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Marisa Sklar

Photo of Marisa Sklar
Title(s)Assistant Adjunct Professor, Psychiatry
SchoolVc-health Sciences-schools
Address9500 Gilman Drive #
La Jolla CA 92093
Emailmasklar@ucsd.edu
ORCID ORCID Icon0000-0002-1263-6132 Additional info
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    Collapse Biography 
    Collapse education and training
    Brown University, Providence, RIPostdoctoral Fellowship2017Health Services Research/Implementation Science
    Brown University, Providence, RIInternship2015Clinical Psychology
    SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CAPhD2015Clinical Psychology
    San Diego State University, San Diego, CAMS2010Applied Psychology: Program Evaluation
    University of California Santa Cruz, Santa Cruz, CABA2006Psychology

    Collapse Overview 
    Collapse overview
    Dr. Sklar is an Assistant Professor, licensed clinical psychologist, implementation scientist, and program evaluator in the Department of Psychiatry at UC San Diego, and associate director of the National Institute of Mental Health (NIMH)-funded IN STEP Center. In addition to NIMH, she has received funding from National Institute on Drug Abuse (NIDA), Agency for Healthcare Research and Quality (AHRQ), National Institute of Nursing Research (NINR), Patient-Centered Outcomes Research Institute (PCORI), W.T. Grant Foundation, Prebys Foundation, and the Veterans Affairs (VA) to assess and address the provider, organization, and system-level factors that influence the delivery of care across multiple healthcare systems in the United States and abroad. She has co-developed and adapted a prominent leadership and organizational change implementation strategy (LOCI) for the implementation of evidence-based practices across numerous health service systems across the United States, Norway, and in Malawi. Dr. Sklar’s research also aims to enhance healthcare services for diverse sexual and gender and minority populations in primary care and school-based health centers.
    Collapse Clinical Trials

    Collapse Research 
    Collapse research activities and funding
    Implementing Structurally Competent Critical Time Intervention for Transgender and Gender-Diverse Patients
    NIH R01HS029683Sep 30, 2024 - Jul 31, 2029
    Role: Co-Investigator
    Aligning facility leadership and climate to advance mental health services integration in Malawi
    NIH R01MH133028Jun 1, 2023 - Mar 31, 2028
    Role: Site-PI
    Enhancing Structural Competency in School-Based Health Centers to Address LGBTQ+ Adolescent Health Equity
    NIH R01NR021019Mar 20, 2023 - Jan 31, 2027
    Role: Site-PI
    Center for Team Effectiveness to Accelerate EBP Implementation in Children's Mental Health Services
    NIH P50MH126231Aug 5, 2022 - May 31, 2027
    Role: Associate Director; Methods Core Co-Lead
    Statewide System and Organizational Strategy for Evidence-Based Practice Implementation and Sustainment in Substance Use Disorder Treatment
    NIH R01DA049891Jul 15, 2020 - May 31, 2025
    Role: Co-Investigator
    Randomized trial of a leadership and organizational change strategy to improve the implementation and sustainment of digital measurement-based care in youth mental health services
    NIH R01MH119127Jun 1, 2019 - Apr 30, 2023
    Role: Co-Investigator
    Enhancing Primary Care Services for Diverse Sexual and Gender Minority Populations
    NIH R21MD011648Sep 12, 2018 - Apr 30, 2021
    Role: Site-PI
    Development and Testing of an Evidence Based Intervention Sustainment Measure
    NIH R03MH117493Sep 1, 2018 - Jun 30, 2021
    Role: Co-Investigator
    Testing the Leadership and Organizational Change for Implementation (LOCI) Intervention in Substance Abuse Treatment Programs
    NIH R01DA038466Sep 30, 2015 - May 31, 2021
    Role: Co-Investigator
    A climate for evidence-based practice implementation in the patient-centered medical home
    NIH F32HS024192Sep 22, 2015 - Sep 21, 2017
    Role: PI
    Mental Health Recovery in the Patient Centered Medical Home
    NIH F31MH100758Sep 19, 2013 - Sep 18, 2015
    Role: PI

    Collapse ORNG Applications 
    Collapse Featured Publications

    Collapse Bibliographic 
    Collapse selected publications
    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help. to make corrections and additions.
