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Kuruppu NR, Tobiano G, Ranse K, Abayadeera A, Chaboyer W. Facilitators, barriers and acceptability of implementing a communication board in Sri Lankan intensive care units: A qualitative descriptive study. Intensive Crit Care Nurs 2024; 83:103708. [PMID: 38643605 DOI: 10.1016/j.iccn.2024.103708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/23/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES To explore patients' and nurses' views of potential facilitators, barriers, and prospective acceptability of implementing a communication board in Sri Lankan intensive care units. DESIGN A qualitative, descriptive study. RESEARCH METHODOLOGY Eight patients who received mechanical ventilation and nine nurses who worked in adult medical and surgical intensive care units were purposively selected. Data were collected via audio-taped, semi-structured, face-to-face interviews in January/February 2023. Interview guide questions were informed by the knowledge-to-action framework and the theoretical framework of acceptability. Data were analysed using inductive and deductive content analysis. The 32-item checklist of the consolidated criteria for reporting qualitative research (COREQ) was used to ensure the quality of reporting. SETTING A 3,000 bed Sri Lankan teaching hospital with 18 intensive care units. FINDINGS Four categories reflecting patients' and nurses' anticipated use of the board were found. The first category described patients' and nurses' 'readiness to use the communication board' and their positive attitudes towards it. The second category focused on the 'potential benefits of the communication board', while the third category emphasised the 'individual patient characteristics' that should be taken into consideration when implementing communication boards. The final category described practical aspects related to 'integrating communication boards into routine practice'. CONCLUSION This study demonstrates communication boards may improve communication between ventilated patients and nurses, and they are acceptable to end users. Adopting these tools may be a pivotal step to enhancing patient-centred care in demanding intensive care settings. IMPLICATIONS FOR CLINICAL PRACTICE An inability to communicate effectively with ventilated intensive care patients creates negative experiences for both patients and nurses. Communication boards may act as a medium to better understand patients' needs during mechanical ventilation.Understanding patients' and nurses' views is beneficial when designing patient-centred communication interventions in intensive care units.
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Affiliation(s)
- Nipuna R Kuruppu
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; Department of Nursing, Faculty of Health Sciences, The Open University of Sri Lanka, Nawala, Nugegoda, Sri Lanka.
| | - Georgia Tobiano
- NHMRC CRE in Wiser Wound Care, Griffith University, Queensland, Australia; Nursing and Midwifery Education and Research Unit, Gold Coast Health, Queensland, Australia
| | - Kristen Ranse
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Anuja Abayadeera
- Department of Anaesthesiology and Critical Care, Faculty of Medicine, University of Colombo, Sri Lanka and National Hospital of Sri Lanka, Sri Lanka
| | - Wendy Chaboyer
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; NHMRC CRE in Wiser Wound Care, Griffith University, Queensland, Australia
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Pedro LMR, de Oliveira MF, Pereira MD, da Fonseca AD, Canavarro MC. Factors Associated with Prospective Acceptability and Preferences for Unified Transdiagnostic Cognitive-Behavioral Treatments and Group Therapy in the Portuguese General Population. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01391-1. [PMID: 38839662 DOI: 10.1007/s10488-024-01391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18-88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p < .001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics.
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Affiliation(s)
- Liliana Maria Rodrigues Pedro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal.
| | | | - Marco Daniel Pereira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Ana Dias da Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
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O'Donoghue M, Kennedy N, Forbes J, Murphy CA. Stakeholder Perceptions of the Acceptability of Peer-Mediated Intervention for Minimally Speaking Preschoolers on the Autism Spectrum. J Autism Dev Disord 2024; 54:1774-1791. [PMID: 36859610 PMCID: PMC9977098 DOI: 10.1007/s10803-023-05928-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 03/03/2023]
Abstract
Peer mediated intervention (PMI) is an evidence-based approach to supporting social and communication development for children on the autism spectrum. For PMI to be integrated into everyday practice, it needs to be acceptable to stakeholders. This article engaged with autistic individuals, early childhood educators, parents, and speech and language pathologists on the prospective acceptability of implementing PMI with minimally speaking preschoolers in inclusive preschool settings. Focus groups and semi-structured interviews were conducted. The transcriptions were analyzed qualitatively using reflexive thematic analysis. Stakeholders described PMI as an acceptable intervention approach for this population and provided valuable insights to inform the development and implementation of PMIs. Attention needs to be paid to how to support preschools to adopt a PMI-friendly philosophy.
