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Hill AB, Kaur R, Sundermeir SM, Kasprzak C, Winkler M, John S, Dombrowski RD, Bode B, Gittelsohn J. Refining the Nutrition Environment Measures Survey (NEMS) for Healthy Community Stores: Adaptations to Capture Alternative Food Retailers and Align with Dietary Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912875. [PMID: 36232175 PMCID: PMC9566451 DOI: 10.3390/ijerph191912875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 05/27/2023]
Abstract
Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will focus on the NEMS-HCS development process, findings, and HFAHEI application. All food items were more likely to be found at grocery stores rather than corner stores. Food pricing was often above the Consumer Price Index averages for six food items. The NEMS-HCS assessment better aligned with the HEI because it included a wider variety of meats, frozen fruits and vegetables, and an increased selection of whole grains. HFAHEI scoring was inclusive of non-traditional and alternative community stores with a health focus, making it suitable for use at the local level, especially in neighborhoods where supermarkets and large chain stores are less common.
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Affiliation(s)
- Alex B. Hill
- Detroit Food Map Initiative and Department of Urban Studies and Planning, College of Liberal Arts and Sciences, Wayne State University, Detroit, MI 48202, USA
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA
| | - Samantha M. Sundermeir
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Christina Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA
| | - Megan Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University San Marcos, San Marcos, CA 92096, USA
| | - Bree Bode
- Division of Kinesiology, Heath and Sport Studies, College of Education, Detroit, MI 48202, USA
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Zerafati-Shoae N, Taghdisi MH, Azadbakht L, Sharif Nia H, Aryaeian N. Defining and Developing Measures of Checklist for Measuring Food Store Environment: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:480-491. [PMID: 34178795 PMCID: PMC8214622 DOI: 10.18502/ijph.v50i3.5588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Food store measurement is important for planners and policy makers to improve unhealthy stores towards healthy stores. This review aimed to outline the concepts and measures development of checklists that assess food store environment in urban communities. Methods: The search was carried out in PubMed, Embase, Web of Science and Scopus as well as reference lists of included studies for obtaining published articles between 1990 up to the date of search (30 June 2017). Eligibility criteria attempted to capture peer-reviewed articles aimed at development and validation of checklists for assessing food stores. Results: From 3,862 records, 24 studies were included in this review. Findings showed constructs included in the instruments were availability (n=22); price (n=22); quality of fresh foods (n=13); promotion (n=6); product placement (n=6); advertisement (n=5); shelf space (n=3); display (n=3); store features or characteristics (n=2); marketing (n=2); accessibility; nutrition information; visibility; food variety; signage. There are differences on the conceptual definition of each constructs across the checklists. Only half of studies pursued fully systematic steps for the measures development. Conclusion: Consensus for definition of constructs of food store measurement is necessary. Besides, the development of the measures of checklists needs to be done by high-quality methods.
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Affiliation(s)
- Nahid Zerafati-Shoae
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Taghdisi
- Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharif Nia
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Naheed Aryaeian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
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Ohri-Vachaspati P, Acciai F, Lloyd K, Tulloch D, DeWeese RS, DeLia D, Todd M, Yedidia MJ. Evidence That Changes in Community Food Environments Lead to Changes in Children's Weight: Results from a Longitudinal Prospective Cohort Study. J Acad Nutr Diet 2021; 121:419-434.e9. [PMID: 33309589 PMCID: PMC8742245 DOI: 10.1016/j.jand.2020.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/22/2020] [Accepted: 10/14/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Strategies to improve the community food environment have been recommended for addressing childhood obesity, but evidence substantiating their effectiveness is limited. OBJECTIVE Our aim was to examine the impact of changes in availability of key features of the community food environment, such as supermarkets, small grocery stores, convenience stores, upgraded convenience stores, pharmacies, and limited service restaurants, on changes in children's body mass index z scores (zBMIs). DESIGN We conducted a longitudinal cohort study. PARTICIPANTS/SETTING Two cohorts of 3- to 15-year-old children living in 4 low-income New Jersey cities were followed during 2- to 5-year periods from 2009 through 2017. Data on weight status were collected at 2 time points (T1 and T2) from each cohort; data on food outlets in the 4 cities and within a 1-mile buffer around each city were collected multiple times between T1 and T2. MAIN OUTCOME MEASURES We measured change in children's zBMIs between T1 and T2. STATISTICAL ANALYSIS Changes in the food environment were conceptualized as exposure to changes in counts of food outlets across varying proximities (0.25 mile, 0.5 mile, and 1.0 mile) around a child's home, over different lengths of time a child was exposed to these changes before T2 (12 months, 18 months, and 24 months). Multivariate models examined patterns in relationships between changes in zBMI and changes in the food environment. RESULTS Increased zBMIs were observed in children with greater exposure to convenience stores over time, with a consistent pattern of significant associations across varying proximities and lengths of exposure. For example, exposure to an additional convenience store over 24 months within 1 mile of a child's home resulted in 11.7% higher odds (P = 0.007) of a child being in a higher zBMI change category at T2. Lower zBMIs were observed in children with increased exposure to small grocery stores selling an array of healthy items, with exposure to an additional small grocery store within 1 mile over 24 months, resulting in 37.3% lower odds (P < 0.05) of being in a higher zBMI change category at T2. No consistent patterns were observed for changes in exposure to supermarkets, limited service restaurants, or pharmacies. CONCLUSIONS Increased availability of small grocery stores near children's homes may improve children's weight status, whereas increased availability of convenience stores is likely to be detrimental.