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    Altmetrics Details PMC Citations indicate the number of times the publication was cited by articles in PubMed Central, and the Altmetric score represents citations in news articles and social media. (Note that publications are often cited in additional ways that are not shown here.) Fields are based on how the National Library of Medicine (NLM) classifies the publication's journal and might not represent the specific topic of the publication. Translation tags are based on the publication type and the MeSH terms NLM assigns to the publication. Some publications (especially newer ones and publications not in PubMed) might not yet be assigned Field or Translation tags.) Click a Field or Translation tag to filter the publications.
    1. Validation of the extended version of the Implementation Leadership Scale (ILS-X). Implement Sci Commun. 2025 Dec 04; 6(1):133. Ehrhart MG, Williams NJ, Sklar M, Vega NR, Kandah A, Aarons GA. PMID: 41345743; PMCID: PMC12676754.
      View in: PubMed   Mentions:
    2. Beyond the surface of capacity building: a mixed-methods study of the core functions and forms of dissemination and implementation science consultations. Implement Sci Commun. 2025 Aug 18; 6(1):87. Swanson KN, Stadnick NA, Aarons GA, Brookman-Frazee L, Bouchard I, Du Z, Brubaker AG, Geremia C, Cain K, Conradi LR, Sklar M, Viglione C, Rabin BA. PMID: 40826438; PMCID: PMC12359906.
      View in: PubMed   Mentions:
    3. Implementation factors for sexual orientation and gender identity patient data collection in a comprehensive cancer center: findings from a center-wide readiness assessment survey for the ASK Sexual Orientation and Gender Identity study. J Natl Cancer Inst Monogr. 2025 Jul 01; 2025(69):117-120. Kano M, Sklar M, O'Connell R, Guest D, Farnbach Pearson A, Sussman AL, Tawfik B, Dayao Z, Crandall C, Willging C. PMID: 40671541; PMCID: PMC12268150.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    4. Beyond the Surface of Capacity Building: A Mixed-Methods Study of the Core Functions and Forms of Dissemination and Implementation Science Consultations. Res Sq. 2025 May 13. Swanson K, Stadnick NA, Aarons GA, Brookman-Frazee L, Bouchard I, Du Z, Brubaker A, Geremia C, Cain K, Conradi L, Sklar M, Viglione C, Rabin B. PMID: 40470185; PMCID: PMC12136196.
      View in: PubMed   Mentions:
    5. Recommendations for promoting affirming healthcare for gender and sexual minorities with intersecting marginalized identities. BMC Health Serv Res. 2025 Apr 23; 25(1):585. Singh RS, Zamarin K, Eckstrand KL, Sklar M, Sturm R, Willging C. PMID: 40269822; PMCID: PMC12016476.
      View in: PubMed   Mentions: 2     Fields:    Translation:Humans
    6. Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health. Psychiatr Serv. 2025 Apr 01; 76(4):358-365. Williams NJ, Aarons GA, Ehrhart MG, Esp S, Vega N, Sklar M, Carandang K, Brookman-Frazee L, Marcus SC. PMID: 39881596; PMCID: PMC11961305.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    7. School-Based Health Centers Addressing Health Equity for LGBTQ + Patients (SBHCs HELP): protocol for a stepped-wedge trial to implement innovations promoting structural competency. BMC Health Serv Res. 2024 Nov 27; 24(1):1485. Willging CE, Shattuck D, Sklar M, Sebastian RA, Stout RL, Ramos MM. PMID: 39604974; PMCID: PMC11603653.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    8. Correction to: Symphony of Success: Leader-Practitioner Reciprocity during Evidence-Based Practice Implementation. Adm Policy Ment Health. 2024 Nov; 51(6):997. Egeland KM, Sklar M, Aarons GA, Ehrhart MG, Skar AS, Borge RH. PMID: 39325342; PMCID: PMC11489298.
