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Rodriguez DK, Hewage SA, Periyakoil VS. Factors affecting the recruitment of Hispanic/Latinx American older adults in clinical trials in the United States: A scoping review. J Am Geriatr Soc 2023; 71:1974-1991. [PMID: 37013348 PMCID: PMC10258132 DOI: 10.1111/jgs.18264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/21/2022] [Accepted: 01/02/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Participation of Hispanic/Latinx American older adults (HLAOA) in clinical trials is fundamental to health equity in aging research. However, information on strategies for the successful recruitment of this population in clinical trials is limited. DESIGN This scoping review aims to identify hindering and facilitating factors that impact the recruitment of HLAOA in clinical trials in the United States. METHODS Two databases (PubMed, EMBASE) were searched for original research articles from inception until March 2022 reporting on factors that engaged HLAoa (≥65) in clinical trials. One thousand and thirteen studies were scrutinized to identify 31 eligible articles. RESULTS Most articles were from cancer clinical trials (14 studies). Hindering factors that impacted the recruitment of HLAoa in clinical trials were related to (i) study design and logistics challenges, (ii) challenges imposed by social determinants of health, (iii) communication barriers, and (iv) patients' mistrust, and (v) family issues. Facilitating factors include (i) effective modes of outreach, (ii) strategic clinical trial design, (iii) incorporating culturally-respectful approaches that are tailored to the participants' sociocultural background, and (iv) bridging language barriers. CONCLUSIONS Successful recruitment of HLAOA into clinical trials requires identifying the study question, co-designing the trial design, implementation, and evaluation in respectful collaboration with the Hispanic/Latinx community with careful attention to their needs and minimizing the study burden on this vulnerable population. Factors identified here may guide researchers to better understand the needs of HLAOA and successfully recruit them into clinical trials, leading to more equitable research that increases their representation in clinical research.
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Affiliation(s)
- Dulce K Rodriguez
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Sumali A Hewage
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Vyjeyanthi S Periyakoil
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
- Veterans Affairs Palo Alto Health Care Center, Palo Alto, California, USA
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Passmore SR, Casper E, Olgin JE, Maguire C, Marcus GM, Pletcher MJ, Thomas SB. Setting and motivation in the decision to participate: An approach to the engagement of diverse samples in mobile research. Contemp Clin Trials Commun 2019; 16:100428. [PMID: 31463416 PMCID: PMC6706628 DOI: 10.1016/j.conctc.2019.100428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/17/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022] Open
Abstract
Internet and mobile based research are powerful tools in the creation of large, cohort studies (eCohort). However, recent analysis indicates that an underrepresentation of minority and low income groups in these studies might exceed that found in traditional research [1-5]. In this report, we present findings from an experiment in research engagement using the Eureka Research Platform developed to enroll diverse populations in support of biomedical clinical research. This experiment involved the recruitment of African American and Latino participants in a smartphone based survey at a temporary, charitable, dental event sponsored, in part, by the research team, in order to explore the impact of setting and approach on recruitment outcomes. 211 participants enrolled including a significant representation of African Americans (51%) and Latinos (31%) and those with education levels at high school or less (37%). Interviews conducted after the study confirmed that our recruitment efforts within the context of a service event affected the decision to participate. While further research is necessary, this experiment holds promise for the engagement of underrepresented groups in research.
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Affiliation(s)
- Susan Racine Passmore
- Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA
- Collaborative Center for Health Equity, University of Wisconsin, Madison, WI, USA
| | - Erica Casper
- Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jeffery E. Olgin
- School of Medicine, University of California, San Francisco, CA, USA
| | - Carol Maguire
- School of Medicine, University of California, San Francisco, CA, USA
| | - Gregory M. Marcus
- School of Medicine, University of California, San Francisco, CA, USA
| | - Mark J. Pletcher
- School of Medicine, University of California, San Francisco, CA, USA
| | - Stephen B. Thomas
- Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA
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Frierson GM, Pinto BM, Denman DC, Leon PA, Jaffe AD. Bridging the Gap: Racial concordance as a strategy to increase African American participation in breast cancer research. J Health Psychol 2017; 24:1548-1561. [DOI: 10.1177/1359105317740736] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lack of African American females in breast cancer research has been receiving substantial attention. This study seeks to identify research perceptions and motivating factors needed to increase racial/ethnic minority participation in breast cancer research. A total of 57 African American women (Σ = 47.8 years), from Rhode Island and Texas, completed a questionnaire and focus group. While many participants were not breast cancer survivors, they reported knowledge of their racial group’s risk for breast cancer. One major finding that could be seen as both a facilitator and barrier is racial concordance between participant and researcher. Cultural sensitivity and trust building is recommended to increase minority participation.
