PAMELA P. HANES Ph.D., is an associate professor, Department of Public Health and Preventive Medicine and associate director for research, Oregon Health Policy Institute, Oregon Health Sciences University, Portland, Oregon. MERWYN R. GREENLICK Ph.D., is professor and chair of the Department of Public Health and Preventive Medicine, School of Medicine, Oregon Health Sciences University. He is former director of the Kaiser Permanente Center for Health Research and vice president for research, Kaiser Foundation Hospitals.