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Miller KK, Hooper L, Kaja SM. Move and Thrive: Development of an Adolescent Friendly and Inclusive Online Fitness Resource. Health Promot Pract 2024:15248399241245055. [PMID: 38590221 DOI: 10.1177/15248399241245055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
While physical activity (PA) is a strong protective factor for adolescents, many youth experience discrimination and intimidation in traditional fitness spaces. This is especially true for youth of color, youth in larger bodies, and transgender youth. This manuscript describes the development of Move and Thrive, an online resource for PA promotion designed specifically for adolescents prioritizing inclusivity and diversity. Working with Community and Youth Advisory Boards, we developed guiding principles of Move and Thrive: to create resources that are 1) youth and community driven; 2) inclusive of diverse representation; 3) body and weight neutral; 4) trauma informed; and 5) accessible. We developed a guide for PA instructors to use trauma informed approaches; avoid mention of weight talk or physical appearance; use gender inclusive language; and offer multiple options to improve accessibility. Specific care was taken to hire instructors diverse in body size, race, ethnicity, and gender identity. The first iteration of Move and Thrive was launched in March 2021, and the current resource contains 72 PA videos. Over the course of 12 months, the site had more than the site had over 9,000 views in over 40 countries, including six continents. Users have reported high levels of satisfaction with Move and Thrive, and physicians have responded enthusiastically to sharing Move and Thrive as a free resource for adolescents. University of Minnesota Move and Thrive Project is currently available on an ad-free YouTube Channel. We believe that Move and Thrive has the potential to reach populations historically excluded from PA resources.
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Affiliation(s)
- Kathleen K Miller
- Children's Minnesota, Minneapolis, MN, USA
- University of Minnesota, Minneapolis, MN, USA
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2
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Nagata JM, Alsamman S, Smith N, Yu J, Ganson KT, Dooley EE, Wing D, Baker FC, Pettee Gabriel K. Social epidemiology of Fitbit daily steps in early adolescence. Pediatr Res 2023; 94:1838-1844. [PMID: 37353663 PMCID: PMC10624619 DOI: 10.1038/s41390-023-02700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Sociodemographic disparities in adolescent physical activity have been documented but mostly rely on self-reported data. Our objective was to examine differences in device-based step metrics, including daily step count (steps d-1), by sociodemographic factors among a diverse sample of 10-to-14-year-old adolescents in the US. METHODS We analyzed prospective cohort data from Year 2 (2018-2020) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 6460). Mixed-effects models were conducted to estimate associations of sociodemographic factors (sex, sexual orientation, race/ethnicity, household income, parental education, and parental marital status) with repeated measures of steps d-1 over the course of 21 days. RESULTS Participants (49.6% female, 39.0% racial/ethnic minority) accumulated an average of 9095.8 steps d-1. In mixed-effects models, 1543.6 more steps d-1 were recorded for male versus female sex, Black versus White race (328.8 more steps d-1), heterosexual versus sexual minority sexual orientation (676.4 more steps d-1), >$200,000 versus <$25,000 household income (1003.3 more steps d-1), and having married/partnered parents versus unmarried/unpartnered parents (326.3 more steps d-1). We found effect modification by household income for Black adolescents and by sex for Asian adolescents. CONCLUSIONS Given sociodemographic differences in adolescent steps d-1, physical activity guidelines should focus on key populations and adopt strategies optimized for adolescents from diverse backgrounds. IMPACT Sociodemographic disparities in physical activity have been documented but mostly rely on self-reported data, which can be limited by reporting and prevarication bias. In this demographically diverse sample of 10-14-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in Fitbit steps per day. More daily steps were recorded for male versus female sex, Black versus White race, heterosexual versus sexual minority, >$100,000 versus <$25,000 household income, and having married/partnered versus unmarried/unpartnered parents. We found effect modification by household income for Black adolescents and by sex for Asian adolescents.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA.
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Jiayue Yu
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA, USA
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla University of California, San Diego, La Jolla, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Hooper L, Puhl R, Eisenberg ME, Reicks M, Neumark-Sztainer D. How is weight teasing cross-sectionally and longitudinally associated with health behaviors and weight status among ethnically/racially and socioeconomically diverse young people? Int J Behav Nutr Phys Act 2022; 19:71. [PMID: 35739552 PMCID: PMC9219184 DOI: 10.1186/s12966-022-01307-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships. Methods Adolescents (n = 1568) were enrolled in EAT 2010–2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics. Results Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m2, not teased: 26.4 kg/m2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups. Conclusions Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01307-y.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA. .,Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA.
| | - Rebecca Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts and Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, 3rd Floor, Minneapolis, MN, 55414, USA
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA
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Examining current physical activity interventions in Black school-age children and parents: A systematic review. Prev Med 2021; 153:106814. [PMID: 34597612 DOI: 10.1016/j.ypmed.2021.106814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/10/2021] [Accepted: 09/26/2021] [Indexed: 11/21/2022]
Abstract
Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.