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Affiliation(s)
- Michelle O'Donoghue
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Norelee Kennedy
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - John Forbes
- Graduate Entry Medical School, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Carol-Anne Murphy
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
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Ekwueme CN, Okeke C, Eze II, Mbachu CO, Onwujekwe O. To what extent did implementing a community-embedded intervention align with the goals and roles of stakeholders in adolescent sexual and reproductive health? Reprod Health 2024; 21:27. [PMID: 38373951 PMCID: PMC10877846 DOI: 10.1186/s12978-024-01753-w] [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: 06/08/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Adolescents' sexual and reproductive health (SRH) needs are largely unmet due to poor access to SRH information and services. A multicomponent community-embedded intervention, comprising advocacy to policymakers and community leaders, training of health workers on the provision of youth-friendly SRH services, and establishment of school health clubs, was implemented in Ebonyi State, Nigeria, to improve access to SRH information and services for adolescents aged 13-18 years in selected communities and secondary schools. This study explored the extent to which the intervention aligned with goals and roles of stakeholders in the State. METHODS Qualitative in-depth interviews (30) were conducted with key stakeholders in adolescent health programming in the State, and community gatekeepers (traditional and religious leaders) in the intervention communities. Sex-disaggregated focus group discussions (10) were conducted with health service providers, parents/guardians of adolescents. Data was analyzed deductively based on fit of strategy and two constructs of the Theoretical Framework for Acceptability - burden, and opportunity cost. The transcripts were coded in NVivo 12, and the subthemes that emerged from each construct were identified. RESULTS Stakeholders perceived the ASRH intervention activities to align with their individual goals of sense of purpose from serving the community and organizational goals of improving the visibility of adolescent reproductive health programs and aligned with their routine work. Hence, implementing or participating in the interventions was not considered a burden by many. Although the delivery of the interventions constituted additional workload and time commitment for the implementers, the benefits of partaking in the intervention were perceived to outweigh the inputs that they were required to make. Some of the community health workers in the intervention felt that provision of financial incentive will help with making the intervention less burdensome. To participate in the intervention, opportunity cost included forgoing work and business activities as well as family commitments. CONCLUSION Findings from the study show that the intervention aligned with individual/organizational goals of stakeholders. To improve acceptability of the ASRH interventions, interventions should leverage on existing programs and routine work of people who will deliver the interventions.
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Affiliation(s)
- Chinazom N Ekwueme
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria.
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Chinyere Okeke
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Irene Ifeyinwa Eze
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, College of Health Sciences, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Chinyere Ojiugo Mbachu
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Nigeria
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Tariq S, Olstad DL, Beall RF, Spackman E, Lipscombe L, Dunn S, Lashewicz BM, Elliott MJ, Campbell DJ. Exploring the prospective acceptability of a healthy food incentive program from the perspective of people with type 2 diabetes and experiences of household food insecurity in Alberta, Canada. Public Health Nutr 2024; 27:e66. [PMID: 38305101 DOI: 10.1017/s1368980024000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE FoodRx is a 12-month healthy food prescription incentive program for people with type 2 diabetes (T2DM) and experiences of household food insecurity. In this study, we aimed to explore potential users' prospective acceptability (acceptability prior to program use) of the design and delivery of the FoodRx incentive and identify factors influencing prospective acceptability. DESIGN We used a qualitative descriptive approach and purposive sampling to recruit individuals who were interested or uninterested in using the FoodRx incentive. Semi-structured interviews were guided by the theoretical framework of acceptability, and corresponding interview transcripts were analysed using differential qualitative analysis guided by the socioecological model. SETTING Individuals living in Alberta, Canada. PARTICIPANTS In total, fifteen adults with T2DM and experiences of household food insecurity. RESULTS People who were interested in using the FoodRx incentive (n 10) perceived it to be more acceptable than those who were uninterested (n 5). We identified four themes that captured factors that influenced users' prospective acceptability: (i) participants' confidence, views and beliefs of FoodRx design and delivery and its future use (intrapersonal), (ii) the shopping routines and roles of individuals in participants' social networks (interpersonal), (iii) access to and experience with food retail outlets (community), and (iv) income and food access support to cope with the cost of living (policy). CONCLUSION Future healthy food prescription programs should consider how factors at all levels of the socioecological model influence program acceptability and use these data to inform program design and delivery.