      View in: PubMed   Mentions:    Fields:    
    9. Symphony of Success: Leader-Practitioner Reciprocity during Evidence-Based Practice Implementation. Adm Policy Ment Health. 2024 11; 51(6):988-996. Egeland KM, Sklar M, Aarons GA, Ehrhart MG, Skar AS, Borge RH. PMID: 39153041; PMCID: PMC11489190.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    10. Randomized trial of the leadership and organizational change for implementation (LOCI) strategy in substance use treatment clinics. J Subst Use Addict Treat. 2024 Oct; 165:209437. Aarons GA, Sklar M, Ehrhart MG, Roesch S, Moullin JC, Carandang K. PMID: 38866139.
      View in: PubMed   Mentions: 7     Fields:    Translation:Humans
    11. Utility of the Leadership and Organizational Change for Implementation-Systems Level (LOCI-SL) strategy for a statewide substance use treatment implementation effort. J Subst Use Addict Treat. 2024 Sep; 164:209433. Crable EL, Sklar M, Kandah A, Samuels HC, Ehrhart MG, Aalsma MC, Hulvershorn L, Willging CE, Aarons GA. PMID: 38852821; PMCID: PMC12014198.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    12. Implementation leadership and implementation climate in context: A single organization intrinsic case study for implementation of digital measurement-based care. Implement Res Pract. 2024 Jan-Dec; 5:26334895241236680. Sklar M, Ehrhart MG, Ramirez N, Carandang K, Kuhn N, Day A, Aarons GA, Williams NJ. PMID: 38550748; PMCID: PMC10976481.
      View in: PubMed   Mentions: 2  
    13. Improving measurement-based care implementation in youth mental health through organizational leadership and climate: a mechanistic analysis within a randomized trial. Implement Sci. 2024 03 28; 19(1):29. Williams NJ, Ehrhart MG, Aarons GA, Esp S, Sklar M, Carandang K, Vega NR, Brookman-Frazee L, Marcus SC. PMID: 38549122; PMCID: PMC10976812.
      View in: PubMed   Mentions: 9     Fields:    Translation:Humans
    14. Randomized Trial of an Organizational Implementation Strategy to Improve Measurement-Based Care Fidelity and Youth Outcomes in Community Mental Health. J Am Acad Child Adolesc Psychiatry. 2024 Oct; 63(10):991-1004. Williams NJ, Marcus SC, Ehrhart MG, Sklar M, Esp SM, Carandang K, Vega N, Gomes AE, Brookman-Frazee L, Aarons GA. PMID: 38070868; PMCID: PMC11265517.
      View in: PubMed   Mentions: 18     Fields:    Translation:Humans
    15. Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol. Implement Sci Commun. 2023 Oct 05; 4(1):121. Sklar M, Kenneally R, Aarons GA, Fettes DL. PMID: 37798808; PMCID: PMC10552205.
      View in: PubMed   Mentions:
    16. Individual-level associations between implementation leadership, climate, and anticipated outcomes: a time-lagged mediation analysis. Implement Sci Commun. 2023 Jul 11; 4(1):75. Egeland KM, Borge RH, Peters N, Bækkelund H, Braathu N, Sklar M, Aarons GA, Skar AS. PMID: 37434244; PMCID: PMC10334553.
      View in: PubMed   Mentions: 6  
    17. Assessing readiness factors for implementation of LGBTQ+ affirmative primary care initiatives: Practice implications from a mixed-method study. Front Health Serv. 2022; 2:901440. Willging CE, Sklar M, Eckstrand K, Sturm R, Davies S, Kano M. PMID: 36925831; PMCID: PMC10012654.
      View in: PubMed   Mentions: 6  
    18. "Change Doesn't Happen by Itself": A Thematic Analysis of First-Level Leaders' Experiences Participating in the Leadership and Organizational Change for Implementation (LOCI) Strategy. Adm Policy Ment Health. 2022 09; 49(5):785-797. Borge RH, Egeland KM, Aarons GA, Ehrhart MG, Sklar M, Skar AS. PMID: 35583566; PMCID: PMC9114289.
      View in: PubMed   Mentions: 3     Fields:    Translation:Humans
    19. Characterization of multilevel influences of mental health care transitions: a comparative case study analysis. BMC Health Serv Res. 2022 Apr 02; 22(1):437. Dickson KS, Sklar M, Chen SZ, Kim B. PMID: 35366865; PMCID: PMC8976965.
