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Shaffer KM, Reese JB, Dressler EV, Glazer JV, Cohn W, Showalter SL, Clayton AH, Danhauer SC, Loch M, Kadi M, Smith C, Weaver KE, Lesser GJ, Ritterband LM. Factorial Trial to Optimize an Internet-Delivered Intervention for Sexual Health After Breast Cancer: Protocol for the WF-2202 Sexual Health and Intimacy Enhancement (SHINE) Trial. JMIR Res Protoc 2024; 13:e57781. [PMID: 39159450 PMCID: PMC11369542 DOI: 10.2196/57781] [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: 02/26/2024] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. OBJECTIVE Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention components. This study aims to determine how intervention components work (mediators) and for whom they work best (moderators). METHODS Partnered, posttreatment adult female survivors of breast cancer (N=320) experiencing at least 1 bothersome sexual symptom (ie, pain with sex, vaginal dryness, low sexual desire, and difficulty with orgasm) related to their breast cancer treatment will be enrolled. Clinic-based recruitment will be conducted via the Wake Forest National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participants will be randomly assigned to 1 of 16 combinations of four intervention components with two levels each in this factorial trial: (1) psychoeducation about cancer-related sexual morbidity (receive either enhanced vs standard versions); (2) communication skills training for discussing concerns with health care providers (received vs not received); (3) communication skills training for discussing concerns with a partner (received vs not received); and (4) intimacy promotion skills training (received vs not received). Cores will be fully automated and implemented using a robust internet intervention platform with highly engaging elements such as animation, video, and automated email prompts. Survivors will complete web-based assessments at baseline (prerandomization time point) and again at 12 and 24 weeks later. The primary study aim will be achieved through a decision-making process based on systematically evaluating the main and interaction effects of components on sexual distress (Female Sexual Distress Scale-Desire, Arousal, Orgasm) and sexual functioning (Female Sexual Function Index) using a generalized linear model approach to ANOVA with effect coding. Mediation analyses will be conducted through a structural equation modeling approach, and moderation analyses will be conducted by extending the generalized linear model to include interaction effects. RESULTS This protocol has been reviewed and approved by the National Cancer Institute Central Institutional Review Board. Data collection is planned to begin in March 2024 and conclude in 2027. CONCLUSIONS By identifying the combination of the fewest and least-intensive intervention components likely to provide survivors of breast cancer the greatest sexual health benefit, this study will result in the first internet intervention that is optimized for maximum impact on the undertreated, prevalent, and distressing problem of breast cancer-related sexual morbidity. TRIAL REGISTRATION ClinicalTrials.gov NCT06216574; https://clinicaltrials.gov/study/NCT06216574. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/57781.
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Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Emily V Dressler
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jillian V Glazer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Wendy Cohn
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Shayna L Showalter
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Anita H Clayton
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Suzanne C Danhauer
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Michelle Loch
- Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Mai Kadi
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Caleigh Smith
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Kathryn E Weaver
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Glenn J Lesser
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Lee M Ritterband
- University of Virginia School of Medicine, Charlottesville, VA, United States
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Mendes-Santos C, Campos T, Ferreira D, Weiderpass E, Santana R, Andersson G. Breast Cancer Survivors' Attitudes toward eMental Health: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:1920. [PMID: 37444755 PMCID: PMC10341406 DOI: 10.3390/healthcare11131920] [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: 05/12/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Breast cancer survivors' (BCS) attitudes toward eMental Health (eMH) are largely unknown, and adoption predictors and their interrelationships remain unclear. This study aimed to explore BCS' attitudes toward eMH and investigate associated variables. METHODS A cross-sectional study involving 336 Portuguese BCS was conducted. Attitudes toward eMH, depression and anxiety symptoms, health-related quality of life, and sociodemographic, clinical, and internet-related variables were assessed using validated questionnaires. Spearman-ranked correlations, χ2, and multiple regression analyses were computed to explore associations between attitudes and collected variables. RESULTS BCS held a neutral stance toward eMH. In models adjusted for age and education, positive attitudes were statistically significantly associated with increased depressive symptoms and worse emotional, cognitive, and body image functioning. Social network use, online health information and mental healthcare seeking, higher self-reported knowledge of eMH, and previous use of remote healthcare were positively associated with better attitudes toward eMH. CONCLUSIONS eMH programs targeting BCS seem to be a promising strategy for providing supportive psychosocial care to BCS. However, increasing awareness about eMH efficacy and security may be necessary to improve its acceptance and use among BCS. Additional research is necessary to understand how BCS' unmet care needs, and specifically their psychological distress severity, may impact BCS' acceptance and use of eMH.