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Affiliation(s)
- Saania Tariq
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Reed F Beall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Eldon Spackman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Lorraine Lipscombe
- Department of Medicine, Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Bonnie M Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Meghan J Elliott
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - David Jt Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
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Chen W, Graham ID, Hu J, Lewis KB, Gifford W. Nurse managers' perceptions of the prospective acceptability of an implementation leadership training programme: A qualitative descriptive study. J Adv Nurs 2024. [PMID: 38186229 DOI: 10.1111/jan.16047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
AIM To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence-based practices, from the perspectives of potential programme participants and deliverers. DESIGN A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. METHODS We conducted individual semi-structured interviews with unit-level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. RESULTS After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi-modal training activities such as group work, experience-sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID-19 pandemic, and support from senior organizational leadership. CONCLUSIONS The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. IMPACT The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally.
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Affiliation(s)
- Wenjun Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jiale Hu
- Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Eze II, Okeke C, Ekwueme C, Mbachu CO, Onwujekwe O. Acceptability of a community-embedded intervention for improving adolescent sexual and reproductive health in south-east Nigeria: A qualitative study. PLoS One 2023; 18:e0295762. [PMID: 38096148 PMCID: PMC10721091 DOI: 10.1371/journal.pone.0295762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Adolescents have limited access to quality sexual and reproductive health (SRH) services that are key to healthy sexual lives in many low and middle-income countries such as Nigeria. Hence, context-specific interventions are required to increase adolescents' access to and utilisation of SRH. This paper provides new knowledge on the acceptability of a community-embedded intervention to improve access to SRH information and services for adolescents in Ebonyi state, southeast Nigeria. METHODS A community-embedded intervention was implemented for six months in selected communities. Thereafter the intervention was assessed for its acceptability using a total of 30 in-depth interviews and 18 focus group discussions conducted with policymakers, health service providers, school teachers, community gatekeepers, parents and adolescents who were purposively selected as relevant stakeholders on adolescent SRH. The interview transcripts were coded in NVivo 12 using a coding framework structured according to four key constructs of the theoretical framework for acceptability (TFA): affective attitude, intervention coherence, perceived effectiveness, and self-efficacy. The outputs of the coded transcripts were analysed, and the emergent themes from each of the four constructs of the TFA were identified. RESULTS The intervention was acceptable to the stakeholders, from the findings of its positive effects, appropriateness, and positive impact on sexual behaviour. Policymakers were happy to be included in collaborating with multiple stakeholders to co-create multi-faceted interventions relevant to their work (positive affective attitude). The stakeholders understood how the interventions work and perceived them as appropriate at individual and community levels, with adequate and non-complex tools adaptable to different levels of stakeholders (intervention coherence). The intervention promoted mutualistic relations across stakeholders and sectors, including creating multiple platforms to reach the target audience, positive change in sexual behaviour, and cross-learning among policymakers, community gatekeepers, service providers, and adolescents (intervention effectiveness), which empowered them to have the confidence to provide and access SRH information and services (self-efficacy). CONCLUSIONS Community-embedded interventions were acceptable as strong mechanisms for improving adolescents' access to SRH in the communities. Policymakers should promote the community-embedded strategy for holistic health promotion of adolescents.
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Affiliation(s)
- Irene Ifeyinwa Eze
- Department of Community Medicine, College of Health Sciences Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chinyere Okeke
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Health Sciences, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chinazom Ekwueme
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Health Sciences, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chinyere Ojiugo Mbachu
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Health Sciences, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
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Paynter C, McDonald C, Story D, Francis JJ. Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights. Br J Health Psychol 2023; 28:1153-1168. [PMID: 37353989 DOI: 10.1111/bjhp.12677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research. METHOD Acceptability was assessed in a consecutive sample of 15 patients at least 3 months post-joint replacement surgery via theory-informed semi-structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings. RESULTS Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled 'perceived safety and risk', and relabelling and redefining an existing construct (new label: 'opportunity costs and gains'). Methodological recommendations for theory-informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis. CONCLUSION The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory-informed interview studies.