      View in: PubMed   Mentions: 2     Fields:    Translation:Humans
    20. A stepped-wedge randomized trial investigating the effect of the Leadership and Organizational Change for Implementation (LOCI) intervention on implementation and transformational leadership, and implementation climate. BMC Health Serv Res. 2022 Mar 04; 22(1):298. Skar AS, Braathu N, Peters N, Bækkelund H, Endsjø M, Babaii A, Borge RH, Wentzel-Larsen T, Ehrhart MG, Sklar M, Brown CH, Aarons GA, Egeland KM. PMID: 35246135; PMCID: PMC8895588.
      View in: PubMed   Mentions: 28     Fields:    Translation:Humans
    21. Implementation outcomes from a pilot of "Access to Tailored Autism Integrated Care" for children with autism and mental health needs. Autism. 2022 10; 26(7):1821-1832. Stadnick NA, Aarons GA, Martinez K, Sklar M, Coleman KJ, Gizzo DP, Lane E, Kuelbs CL, Brookman-Frazee L. PMID: 35083919; PMCID: PMC9325918.
      View in: PubMed   Mentions: 11     Fields:    Translation:Humans
    22. Provider REport of Sustainment Scale (PRESS): development and validation of a brief measure of inner context sustainment. Implement Sci. 2021 08 30; 16(1):86. Moullin JC, Sklar M, Ehrhart MG, Green A, Aarons GA. PMID: 34461948; PMCID: PMC8404332.
      View in: PubMed   Mentions: 30     Fields:    Translation:Humans
    23. COVID-related work changes, burnout, and turnover intentions in mental health providers: A moderated mediation analysis. Psychiatr Rehabil J. 2021 Sep; 44(3):219-228. Sklar M, Ehrhart MG, Aarons GA. PMID: 33998824; PMCID: PMC8675296.
      View in: PubMed   Mentions: 29     Fields:    Translation:HumansCells
    24. An observational study of the impact of COVID-19 and the rapid implementation of telehealth on community mental health center providers. Implement Sci Commun. 2021 Mar 11; 2(1):29. Sklar M, Reeder K, Carandang K, Ehrhart MG, Aarons GA. PMID: 33706815; PMCID: PMC7948664.
      View in: PubMed   Mentions: 21  
    25. Racial and Ethnic Differences in Depressive Profiles of Child Welfare-Involved Families Receiving Home Visitation Services. Psychiatr Serv. 2021 05 01; 72(5):539-545. Fettes DL, Sklar M, Green AE, Sandhu A, Hurlburt MS, Aarons GA. PMID: 33691489.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    26. Advancing the pragmatic measurement of sustainment: a narrative review of measures. Implement Sci Commun. 2020; 1:76. Moullin JC, Sklar M, Green A, Dickson KS, Stadnick NA, Reeder K, Aarons GA. PMID: 32964208; PMCID: PMC7499830.
      View in: PubMed   Mentions: 36  
    27. An Observational Study of the Impact of COVID-19 and the Transition to Telehealth on Community Mental Health Center Providers. Res Sq. 2020 Jul 29. Sklar M, Reeder K, Carandang K, Ehrhart MG, Aarons GA. PMID: 32793893; PMCID: PMC7402050.
      View in: PubMed   Mentions:
    28. Enhancing primary care services for diverse sexual and gender minority populations: a developmental study protocol. BMJ Open. 2020 02 25; 10(2):e032787. Willging C, Kano M, Green AE, Sturm R, Sklar M, Davies S, Eckstrand K. PMID: 32102808; PMCID: PMC7045086.
      View in: PubMed   Mentions: 8     Fields:    Translation:HumansCTClinical Trials
    29. Comparative case studies in integrated care implementation from across the globe: a quest for action. BMC Health Serv Res. 2019 Nov 27; 19(1):899. Stadnick NA, Sadler E, Sandall J, Turienzo CF, Bennett IM, Borkan J, Oladeji B, Gureje O, Aarons GA, Sklar M. PMID: 31775740; PMCID: PMC6882190.