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Chang TE, Brill CD, Traeger L, Bedoya CA, Inamori A, Hagan PN, Flaherty K, Hails K, Yeung A, Trinh NH. Association of Race, Ethnicity and Language with Participation in Mental Health Research Among Adult Patients in Primary Care. J Immigr Minor Health 2017; 17:1660-9. [PMID: 25398517 DOI: 10.1007/s10903-014-0130-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Racial and ethnic minorities remain underrepresented in clinical psychiatric research, but the reasons are not fully understood and may vary widely between minority groups. We used the Z-test of independent proportions and binary logistic regression to examine the relationship between race, ethnicity or primary language and participation in screening as well as interest in further research participation among primary care patients being screened for a depression study. Minorities were less likely than non-Hispanic Whites to complete the initial screening survey. Latinos and Blacks were more likely to agree to be contacted for research than non-Hispanic Whites. Among Latinos, primary language was associated with willingness to be contacted for research. Associations between research participation and race, ethnicity and language are complex and vary across different enrollment steps. Future research should consider stages of the research enrollment process separately to better understand barriers and identify targets for intervention.
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Affiliation(s)
- Trina E Chang
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA.
| | - Charlotte D Brill
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA
| | - Lara Traeger
- Behavioral Medicine Program, Massachusetts General Hospital, Boston, MA, USA
| | - C Andres Bedoya
- Behavioral Medicine Program, Massachusetts General Hospital, Boston, MA, USA
| | - Aya Inamori
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA
| | - Patrick N Hagan
- Center for Community Health Improvement, Massachusetts General Hospital, Boston, MA, USA
| | | | - Katherine Hails
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA
| | - Albert Yeung
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA
| | - Nhi-Ha Trinh
- Depression Clinical and Research Program (DCRP), Massachusetts General Hospital, 1 Bowdoin Square, 6th Fl, Boston, MA, 02114, USA
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Bishop WP, Craddock Lee SJ, Skinner CS, Jones TM, McCallister K, Tiro JA. Validity of Single-Item Screening for Limited Health Literacy in English and Spanish Speakers. Am J Public Health 2016; 106:889-92. [PMID: 26985600 DOI: 10.2105/ajph.2016.303092] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. METHODS We recruited 324 English and 314 Spanish speakers from a community research registry in Dallas, Texas, enrolled between 2009 and 2012. We used 3 screening measures: (1) How would you rate your ability to read?; (2) How confident are you filling out medical forms by yourself?; and (3) How often do you have someone help you read hospital materials? In analyses stratified by language, we used area under the receiver operating characteristic (AUROC) curves to compare each item with the validated 40-item Short Test of Functional Health Literacy in Adults. RESULTS For English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials" (AUROC curve = 0.76 vs 0.65; P = .019). CONCLUSIONS The "ability to read" item performed the best, supporting use as a screening tool in safety-net systems caring for diverse populations. Future studies should investigate how to implement brief measures in safety-net settings and whether highlighting health literacy level influences providers' communication practices and patient outcomes.
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Affiliation(s)
- Wendy Pechero Bishop
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
| | - Simon J Craddock Lee
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
| | - Celette Sugg Skinner
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
| | - Tiffany M Jones
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
| | - Katharine McCallister
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
| | - Jasmin A Tiro
- Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center
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Hall LN, Ficker LJ, Chadiha LA, Green CR, Jackson JS, Lichtenberg PA. Promoting Retention: African American Older Adults in a Research Volunteer Registry. Gerontol Geriatr Med 2016; 2:2333721416677469. [PMID: 28138501 PMCID: PMC5117259 DOI: 10.1177/2333721416677469] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/25/2016] [Accepted: 10/05/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives: The objectives of this study were to evaluate the capability of a research volunteer registry to retain community-dwelling African American older adults, and to explore demographic and health factors associated with retention. Method: A logistic regression model was used to determine the influence of demographics, health factors, and registry logic model activities on retention in a sample of 1,730 older African American adults. Results: Almost 80% of participants active in the volunteer research registry between January 2012 and June 2015 were retained. Employment, being referred to research studies, a higher number of medical conditions, and more follow-up contacts were associated with an increased likelihood of retention. Older age, more months in the registry, and more mobility problems decreased the likelihood of retention. Discussion: These results suggest the Michigan Center for Urban African American Aging Research logic model promotes retention through involving older African American adults in research through study referrals and intensive follow-up. The loss of participants due to age- and mobility-related issues indicate the registry may be losing its most vulnerable participants.
