effects on their behavior at school age.
Distributing computers with educational software to low income families to try and improve kindergarten readiness. - Research Focus Area
-
Health Promotion and Disease Prevention