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Affiliation(s)
- Camille Paynter
- Department of Critical Care, Faculty Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Victoria, Australia
- School of Health Sciences, Faculty Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Cassie McDonald
- Department of Critical Care, Faculty Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Victoria, Australia
- School of Health Sciences, Faculty Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Allied Health, Alfred Health, Melbourne, Victoria, Australia
| | - David Story
- Department of Critical Care, Faculty Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Victoria, Australia
| | - Jill J Francis
- School of Health Sciences, Faculty Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
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Deegan O, Fullen BM, Hearty C, Doody CM. Acceptability of the combined online interactive mindfulness and exercise programme (MOVE-Online) for adults with chronic pain - A qualitative study. Disabil Rehabil 2023:1-13. [PMID: 37886895 DOI: 10.1080/09638288.2023.2274875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE The aim of this qualitative study was to utilise the recent Theoretical Framework of Acceptability (TFA) to explore participants' acceptability of the mindfulness and exercise interventions in the MOVE-Online pain management programme (PMP) and the programmes' online delivery method. METHODS Online focus groups were carried out following the completion of the PMP. The data were analysed using template analysis in terms of the seven TFA constructs of acceptability [(i) Perceived Effectiveness, (ii) Affective Attitude, (iii) Self-Efficacy, (iv) Ethicality, (v) Burden, (vi) Opportunity Costs and (vii) Intervention Coherence]. RESULTS Twenty-one participants took part in the focus groups. Five of the seven TFA constructs of acceptability were identified in the analysis. The participants perceived the intervention to have been effective at achieving the goals of the PMP (TFA construct: (i) Perceived Effectiveness), to have supported their emotional management ((ii) Affective Attitude), promoted long term self-directed engagement ((iii) Self-Efficacy), fostered a valued group environment ((iv) Ethicality) and the online delivery of the programme reduced the physical burden associated with participation at an in-person PMP ((v) Burden). CONCLUSION The results of the study supports the utility of the TFA as a tool to explore the multi-dimensional construct of acceptability for the participants in the MOVE-Online programme.
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Affiliation(s)
- Orla Deegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Conor Hearty
- Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Catherine M Doody
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Musanje K, Kamya MR, Kasujja R, Hooper N, Katahoire AR, White RG, Kimera E, Getahun M, Sinclair DL, Ojiambo D, Camlin CS. Acceptability of an adapted mindfulness and acceptance-based intervention to support adolescents with HIV: A qualitative study with Ugandan health care providers. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 29:160-168. [PMID: 37519920 PMCID: PMC10373499 DOI: 10.1016/j.jcbs.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
While the adaptation of evidence-based psychosocial support tailors the intervention components to the targeted context, minimizing the associated costs of developing new interventions for low-income contexts, the acceptability of such adapted interventions is important for augmenting successful implementation and sustainability. Given that psychosocial support to persons living with HIV is mostly rendered by healthcare providers, their acceptance of adapted interventions before implementation is crucial. This study explored healthcare providers' acceptance of an adapted mindfulness and acceptance-based intervention supporting adolescents with HIV. Ten healthcare providers at two urban clinics in Kampala, Uganda attended a three-day training on using the adapted intervention and gave feedback on its appropriateness during in-depth interviews conducted thereafter. Semi-structured interviews were based on the Theoretical Framework of Acceptability and findings were analyzed abductively within the seven components of the framework. Overall, the adapted intervention was perceived to be acceptable and appropriate for use with adolescents. Benefits included the intervention offering support beyond a focus on adherence to drugs, refocusing adolescents on aspects in their lives that matter most, and being easy to integrate into providers' work processes. Providers however expressed concern about the time the intervention requires and the possibility of increasing their workload. These findings will support further adaptation and implementation.