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Prevalent Health Concerns Among African American Women Belonging to a National Volunteer Service Organization (The Links, Incorporated). J Racial Ethn Health Disparities 2015; 4:19-24. [PMID: 27294766 DOI: 10.1007/s40615-015-0195-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/25/2015] [Accepted: 11/27/2015] [Indexed: 01/06/2023]
Abstract
OBJECTIVE African American women bear a disproportionate burden of cardiovascular disease (CVD) and cancer. The purpose of this study was to identify prevalent health concerns among African American women who are members of The Links, Incorporated (Links), a large national service organization with health programming for communities of color. METHODS Survey data (n = 391) were collected during the 2012 Links National Assembly. Twenty-six health issues were presented within five groups: cancer, CVD, pulmonary disease, chronic conditions, and behavioral health. For each issue, women indicated if it was a concern for "you/your family" or "the African American community" via check-boxes. Differences in the proportions for "you/your family" and "the African American community" were evaluated using the McNemar test. RESULTS Hypertension was the most frequently endorsed concern for you/your family (79 %); 73 % indicated this was a concern for the African American community. Sickle cell anemia was the most frequently endorsed concern for the African American community (77 %). Melanoma was the least endorsed health issue overall (15 % you/your family, 55 % community). Breast was the most frequently endorsed cancer concern, while lung was among the least. For 23 out of 26 health issues, the proportion concerned was greater for the "African American community" than for "you/your family" (all p < 0.05). CONCLUSION CVD and breast cancer were salient concerns; both are topics for which national awareness campaigns and Links health programming exist. Comparatively lower concern was observed for melanoma, a cancer with known survival disparities, and for lung cancer, a leading cause of death in women.
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Higashi RT, Craddock Lee SJ, Leonard T, Cuate EL, Cole J, Pruitt SL. Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site. Clin Transl Sci 2015; 8:584-90. [PMID: 26277918 DOI: 10.1111/cts.12325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. METHODS Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. RESULTS Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CONCLUSION CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population.
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Affiliation(s)
- Robin T Higashi
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Simon J Craddock Lee
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, Dallas, Texas, USA
| | - Tammy Leonard
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Economics Department, University of Dallas, Dallas, Texas, USA
| | - Erica L Cuate
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jay Cole
- Crossroads Community Services, Dallas, Texas, USA
| | - Sandi L Pruitt
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, Dallas, Texas, USA
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Bishop WP, Tiro JA, Sanders JM, Craddock Lee SJ, Skinner CS. Effectiveness of a community research registry to recruit minority and underserved adults for health research. Clin Transl Sci 2014; 8:82-4. [PMID: 25354322 DOI: 10.1111/cts.12231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Recruiting minorities and underserved populations into population-based studies is a long standing challenge. This study examined the feasibility of recruiting adults from a community research registry. METHODS Ethnically diverse, bilingual staff attended health fairs, inviting adults to join a registry. We examined rates of successful contact, scheduling, and participation for studies that used the registry. RESULTS Five studies queried 6,886 research registry members (48% Hispanic and 38% black) and attempted to contact 2,301 potentially eligible participants; eligibility criteria varied across studies. We successfully contacted 1,130 members, 51.9% were scheduled to participate and of those, 60.8% completed their study appointment. Non-Hispanic whites were less likely than Hispanics to be interested, but among those scheduling an appointment, participation did not differ by race/ethnicity. CONCLUSION Community research registries are a feasible and efficient method for recruiting minority and underserved adults and may address disparities in access to and participation in health research.
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Affiliation(s)
- Wendy Pechero Bishop
- Division of Behavioral and Communication Sciences, Department of Clinical Sciences, University of Texas Southwestern Medical Center and Harold C. Simmons Cancer Center, Dallas, Texas, USA
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Green MA, Kim MM, Barber S, Odulana AA, Godley PA, Howard DL, Corbie-Smith GM. Connecting communities to health research: development of the Project CONNECT minority research registry. Contemp Clin Trials 2013; 35:1-7. [PMID: 23340183 DOI: 10.1016/j.cct.2013.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 01/09/2013] [Accepted: 01/11/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Prevention and treatment standards are based on evidence obtained in behavioral and clinical research. However, racial and ethnic minorities remain relatively absent from the science that develops these standards. While investigators have successfully recruited participants for individual studies using tailored recruitment methods, these strategies require considerable time and resources. Research registries, typically developed around a disease or condition, serve as a promising model for a targeted recruitment method to increase minority participation in health research. This study assessed the tailored recruitment methods used to populate a health research registry targeting African-American community members. METHODS We describe six recruitment methods applied between September 2004 and October 2008 to recruit members into a health research registry. Recruitment included direct (existing studies, public databases, community outreach) and indirect methods (radio, internet, and email) targeting the general population, local universities, and African American communities. We conducted retrospective analysis of the recruitment by method using descriptive statistics, frequencies, and chi-square statistics. RESULTS During the recruitment period, 608 individuals enrolled in the research registry. The majority of enrollees were African American, female, and in good health. Direct and indirect methods were identified as successful strategies for subgroups. Findings suggest significant associations between recruitment methods and age, presence of existing health condition, prior research participation, and motivation to join the registry. CONCLUSIONS A health research registry can be a successful tool to increase minority awareness of research opportunities. Multi-pronged recruitment approaches are needed to reach diverse subpopulations.
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Affiliation(s)
- Melissa A Green
- Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, USA.
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