      View in: PubMed   Mentions: 12     Fields:    Translation:Humans
    30. Validation of the Implementation Climate Scale (ICS) in substance use disorder treatment organizations. Subst Abuse Treat Prev Policy. 2019 08 23; 14(1):35. Ehrhart MG, Torres EM, Hwang J, Sklar M, Aarons GA. PMID: 31443666; PMCID: PMC6708170.
      View in: PubMed   Mentions: 16     Fields:    Translation:Humans
    31. Beyond checkboxes: A qualitative assessment of physicians' experiences providing care in a patient-centred medical home. J Eval Clin Pract. 2019 Dec; 25(6):1142-1151. Sklar M, Seijo C, Goldman RE, Eaton CB. PMID: 30997740.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    32. Testing the leadership and organizational change for implementation (LOCI) intervention in Norwegian mental health clinics: a stepped-wedge cluster randomized design study protocol. Implement Sci. 2019 03 13; 14(1):28. Egeland KM, Skar AS, Endsjø M, Laukvik EH, Bækkelund H, Babaii A, Granly LB, Husebø GK, Borge RH, Ehrhart MG, Sklar M, Brown CH, Aarons GA. PMID: 30866973; PMCID: PMC6417075.
      View in: PubMed   Mentions: 24     Fields:    Translation:HumansCTClinical Trials
    33. A climate for evidence-based practice implementation in the patient-centred medical home. J Eval Clin Pract. 2019 Aug; 25(4):637-647. Sklar M, Hatch MR, Aarons GA. PMID: 30350470.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    34. "Scaling-out" evidence-based interventions to new populations or new health care delivery systems. Implement Sci. 2017 09 06; 12(1):111. Aarons GA, Sklar M, Mustanski B, Benbow N, Brown CH. PMID: 28877746; PMCID: PMC5588712.
      View in: PubMed   Mentions: 188     Fields:    Translation:Humans
    35. HCV Integrated Care: A Randomized Trial to Increase Treatment Initiation and SVR with Direct Acting Antivirals. Int J Hepatol. 2017; 2017:5834182. Groessl EJ, Liu L, Sklar M, Ho SB. PMID: 28819570; PMCID: PMC5551521.
      View in: PubMed   Mentions: 6  
    36. Discrepancies in Leader and Follower Ratings of Transformational Leadership: Relationship with Organizational Culture in Mental Health. Adm Policy Ment Health. 2017 Jul; 44(4):480-491. Aarons GA, Ehrhart MG, Farahnak LR, Sklar M, Horowitz J. PMID: 26164567; PMCID: PMC4775440.
      View in: PubMed   Mentions: 28     Fields:    Translation:Humans
    37. Cost-Effectiveness of the Hepatitis C Self-Management Program. Health Educ Behav. 2017 02; 44(1):113-122. Groessl EJ, Sklar M, Laurent DD, Lorig K, Ganiats TG, Ho SB. PMID: 27206463.
      View in: PubMed   Mentions: 5     Fields:    Translation:Humans
    38. Yoga as a treatment for chronic low back pain: A systematic review of the literature. J Orthop Rheumatol. 2016 Jan 01; 3(1):1-8. Chang DG, Holt JA, Sklar M, Groessl EJ. PMID: 27231715; PMCID: PMC4878447.
      View in: PubMed   Mentions: 27  
    39. Mental Health Recovery in the Patient-Centered Medical Home. Am J Public Health. 2015 Sep; 105(9):1926-34. Sklar M, Aarons GA, O'Connell M, Davidson L, Groessl EJ. PMID: 26180945; PMCID: PMC4539809.
      View in: PubMed   Mentions: 8     Fields:    Translation:Humans
    40. Integrated Care Increases Treatment and Improves Outcomes of Patients With Chronic Hepatitis C Virus Infection and Psychiatric Illness or Substance Abuse. Clin Gastroenterol Hepatol. 2015 Nov; 13(11):2005-14.e1-3. Ho SB, Bräu N, Cheung R, Liu L, Sanchez C, Sklar M, Phelps TE, Marcus SG, Wasil MM, Tisi A, Huynh L, Robinson SK, Gifford AL, Asch SM, Groessl EJ. PMID: 25724704.