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Affiliation(s)
- Khamisi Musanje
- Department of Educational, Social and Organizational Psychology, Makerere University, Uganda
- Clinical Epidemiology Unit, Makerere University, Uganda
| | | | - Rosco Kasujja
- Department of Mental Health and Community Psychology, Makerere University, Uganda
| | - Nic Hooper
- School of Psychology, Cardiff University, Wales, UK
| | | | - Ross G. White
- School of Psychology, Queens University, Belfast, Northern Ireland
| | - Emanuel Kimera
- Department of Public Health, Mountain of the Moon University, Uganda
| | - Monica Getahun
- Institute for Global Health Sciences, University of California, San Francisco, USA
| | | | - Deborah Ojiambo
- Department of Mental Health and Community Psychology, Makerere University, Uganda
| | - Carol S. Camlin
- Department of Obstetrics, Gynecology & Reproductive Sciences. University of California, San Francisco, USA
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Hosking R, O’Connor SY, Wangdi K, Kurscheid J, Lal A. Acceptability measures of water, sanitation and hygiene interventions in low- and middle-income countries, a systematic review. PLoS Negl Trop Dis 2022; 16:e0010702. [PMID: 36094954 PMCID: PMC9499221 DOI: 10.1371/journal.pntd.0010702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/22/2022] [Accepted: 07/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Inadequate access to water, sanitation, and hygiene (WASH) is an environmental risk factor for poor health outcomes globally, particularly for children in low- and middle-income countries (LMIC). Despite technological advancements, many interventions aimed at improving WASH access return less than optimal results on long term impact, efficacy and sustainability. Research focus in the ‘WASH sector’ has recently expanded from investigating ‘which interventions work’ to ‘how they are best implemented’. The ‘acceptability’ of an intervention is a key component of implementation that can influence initial uptake and sustained use. Acceptability assessments are increasingly common for health interventions in clinical settings. A broad scale assessment of how acceptability has been measured in the WASH sector, however, has not yet been conducted.
Methods/Principal findings
We conducted a systematic literature review of intervention studies published between 1990 and 2021 that evaluated the acceptability of WASH interventions in LMIC settings. Using an implementation science approach, focused outcomes included how acceptability was measured and defined, and the timing of acceptability assessment. We conducted quality assessment for all included studies using the Cochrane Risk of Bias tool for randomised studies, and the Newcastle-Ottawa Scale for non-randomised studies.
Of the 1238 records; 36 studies were included for the analysis, 22 of which were non-randomized interventions and 16 randomized or cluster-randomized trials. We found that among the 36 studies, four explicitly defined their acceptability measure, and six used a behavioural framework to inform their acceptability study design. There were few acceptability evaluations in schools and healthcare facilities. While all studies reported measuring WASH acceptability, the measures were often not comparable or described.
Conclusions
As focus in WASH research shifts towards implementation, a consistent approach to including, defining, and measuring acceptability is needed.
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Affiliation(s)
- Rose Hosking
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Acton, Australia
| | - Suji Y O’Connor
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Acton, Australia
| | - Kinley Wangdi
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Acton, Australia
| | - Johanna Kurscheid
- Swiss Tropical and Public Health Institute, Associate Institute of University of Basel, Allschwil, Switzerland
| | - Aparna Lal
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Acton, Australia
- * E-mail:
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Fox MT, Sidani S, Zaheer S, Butler JI. Healthcare consumers' and professionals' perceived acceptability of evidence-based interventions for rural transitional care. Worldviews Evid Based Nurs 2022; 19:388-395. [PMID: 35876254 DOI: 10.1111/wvn.12599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND There is a pressing need for high quality hospital-to-home transitional care in rural communities. Four evidence-based interventions (discharge planning, treatments, warning signs, and physical activity) have the potential to improve rural transitional care. However, there is limited understanding of how the perceptions of healthcare consumers and professionals compare on the acceptability of the interventions. Convergent views on intervention acceptability support implementation, whereas divergent views highlight areas requiring reconciliation prior to implementation. AIMS This study compared the acceptability of four evidence-based interventions proposed for rural transitional care, as perceived by healthcare consumers and professionals. METHODS A cross-sectional, comparative design was used. The convenience sample included 36 healthcare consumers (20 patients and 16 family caregivers) who had experienced a hospital-to-home transition in the past month and 30 healthcare professionals (29 registered nurses and one nurse practitioner) who provided transitional care in rural Ontario, Canada. Participants were presented with descriptions of the four interventions and completed an established intervention acceptability measure. Presentation of the four intervention descriptions and respective acceptability measures was randomized to control for possible order effects. The perceived overall acceptability of the interventions and their attributes (i.e., effectiveness, appropriateness, risk, and convenience) were compared using independent samples t-tests. RESULTS Consumer ratings were consistently higher across all four interventions in terms of overall acceptability as well as effectiveness, appropriateness, and convenience (all p's < .01; effect sizes 0.70-1.13). No significant between-group differences in perceived risk were found. LINKING EVIDENCE TO ACTION Contextual and methodological differences may account for variability in ratings, but further research is needed to explore these propositions. The results support future qualitative inquiry targeting professionals to better understand their perspectives on the effectiveness, appropriateness, and convenience of the four interventions.
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Affiliation(s)
- Mary T Fox
- York University Centre for Aging Research and Education, School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Souraya Sidani
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada
| | - Shahram Zaheer
- York University Centre for Aging Research and Education, School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Jeffrey I Butler
- York University Centre for Aging Research and Education, School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada.,Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Lawes-Wickwar S, McBain H, Brini S, Hirani SP, Hurt CS, Flood C, Dunlop N, Solly D, Crampton B, Newman SP, Ezra DG. A patient-initiated treatment model for blepharospasm and hemifacial spasm: a randomized controlled trial. BMC Neurol 2022; 22:99. [PMID: 35300599 PMCID: PMC8928587 DOI: 10.1186/s12883-022-02603-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background To test, in a two-arm, single center, superiority, randomized controlled trial, the effectiveness of and costs associated with a patient-initiated treatment model for people with hemifacial spasm (HFS) and blepharospasm (BEB) in comparison to usual care. Methods One hundred and thirty patients with HFS or BEB, aged 18 years or over, were recruited from a nurse-led botulinum toxin type A clinic at an eye hospital in the United Kingdom (UK), completed baseline measures and were randomized (1:1). The intervention group determined their own botulinum toxin type A (BoNT/A) treatment schedule during the trial period (9 months) and received an information leaflet with a “hotline” number to book an appointment. Usual care appointments were scheduled by treating clinicians. Data analysts were blind to study group. The primary outcomes were disease severity and functional disability, as measured by the Jankovic Rating Scale and Blepharospasm Disability Index, respectively. Secondary outcomes included quality of life, anxiety and depression, satisfaction with care, confidence in the service, economic costs and employment days lost. Results Sixty-five patients were randomized to each group. The intervention demonstrated no statistically significant difference to usual care for any of primary outcomes. On secondary outcomes the levels of anxiety differed significantly (F2, 142.39 = 1.65, p = 0.02), with the intervention arm exhibiting a decrease and the control arm an increase (Hedges’ g = − 0.26 [99% CI -0.83, 0.32]). No other statistically significant differences were found for secondary outcomes. Overall healthcare costs and costs to the patient were on average £198.95 less (95% CI -£256.76, £654.67; p = 0.10) per participant for those in the intervention compared to usual care, although this finding was not significant. Conclusions We did not observe differences between the patient-initiated treatment model and usual care for people with BEB or HFS, on any primary outcome measure, quality of life, or depression. The patient-initiated treatment model may, however, have the potential to save healthcare costs and reduce anxiety. Patients using this new model were also equally as satisfied in the service and confident in their care as those receiving treatment as usual. Trial registration
Clinicaltrials.gov ID NCT02577224, 16th October 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02603-7.
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Affiliation(s)
- Sadie Lawes-Wickwar
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK. .,University College London, Institute of Epidemiology and Health Care, London, UK.