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Affiliation(s)
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Kristen Lloyd
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ
| | - David Tulloch
- Center for Remote Sensing and Spatial Analysis, Department of Landscape Architecture, Rutgers University, New Brunswick, NJ
| | - Robin S DeWeese
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Derek DeLia
- MedStar Health Research Institute, Hyattsville, MD; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ
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Misiaszek C, Kvit A, Burns C, Harding J, Buczynski A, Freishtat H, Bassarab K, Bilal U, Palmer A. Reliability of an Audit Tool to Measure Healthy Food Availability in Food Outlets across Baltimore City. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2019.1658680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Caitlin Misiaszek
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anton Kvit
- Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Jamie Harding
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Holly Freishtat
- Baltimore City Department of Planning, Baltimore Food Policy Initiative, Baltimore, MD, USA
| | - Karen Bassarab
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel School of Public Health, Philadelphia, PA, USA
| | - Anne Palmer
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Downs SM, Ahmed S, Fanzo J, Herforth A. Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets. Foods 2020; 9:E532. [PMID: 32331424 PMCID: PMC7230632 DOI: 10.3390/foods9040532] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health.
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Affiliation(s)
- Shauna M. Downs
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Selena Ahmed
- Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
| | - Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies and Bloomberg School of Public Health, Johns Hopkins University, Washington, DC 21205, USA;
| | - Anna Herforth
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, University Boston, MA 02125, USA;
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Pereyra-Zamora P. Data Collection Instruments for Obesogenic Environments in Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1414. [PMID: 31010209 PMCID: PMC6518267 DOI: 10.3390/ijerph16081414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 12/25/2022]
Abstract
The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
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Appraisal of short and long versions of the Nutrition Environment Measures Survey (NEMS-S and NEMS-R) in Australia. Public Health Nutr 2018; 22:564-570. [PMID: 30375297 DOI: 10.1017/s1368980018002732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Research has begun to take a more ecological view of eating behaviour, examining multiple levels of influence: personal, social and environmental. The food environment is a major influence on eating behaviour, attracting the attention of researchers who have measured it in a number of ways. The present paper examines the short-form version, in comparison to the long-form version, of the Nutrition Environment Measures Survey (NEMS) - an observational food outlet audit tool. DESIGN Both the short-form and long-form were examined to qualitatively appraise the dimensions of the food environment assessed by each measure. Data from 135 food outlets in Australia were then used to compare results obtained using the short-form with the results from the long-form method, to consider the utility of the short-form measure. SETTING The retail food environment in Australia.ParticipantsOne hundred and thirty-five food outlets in Australia. RESULTS Results indicate that the short-form predominantly assessed availability of healthful foods (one aspect of the food environment). Several critical dimensions of the food environment known to influence eating behaviour were not assessed. For this data set, the short-form produced scores inconsistent with the longer version of the measure, delivering inflated estimates for stores and deflated estimates for restaurants. CONCLUSIONS Scores between the long-form and short-form versions were not comparable in this Australian study. Further development of food environment measures is recommended and must balance instrument brevity with the need to accurately capture important aspects of the food environment known to influence eating behaviour.
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DeWeese RS, Ohri-Vachaspati P. Cost of Children's Healthy vs Unhealthy Snacks Does Not Differ at Convenience Stores. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:241-243.e1. [PMID: 28073622 PMCID: PMC5346473 DOI: 10.1016/j.jneb.2016.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study compared the prices of unhealthy (chips) and healthy (ready-to-eat fruit) snacks that students are likely to purchase from corner stores. METHODS Snacks were purchased from 325 New Jersey corner stores; chip prices were compared with fruit prices overall and by store sales volume and block group characteristics. RESULTS Prices did not differ significantly between chips and fruit in the overall sample in which both items were available (n = 104) (chips: $0.46 ± $0.15; fruit: $0.49 ± $0.19; P = .48) or by store or block group characteristics. Neither mean fruit prices nor mean chip prices differed by store sales volume or by neighborhood characteristics. CONCLUSIONS AND IMPLICATIONS Promoting ready-to-eat fruits in corner stores to children as a price-neutral alternative to calorically dense snacks can be a viable strategy to improve the nutritional quality of snacks commonly purchased at corner stores.
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Affiliation(s)
- Robin S DeWeese
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ.
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DeWeese RS, Todd M, Karpyn A, Yedidia MJ, Kennedy M, Bruening M, Wharton CM, Ohri-Vachaspati P. Healthy store programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but not the Supplemental Nutrition Assistance Program (SNAP), are associated with corner store healthfulness. Prev Med Rep 2016; 4:256-61. [PMID: 27419041 PMCID: PMC4939392 DOI: 10.1016/j.pmedr.2016.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/16/2016] [Accepted: 06/27/2016] [Indexed: 11/29/2022] Open
Abstract
In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores. Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments. Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65-3.71; non-upgraded: M = 2.52, 95% CI 2.32-2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6-14.1; non-upgraded: M = 12.5, 95% CI 12.0-13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores. WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.
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Affiliation(s)
- Robin S DeWeese
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Michael Todd
- Arizona State University, College of Nursing and Health Innovation, 500 N 3rd St, Phoenix, AZ 85004-0690, USA
| | - Allison Karpyn
- University of Delaware, Center for Research in Education, and Social Policy, 16 W Main St, Newark, DE 19716, USA
| | - Michael J Yedidia
- Rutgers University, Center for State Health Policy, 112 Paterson, New Brunswick, NJ 08901-1293, USA
| | - Michelle Kennedy
- Rutgers University, Center for State Health Policy, 112 Paterson, New Brunswick, NJ 08901-1293, USA
| | - Meg Bruening
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Christopher M Wharton
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Punam Ohri-Vachaspati
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
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