1 Department of Family & Community Medicine and Department of Epidemiology & Prevention, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (Dr Moore); Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St Louis, Missouri (Dr Brownson); and Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson).