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Martei YM, Mokokwe L, Ngwako N, Kebuang K, Setlhako DI, Gabaatlhole G, Baaitse B, Segadimo T, Shulman LN, Barg F, Gaolebale BE. Development, acceptability and usability of culturally appropriate survivor narrative videos for breast cancer treatment in Botswana: a pilot study. BMJ Open 2024; 14:e073867. [PMID: 38296302 PMCID: PMC10828869 DOI: 10.1136/bmjopen-2023-073867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 12/14/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES Narrative communication has demonstrated effectiveness in promoting positive health behaviours, delivering support and coping with complex decision-making. Formal research evaluating this intervention for cancer treatment in Africa is lacking. We aimed to develop, and assess acceptability and usability of survivor video narrative interventions for breast cancer treatment in Botswana. DESIGN A pilot study design. SETTING Single-centre, tertiary hospital, sub-Saharan Africa. PARTICIPANTS Eight women, ≥18 years old, with stages I-III breast cancer were enrolled for the video intervention. 106 women, ≥18 years old, with stages I-IV breast cancer viewed the narrative videos and 98 completed the acceptability and usability surveys. INTERVENTION Survivor narrative videos were developed using the theory of planned behaviour and using a purposive sample of Batswana, Setswana-speaking, breast cancer survivors, who had completed systemic treatment and surgery with high rates of adherence to the prescribed treatment plan. PRIMARY OUTCOMES We assessed acceptability and usability among prospectively enrolled patients presenting for routine breast cancer care at Princess Marina Hospital in Botswana, using a 13-item survey. RESULTS Participants expressed high acceptability and usability of the videos, including 99% (97/98) who strongly agreed/agreed that the video presentations were easy to understand, 92% (90/98) who would recommend to other survivors and 94% (92/98) who wished there were more videos. Additionally, 89% (87/98) agreed or strongly agreed that the one-on-one instruction on how to use the tablet was helpful and 87% (85/98) that the video player was easy to use. CONCLUSION Culturally appropriate survivor video narratives have high acceptability and usability among patients with breast cancer in Botswana. There is an opportunity to leverage this intervention in routine breast cancer care for treatment support. Future studies will test the implementation and effectiveness of narrative videos on a wider scale, including for patients being treated for other cancers.
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Affiliation(s)
- Yehoda M Martei
- Department of Medicine (Hematology - Oncology Division), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lebogang Mokokwe
- Botswana University of Pennsylvania Partnership, Gaborone, Botswana
- University of Botswana, Gaborone, Botswana
| | | | | | | | | | | | | | - Lawrence N Shulman
- Department of Medicine (Hematology - Oncology Division), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Frances Barg
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Medical Society of Delaware. Dela J Public Health 2022; 8:13. [PMID: 36751618 PMCID: PMC9894032 DOI: 10.32481/djph.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Abstract
Objective Storytelling is an engaging approach for promoting health and wellness among individuals with health conditions including type 2 diabetes (TTDM), breast cancer, and hypertension. Storytelling interventions are an evidence-based approach that has been effective in promoting behavioral change such as increasing physical activity, medication adherence, and making dietary changes. The use of storytelling to convey health information and promote behavior change is associated with increased engagement in self-management particularly in communities of color. The primary objective of this paper was to describe our process for developing the storytelling study; specifically, recruitment, screening, selecting storytellers, and developing a study-specific interactive website. The secondary objective was to describe the approach for conducting the feasibility study and conduct a 6-week web-based storytelling study. Methods Between 2017 to 2020, we developed a storytelling study for African Americans with hypertension. During that period we recruited participants from a Federally Qualified Health Center, a local church, and at community events. We selected storytellers to share their experiences managing hypertension and filmed 10 storytellers. Presently, a feasibility and pilot study are underway, the goal of the feasibility study is to ascertain feedback about the stories and the study website from African American adults with hypertension. We will also conduct a 6-week pilot study with 30 African American adults to see if conducting a storytelling study online would be an effective approach for promoting behavioral change. Conclusions We successfully recruited and filmed 10 storytellers and produced 9 stories about living with and managing hypertension. The feedback we received from participants in the feasibility and pilot study will be useful as we refine the design of the study to determine the potential for a future randomized controlled trial (RCT).
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Shaffer VA, Brodney S, Gavaruzzi T, Zisman-Ilani Y, Munro S, Smith S, Thomas E, Valentine KD, Bekker HL. Do Personal Stories Make Patient Decision Aids More Effective? An Update from the International Patient Decision Aids Standards. Med Decis Making 2021; 41:897-906. [PMID: 34027739 DOI: 10.1177/0272989x211011100] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This article evaluates the evidence for the inclusion of patient narratives in patient decision aids (PtDAs). We define patient narratives as stories, testimonials, or anecdotes that provide illustrative examples of the experiences of others that are relevant to the decision at hand. METHOD To evaluate the evidence for the effectiveness of narratives in PtDAs, we conducted a narrative scoping review of the literature from January 2013 through June 2019 to identify relevant literature published since the last International Patient Decision Aid Standards (IPDAS) update in 2013. We considered research articles that examined the impact of narratives on relevant outcomes or described relevant theoretical mechanisms. RESULTS The majority of the empirical work on narratives did not measure concepts that are typically found in the PtDA literature (e.g., decisional conflict). Yet, a few themes emerged from our review that can be applied to the PtDA context, including the impact of narratives on relevant outcomes (knowledge, behavior change, and psychological constructs), as well as several theoretical mechanisms about how and why narratives work that can be applied to the PtDA context. CONCLUSION Based on this evidence update, we suggest that there may be situations when narratives could enhance the effectiveness of PtDAs. The recent theoretical work on narratives has underscored the fact that narratives are a multifaceted construct and should no longer be considered a binary option (include narratives or not). However, the bottom line is that the evidence does not support a recommendation for narratives to be a necessary component of PtDAs.
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Affiliation(s)
- Victoria A Shaffer
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Suzanne Brodney
- Division of Internal Medicine, Massachusetts General Hospital, Padova, Veneto, Italy
| | - Teresa Gavaruzzi
- Department of Developmental Psychology and Socialization, Universita degli Studi di Padova Scuola di Psicologia, Padova, Veneto, Italy
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Sian Smith
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Elizabeth Thomas
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | | | - Hilary L Bekker
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
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Anastasi N, Lusher J. The impact of breast cancer awareness interventions on breast screening uptake among women in the United Kingdom: A systematic review. J Health Psychol 2017; 24:113-124. [PMID: 28810435 DOI: 10.1177/1359105317697812] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The impact of breast screening awareness campaigns on mammography attendance among British women was explored. British Nursing Index, Medline, PsycINFO, Embase and Cumulative Index to Nursing and Allied Health were searched between October 2012 and February 2013. Searches identified research on breast cancer awareness interventions and breast self-examination. In total, 867 articles were identified and 14 met criteria for review. Breast cancer awareness interventions were found to increase the uptake of breast self-examination behaviours and increase the likelihood of breast cancer screening attendance. Predicting the impact of these interventions on survivability and general morbidity/mortality outcomes remains a challenge due to a shortage of suitably evaluated campaigns.
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Lyons EJ, Baranowski T, Basen-Engquist KM, Lewis ZH, Swartz MC, Jennings K, Volpi E. Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial. BMC Cancer 2016; 16:202. [PMID: 26960972 PMCID: PMC4784467 DOI: 10.1186/s12885-016-2244-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 03/02/2016] [Indexed: 01/02/2023] Open
Abstract
Background Physical activity reduces risk for numerous negative health outcomes, but postmenopausal breast cancer survivors do not reach recommended levels. Many interventions encourage self-monitoring of steps, which can increase physical activity in the short term. However, these interventions appear insufficient to increase motivation for sustained change. There is a need for innovative strategies to increase physical activity motivation in this population. Narratives are uniquely persuasive, and video games show promise for increasing motivation. This study will determine the effectiveness of an intervention that combines narrative and gaming to encourage sustained physical activity. Methods/Design SMARTGOAL (Self-Monitoring Activity: a Randomized Trial of Game-Oriented AppLications) is a randomized controlled intervention trial. The intervention period is six months, followed by a six month maintenance period. Participants (overweight, sedentary postmenopausal breast cancer survivors aged 45–75) will be randomized to a self-monitoring group or an enhanced narrative game group. The self-monitoring group will be encouraged to use a mobile application for self-monitoring and feedback and will receive 15 counseling phone calls emphasizing self-regulation. The narrative game group will be encouraged to use a mobile application that includes self-monitoring and feedback as well as a narrative-based active video game. The 15 calls for this group will emphasize concepts related to the game storyline. Counseling calls in both groups will occur weekly in months 1 – 3 and monthly in months 4 – 6. No counseling calls will occur after month 6, but both groups will be encouraged to continue using their apps. The primary outcome of the study is minutes of moderate to vigorous physical activity at six months. Other objectively measured outcomes include fitness and physical function. Self-reported outcomes include quality of life, depression, and motivation. Discussion This protocol will result in implementation and evaluation of two technology-based physical activity interventions among breast cancer survivors. Both interventions hold promise for broad dissemination. Understanding the potential benefit of adding narrative and game elements to interventions will provide critical information to interventionists, researchers, clinicians, and policymakers. This study is uniquely suited to investigate not just whether but how and why game elements may improve breast cancer survivors’ health. Trial registration clinicaltrials.gov NCT02341235 (January 9, 2015) Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2244-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elizabeth J Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1124, USA.
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, USA
| | - Karen M Basen-Engquist
- Department of Behavioral Science and Center for Energy Balance in Cancer Prevention and Survivorship, M.D. Anderson Cancer Center, 1155 Pressler St, Houston, TX, 77030, USA
| | - Zakkoyya H Lewis
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Maria C Swartz
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Kristofer Jennings
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Elena Volpi
- Department of Geriatrics and Claude D. Pepper Older Americans Independence Center, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
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Moran MB, Frank LB, Chatterjee JS, Murphy ST, Baezconde-Garbanati L. A pilot test of the acceptability and efficacy of narrative and non-narrative health education materials in a low health literacy population. JOURNAL OF COMMUNICATION IN HEALTHCARE 2016; 9:40-48. [PMID: 27872657 PMCID: PMC5115781 DOI: 10.1080/17538068.2015.1126995] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although entertainment-education narratives are increasingly being used to communicate health information to a diversity of populations, there is limited evidence examining the use of narrative health education videos in low compared with adequate health literacy populations. There are also very few studies directly comparing narrative materials to more traditional, non-narrative materials. Because individuals with low health literacy are less likely than those with adequate health literacy to benefit from health communication interventions, it is especially important to develop an evidence base supporting the use of narrative health education materials in low literacy populations. This study extends knowledge on the use of narrative health education materials in populations with low health literacy by conducting a randomized trial comparing the acceptability and efficacy (knowledge gain) of two fact-equivalent films, one in a narrative and one in a non-narrative format, on individuals with adequate and low health literacy. This study finds that while both films were well-accepted and produced knowledge gains, the narrative film was more effective in this regard. This effect occurred regardless of health literacy level, indicating that narrative health communication materials are appropriate for individuals with low health literacy and do not exacerbate existing health disparities. These findings add to a small but growing body of evidence testing narrative health education materials in individuals with low health literacy, and provide new evidence supporting narrative, entertainment-education style video as a health communication tool to help reduce health literacy-related health disparities.
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Affiliation(s)
- Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 20005 USA
| | - Lauren B. Frank
- Department of Communication, Portland State University, Portland, OR 97201, USA
| | - Joyee S. Chatterjee
- Annenberg School for Communication & Journalism, University of Southern California, Los Angeles, CA 90089, USA
| | - Sheila T. Murphy
- Annenberg School for Communication & Journalism, University of Southern California, Los Angeles, CA 90089, USA
| | - Lourdes Baezconde-Garbanati
- Institute for Health Promotion & Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
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Stalker C, Elander J. Effects of a pain self-management intervention combining written and video elements on health-related quality of life among people with different levels of education. J Pain Res 2015; 8:581-90. [PMID: 26316809 PMCID: PMC4548759 DOI: 10.2147/jpr.s85741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Combining written and video material could increase the impact of health education for people with less education, but more evidence is needed about the impact of combined materials in different formats, especially in the context of chronic pain self-management. This study tested the impact of combining written information about self-managing chronic joint pain, which used language at a high reading level, with a DVD containing narrative video material presented directly by patients, using language at a lower reading level. Physical and mental health-related quality of life (36-Item Short Form Health Survey) was measured among 107 men with hemophilia before and 6 months after being randomly assigned to receive an information booklet alone or the booklet plus the DVD. Analysis of covariance was used to compare health outcomes between randomized groups at follow-up, using the baseline measures as covariates, with stratified analyses for groups with different levels of education. The DVD significantly improved mental health-related quality of life among those with only high school education. Video material could therefore supplement written information to increase its impact on groups with less education, and combined interventions of this type could help to achieve health benefits for disadvantaged groups who are most in need of intervention.