| | - Hayley McBain
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK
| | - Stefano Brini
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK
| | - Shashivadan P Hirani
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK
| | - Catherine S Hurt
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK
| | - Chris Flood
- London South Bank University, School of Health and Social Care, London, UK
| | - Nicola Dunlop
- Moorfields Eye Hospital NHS Foundation Trust, Adnexal Department, London, UK
| | | | | | - Stanton P Newman
- City, University of London, School of Health Sciences, 10 Northampton Square, London, EC1V 0HB, UK
| | - Daniel G Ezra
- Moorfields Eye Hospital NHS Foundation Trust, Adnexal Department, London, UK
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She H, Man Y. Anticipatory Burden in Adult-Child Caregivers: A Concept Analysis. Healthcare (Basel) 2022; 10:healthcare10020356. [PMID: 35206970 PMCID: PMC8872093 DOI: 10.3390/healthcare10020356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/06/2023] Open
Abstract
This study aims to analyze the concept of anticipatory burden in adult-child caregivers. A systematic literature review was performed using four databases, Pubmed, CINAHL, PsycINFO and Medline, with the keywords of “anticipatory burden” and “anticipated burden”. Simplified Wilson’s classic concept analysis modified by Walker and Avant was employed to identify the attributes, antecedents and consequences of anticipatory burden in the adult-child caregivers. Eighteen articles were analyzed. Attributes of anticipatory burden in adult-child caregivers were found to be: (1) subjective burden, (2) anticipation, (3) overestimation, (4) inability, and (5) family relationship. Antecedents were identified as: (1) potential care recipients, (2) caregiving willingness, and (3) a lack of resources. Consequences included: (1) prediction of caregiving willingness, (2) impacts on caregivers’ health, (3) intervention promotion, and (4) behavioral changes. As the adult-child caregiver is one of the main types of family caregivers for the fast-growing aging population, it is important to understand the attributes, antecedents, and consequences of their anticipatory burden. Based on the results of this study, resources such as intervention, policy, and counseling services are recommended to help adult-child caregivers lower their anticipatory burden and get better prepared for providing family care.
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Affiliation(s)
- Hangying She
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
- Correspondence:
| | - Yuncheng Man
- Case School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA;
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15
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Bartlett YK, Kenning C, Crosland J, Newhouse N, Miles LM, Williams V, McSharry J, Locock L, Farmer AJ, French DP. Understanding acceptability in the context of text messages to encourage medication adherence in people with type 2 diabetes. BMC Health Serv Res 2021; 21:608. [PMID: 34182988 PMCID: PMC8240254 DOI: 10.1186/s12913-021-06663-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/11/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Acceptability is recognised as a key concept in the development of health interventions, but there has been a lack of consensus about how acceptability should be conceptualised. The theoretical framework of acceptability (TFA) provides a potential tool for understanding acceptability. It has been proposed that acceptability measured before use of an intervention (anticipated acceptability) may differ from measures taken during and after use (experienced acceptability), but thus far this distinction has not been tested for a specific intervention. This paper 1) directly compares ratings of anticipated and experienced acceptability of a text message-based intervention, 2) explores the applicability of the TFA in a technology-based intervention, and 3) uses these findings to inform suggestions for measuring acceptability over the lifespan of technology-based health interventions. METHODS Data were obtained from a quantitative online survey assessing anticipated acceptability of the proposed text messages (n = 59) and a 12-week proof-of-concept mixed methods study assessing experienced acceptability while receiving the text messages (n = 48). Both quantitative ratings by return text message, and qualitative data from participant interviews were collected during the proof-of-concept study. RESULTS The quantitative analysis showed anticipated and experienced acceptability were significantly positively correlated (rs > .4). The qualitative analysis identified four of the seven constructs of the TFA as themes (burden, intervention coherence, affective attitude and perceived effectiveness). An additional two themes were identified as having an important impact on the TFA constructs (perceptions of appropriateness and participants' role). Three suggestions are given related to the importance of appropriateness, what may affect ratings of acceptability and what to consider when measuring acceptability. CONCLUSIONS The high correlation between anticipated and experienced acceptability was a surprising finding and could indicate that, in some cases, acceptability of an intervention can be gauged adequately from an anticipated acceptability study, prior to an expensive pilot or feasibility study. Directly exploring perceptions of appropriateness and understanding whether the acceptability described by participants is related to the intervention or the research - and is for themselves or others - is important in interpreting the results and using them to further develop interventions and predict future use.
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Affiliation(s)
- Y Kiera Bartlett
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Cassandra Kenning
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jack Crosland
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
| | - Nikki Newhouse
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lisa M Miles
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
| | | | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Republic of Ireland
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
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