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Yengo-Kahn AM, Wallace J, Jimenez V, Totten DJ, Bonfield CM, Zuckerman SL. Exploring the outcomes and experiences of Black and White athletes following a sport-related concussion: a retrospective cohort study. J Neurosurg Pediatr 2021; 28:516-525. [PMID: 34428742 DOI: 10.3171/2021.2.peds2130] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Young American athletes, at risk of sport-related concussion (SRC), represent many races; however, it is unknown how race may influence the experience and outcome of SRC. The authors' objective was to compare White and Black athletes' recovery and subjective experiences after SRC. METHODS A retrospective study was performed using the Vanderbilt Sports Concussion registry. Self-reported White and Black young athletes (ages 12-23 years) who had been treated for SRC between 2012 and 2015 were included. Athletes with learning disabilities or psychiatric conditions were excluded. Data were collected by electronic medical record review and phone calls to athletes and parents or guardians. The primary outcomes were as follows: 1) days to symptom resolution (SR), 2) days to return to school, and changes in 3) any daily activity (binary) and 4) sport behavior (binary). Secondary outcomes were changes (more, unchanged, or less) in specific activities such as sleep, schoolwork, and television time, as well as equipment (binary) or playing style (more reckless, unchanged, or less reckless) and whether the athlete retired from sport. Descriptive analyses, multivariable Cox proportional hazards models, and logistic regression were performed. RESULTS The final cohort included 247 student-athletes (36 Black, 211 White). Black athletes were male (78% vs 58%) more often than White athletes, but both races were similar in age, sport, and medical/family histories. Black athletes more frequently had public insurance (33.3% vs 5.7%) and lived in areas with a low median income (41.2% vs 26.6%). After adjusting for age, sex, concussion history, insurance status, and zip code median income, Black athletes reached an asymptomatic status (HR 1.497, 95% CI 1.014-2.209, p = 0.042) and returned to school earlier (HR 1.522, 95% CI 1.020-2.270, p = 0.040). Black athletes were less likely to report a change in any daily activity than White athletes (OR 0.368, 95% CI 0.136-0.996, p = 0.049). Changes in sport behavior were comparable between the groups. CONCLUSIONS Racial differences appear to exist in the outcomes and experience of SRC for young athletes, as Black athletes reached SR and return to school sooner than White athletes. Race should be considered as an important social determinant in SRC treatment.
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Affiliation(s)
- Aaron M Yengo-Kahn
- 1Department of Neurological Surgery, Vanderbilt University Medical Center.,2Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jessica Wallace
- 3Department of Health Science, Athletic Training Program, University of Alabama, Tuscaloosa, Alabama
| | - Viviana Jimenez
- 2Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee.,4Department of Neurology, Vanderbilt University Medical Center; and
| | - Douglas J Totten
- 2Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee.,5Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Christopher M Bonfield
- 1Department of Neurological Surgery, Vanderbilt University Medical Center.,2Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Scott L Zuckerman
- 1Department of Neurological Surgery, Vanderbilt University Medical Center.,2Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee
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A Qualitative Study of Stress and Coping to Inform the LEADS Health Promotion Trial for African American Adolescents with Overweight and Obesity. Nutrients 2021; 13:nu13072247. [PMID: 34210069 PMCID: PMC8308260 DOI: 10.3390/nu13072247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 12/20/2022] Open
Abstract
The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70–0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.
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Bustamante EE, Ramer JD, Santiago-Rodríguez ME, Mehta TG, Bustamante AS, Marquez DX, Frazier SL. The S.P.A.C.E Hypothesis: Physical Activity as Medium - Not Medicine - for Public Health Impact. Exerc Sport Sci Rev 2021; 49:133-145. [PMID: 33720915 PMCID: PMC8944943 DOI: 10.1249/jes.0000000000000248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Most scientifically tested physical activity interventions end when research funding ends; interventions that last struggle to sustain benefits. We hypothesize that long-term public health impact will benefit from a shift in how interventionists conceptualize physical activity - from a form of medicine, of value for its innate health benefits, to a malleable medium, of value for the dynamic contexts it creates.
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Affiliation(s)
- Eduardo Esteban Bustamante
- University of Illinois at Chicago, College of Applied Health Sciences, Department of Kinesiology and Nutrition
| | - Jared Donald Ramer
- University of Illinois at Chicago, College of Applied Health Sciences, Department of Kinesiology and Nutrition
| | | | - Tara Gisela Mehta
- University of Illinois at Chicago, Institute for Juvenile Research, Department of Psychiatry
| | | | - David X. Marquez
- University of Illinois at Chicago, College of Applied Health Sciences, Department of Kinesiology and Nutrition
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Ajibewa TA, Beemer LR, Sonneville KR, Miller AL, Toledo-Corral C, Robinson LE, Hasson RE. Psychological Stress and Lowered Physical Activity Enjoyment in Adolescents With Overweight/Obesity. Am J Health Promot 2021; 35:766-774. [PMID: 33626891 DOI: 10.1177/0890117121997042] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE The purpose of this study was 2-fold: 1) to determine the cross-sectional associations between psychological stress, physical activity enjoyment, and physical activity participation [moderate-to-vigorous physical activity (MVPA), total physical activity (TPA)]; and 2) to determine the moderating effect of physical activity enjoyment on the associations between stress, MVPA, and TPA in adolescents with overweight/obesity. DESIGN Cross-sectional, secondary data analysis of the Health and Culture Project and the Stress, Obesity, and Diabetes in Adolescents study. SAMPLE One hundred and ten adolescents (73% female; 65.4% non-white; age 15.8 ± 1.9 years) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis. MEASURES Psychological stress was assessed using the Perceived Stress Scale (PSS-14); enjoyment was measured via the Physical Activity Enjoyment Scale; and MVPA and TPA were objectively measured using accelerometry over a minimum of 4 days. RESULTS Higher perceived stress was associated with lower physical activity enjoyment (β = -0.41 ± 0.15; p = 0.008). Stress was not associated with MVPA or TPA (ps > 0.05), nor was enjoyment a significant moderator in the associations between stress and MVPA or stress and TPA (pinteraction > 0.05). CONCLUSIONS These findings suggest that psychological stress is associated with lower physical activity enjoyment among adolescents with overweight/obesity. Longitudinal studies are needed to understand the long-term effects of stress on psychological factors that may serve as antecedents to physical activity participation among adolescents with overweight/obesity.
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Affiliation(s)
- Tiwaloluwa A Ajibewa
- 158359University of Michigan School of Kinesiology, Ann Arbor, MI, USA.,1259University of Michigan Childhood Disparities Research Laboratory, Ann Arbor, MI, USA
| | - Lexie R Beemer
- 158359University of Michigan School of Kinesiology, Ann Arbor, MI, USA.,1259University of Michigan Childhood Disparities Research Laboratory, Ann Arbor, MI, USA
| | | | - Alison L Miller
- 51329University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Claudia Toledo-Corral
- Department of Health Sciences, 14671California State University, Northridge, CA, USA
| | - Leah E Robinson
- 158359University of Michigan School of Kinesiology, Ann Arbor, MI, USA
| | - Rebecca E Hasson
- 158359University of Michigan School of Kinesiology, Ann Arbor, MI, USA.,1259University of Michigan Childhood Disparities Research Laboratory, Ann Arbor, MI, USA.,51329University of Michigan School of Public Health, Ann Arbor, MI, USA
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Social Cognitive Orientations, Social Support, and Physical Activity among at-Risk Urban Children: Insights from a Structural Equation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186745. [PMID: 32947944 PMCID: PMC7558557 DOI: 10.3390/ijerph17186745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 11/17/2022]
Abstract
This study investigates the effects of cognitive orientations associated with social cognitive theory (SCT) and exercise enjoyment on physical activity (PA) of urban at-risk children, accounting for mediating effects associated with various sources of social support. We use 2016–2017 survey data from 725 school-age children in an urban school district in Akron, Ohio in the United States (US) to inform a structural equation model, which assesses direct and indirect effects of self-efficacy, behavioral intention, and exercise enjoyment on children’s PA, using mediating variables that measure social support that children report receiving from parents, Physical Education (PE) teachers, and peers. We find that self-efficacy and exercise enjoyment have notable direct and indirect effects on the children’s PA. We also find that the support children receive from PE teachers and peers appears to have greater effects on PA than does the children’s reported social support from parents. These findings suggest that children’s social cognitive orientations may influence both sources of perceived social support and the extent to which children engage in PA. While these findings have potential implications for intervention strategies to increase PA among at-risk children, further research is appropriate to improve our understanding of the determinants of PA among at-risk urban children.
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