      View in: PubMed   Mentions: 53     Fields:    Translation:Humans
    41. Stigma experienced by people using mental health services in San Diego County. Soc Psychiatry Psychiatr Epidemiol. 2015 May; 50(5):747-56. Sarkin A, Lale R, Sklar M, Center KC, Gilmer T, Fowler C, Heller R, Ojeda VD. PMID: 25406401.
      View in: PubMed   Mentions: 5     Fields:    Translation:Humans
    42. Fidelity to the housing first model and effectiveness of permanent supported housing programs in California. Psychiatr Serv. 2014 Nov 01; 65(11):1311-7. Gilmer TP, Stefancic A, Katz ML, Sklar M, Tsemberis S, Palinkas LA. PMID: 25022911.
      View in: PubMed   Mentions: 16     Fields:    Translation:Humans
    43. Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation. Annu Rev Public Health. 2014; 35:255-74. Aarons GA, Ehrhart MG, Farahnak LR, Sklar M. PMID: 24641560; PMCID: PMC4348088.
      View in: PubMed   Mentions: 231     Fields:    Translation:HumansPHPublic Health
    44. Development and validation of a Housing First fidelity survey. Psychiatr Serv. 2013 Sep 01; 64(9):911-4. Gilmer TP, Stefancic A, Sklar M, Tsemberis S. PMID: 24026835.
      View in: PubMed   Mentions: 14     Fields:    Translation:Humans
    45. Instruments for measuring mental health recovery: a systematic review. Clin Psychol Rev. 2013 Dec; 33(8):1082-95. Sklar M, Groessl EJ, O'Connell M, Davidson L, Aarons GA. PMID: 24080285.
      View in: PubMed   Mentions: 33     Fields:    Translation:Humans
    46. Increasing antiviral treatment through integrated hepatitis C care: a randomized multicenter trial. Contemp Clin Trials. 2013 Jul; 35(2):97-107. Groessl EJ, Sklar M, Cheung RC, Bräu N, Ho SB. PMID: 23669414.
      View in: PubMed   Mentions: 10     Fields:    Translation:Humans
    47. Measuring the impact of cataract surgery on generic and vision-specific quality of life. Qual Life Res. 2013 Aug; 22(6):1405-14. Groessl EJ, Liu L, Sklar M, Tally SR, Kaplan RM, Ganiats TG. PMID: 23015266; PMCID: PMC3578053.
      View in: PubMed   Mentions: 20     Fields:    Translation:HumansCells
    48. The psychometric properties of the Illness Management and Recovery scale in a large American public mental health system. Psychiatry Res. 2012 Oct 30; 199(3):220-7. Sklar M, Sarkin A, Gilmer T, Groessl E. PMID: 22503383.
      View in: PubMed   Mentions: 20     Fields:    Translation:Humans
    49. Racial differences in self-rated health diminishing from 1972 to 2008. J Behav Med. 2013 Feb; 36(1):44-50. Sarkin AJ, Groessl EJ, Mulligan B, Sklar M, Kaplan RM, Ganiats TG. PMID: 22322908.
      View in: PubMed   Mentions: 3     Fields:    Translation:Humans
    50. Evaluating a measure of social health derived from two mental health recovery measures: the California Quality of Life (CA-QOL) and Mental Health Statistics Improvement Program Consumer Survey (MHSIP). Community Ment Health J. 2011 Aug; 47(4):454-62. Carlson JA, Sarkin AJ, Levack AE, Sklar M, Tally SR, Gilmer TP, Groessl EJ. PMID: 20878235; PMCID: PMC3149666.
      View in: PubMed   Mentions: 7     Fields:    Translation:Humans
    51. Residual tobacco smoke in used cars: futile efforts and persistent pollutants. Nicotine Tob Res. 2010 Oct; 12(10):1029-36. Fortmann AL, Romero RA, Sklar M, Pham V, Zakarian J, Quintana PJ, Chatfield D, Matt GE. PMID: 20805293.
      View in: PubMed   Mentions: 11     Fields:    Translation:HumansPHPublic Health
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