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Affiliation(s)
- Carol Stalker
- Centre for Psychological Research, Department of Life Sciences, University of Derby, Derby, UK
| | - James Elander
- Centre for Psychological Research, Department of Life Sciences, University of Derby, Derby, UK
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Thompson T, Kreuter MW. Using written narratives in public health practice: a creative writing perspective. Prev Chronic Dis 2014; 11:E94. [PMID: 24901794 PMCID: PMC4049201 DOI: 10.5888/pcd11.130402] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Narratives have become an increasingly common health communication tool in recent years. Vivid, engaging writing can help audiences identify with storytellers and understand health messages, but few public health practitioners are trained to create such stories. A transdisciplinary perspective, informed by both creative writing advice and evidence-based public health practices, can help public health professionals use stories more effectively in their work. This article provides techniques for creating written narratives that communicate health information for chronic disease prevention. We guide public health professionals through the process of soliciting, writing, and revising such stories, and we discuss challenges and potential solutions.
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Affiliation(s)
- Tess Thompson
- Washington University in St Louis, One Brookings Dr, Brown School of Social Work, Campus Box 1196, St Louis, MO 63130. E-mail:
| | - Matthew W Kreuter
- Washington University in St Louis, Health Communication Research Laboratory, St Louis, Missouri
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Kreuter MW, McBride TD, Caburnay CA, Poor T, Thompson VLS, Alcaraz KI, Eddens KS, Rath S, Perkins H, Casey C. What can health communication science offer for ACA implementation? Five evidence-informed strategies for expanding Medicaid enrollment. Milbank Q 2014; 92:40-62. [PMID: 24597555 DOI: 10.1111/1468-0009.12040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage. METHODS From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA. FINDINGS We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps. CONCLUSIONS Health communication science can inform the development and execution of strategies to increase the public's understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory, Washington University in St. Louis; Brown School of Social Work, Washington University in St. Louis
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User Engagement with Mental Health Videos on YouTube. JOURNAL OF THE CANADIAN HEALTH LIBRARIES ASSOCIATION 2013. [DOI: 10.5596/c13-057] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Mental health is a primary determinant of well-being, and as more people look online for mental health information, YouTube is an increasingly important information source. Although authoritative organizations such as the World Health Organization post videos to YouTube, when retrieved these videos are interspersed with personal, commercial, governmental, television or other media segments, and institutional videos. YouTube was searched for videos on mental health to measure user engagement with these videos. It was hypothesized that videos posted to YouTube that contained personal narratives would generate more user engagement in terms of more video view counts, likes, and number of comments. Methods: YouTube was searched for mental health information using three different search terms and phrases: “depression,” “bipolar disorder,” and “mental health.” The first 20 results for the terms depression and bipolar disorder were screen captured and for the search phrase mental health the first 40 videos were screen captured. All 80 videos were categorized according to video producer type and analyzed using YouTube metrics including number of “likes,” view counts, and comments to measure user engagement with the videos. Results: The majority of videos returned in the top results were posted by laypersons and the videos focus on the poster's personal experience (38%) followed by videos produced for television and other media (29%). Videos that contain personal narratives and experiential knowledge generate the most user engagement and are preferred sources for users searching for mental health information. Discussion: Users’ greater engagement with personal videos indicates that there is an important role for librarians and information professionals in assisting users in deciding what mental health information is accurate, authoritative, and reliable regardless of the authority of the video producer. In addition, the results of this research might inform best practices for professional organizations posting videos to YouTube.
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Baranowski MT, Lu AS, Buday R, Lyons EJ, Schell J, Russoniello C. Stories in Games for Health: More Pros or Cons? Games Health J 2013. [PMID: 26196925 DOI: 10.1089/g4h.2013.0052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There has been a debate about whether entertainment videogames should incorporate story or narrative. A concern has been whether story cut scenes break game immersion, and thereby minimize the fun of gameplay. Alternatively, games for health (G4H) have an agenda that goes beyond just having fun. The possible role of story in G4H has not been thoroughly addressed. We have assembled a group of experts who have worked with stories in G4H, and asked some pointed questions.
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Affiliation(s)
- Moderator Tom Baranowski
- 1 Baylor College of Medicine , Houston, Texas; and Editor, Games for Health Journal: Research, Development, and Clinical Applications
| | | | | | | | - Jesse Schell
- 5 Schell Games, Pittsburgh , Pennsylvania.,6 Carnegie Mellon University , Pittsburgh, Pennsylvania
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