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Affiliation(s)
- Cristina Mendes-Santos
- Fraunhofer Portugal AICOS, 4200-135 Porto, Portugal
- Department of Culture and Society (IKOS), Linköping University, 58183 Linköping, Sweden
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, 1099-085 Lisbon, Portugal;
| | - Teresa Campos
- Faculty of Sports, University of Porto (FADEUP), 4099-002 Porto, Portugal;
| | - Diana Ferreira
- Center for Psychology, University of Porto, 4200-135 Porto, Portugal;
| | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, 1099-085 Lisbon, Portugal;
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning (IBL), Department of Biomedical and Clinical Sciences, Linköping University, 58183 Linköping, Sweden;
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, 17177 Stockholm, Sweden
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Cooke S, Nelson D, Green H, McPeake K, Gussy M, Kane R. Rapid systematic review on developing web-based interventions to support people affected by cancer. BMJ Open 2022; 12:e062026. [PMID: 36691118 PMCID: PMC9454073 DOI: 10.1136/bmjopen-2022-062026] [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: 02/16/2022] [Accepted: 07/21/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To systematically identify and explore the existing evidence to inform the development of web-based interventions to support people affected by cancer (PABC). DESIGN A rapid review design was employed in accordance with the guidance produced by the Cochrane Rapid Reviews Methods Group and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A rapid review was chosen due to the need for a timely evidence synthesis to underpin the subsequent development of a digital resource (Shared Lives: Cancer) as part of an ongoing funded project. METHODS AND OUTCOMES Keyword searches were performed in MEDLINE to identify peer-reviewed literature that reported primary data on the development of web-based interventions designed to support PABC. The review included peer-reviewed studies published in English with no limits set on publication date or geography. Key outcomes included any primary data that reported on the design, usability, feasibility, acceptability, functionality and user experience of web-based resource development. RESULTS Ten studies were identified that met the pre-specified eligibility criteria. All studies employed an iterative, co-design approach underpinned by either quantitative, qualitative or mixed methods. The findings were grouped into the following overarching themes: (1) exploring current evidence, guidelines and theory, (2) identifying user needs and preferences and (3) evaluating the usability, feasibility and acceptability of resources. Resources should be informed by the experiences of a wide range of end-users taking into consideration current guidelines and theory early in the design process. Resource design and content should be developed around the user's needs and preferences and evaluated through usability, feasibility or acceptability testing using quantitative, qualitative or mixed methods. CONCLUSION The findings of this rapid review provide novel methodological insights into the approaches used to design web-based interventions to support PABC. Our findings have the potential to inform and guide researchers when considering the development of future digital health resources. TRIAL REGISTRATION NUMBER The review protocol was registered on the Open Science Framework (https://osf.io/ucvsz).
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Affiliation(s)
- Samuel Cooke
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
- Macmillan Cancer Support, London, UK
| | - Heidi Green
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Kathie McPeake
- Macmillan Cancer Support, London, UK
- NHS Lincolnshire Clinical Commissioning Group, Lincoln, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, UK
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Chen M, Gong J, Li Q. The application of eHealth in cancer survivorship care: A review of web-based dyadic interventions for post-treatment cancer survivors and caregivers. Asia Pac J Oncol Nurs 2022; 9:100109. [PMID: 36118622 PMCID: PMC9475270 DOI: 10.1016/j.apjon.2022.100109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Both cancer survivors and caregivers often experience a range of problems and unmet needs during the post-treatment survivorship. Web-based dyadic interventions may be critical for cancer survivors and their caregivers. This article aims to systematically explore existing web-based dyadic interventions for post-treatment cancer survivors and caregivers in terms of intervention focus, content, delivery, and outcomes and to provide valuable recommendations for future research. Methods A comprehensive literature search was conducted to identify articles published in English or Chinese in the English databases PubMed, EMBASE, MEDLINE, PsycINFO, and Cochrane Library, and the Chinese databases CNKI and Wanfang Data, from database inception to March 2022. The literature references were also manually searched for additional eligible articles. Results Thirteen studies were included for analysis in this review. Cancer couple dyads were the main target of the interventions that were included. Information support, psychotherapy, self-management skills training, dyadic coping, and social support were the main intervention treatment elements. The combined results in this review support the feasibility, usability, and acceptability of eHealth interventions and showed trends in positive intervention effects for cancer survivors and caregivers in terms of self-efficacy, quality of life, physical health, mental health, and dyadic relationship. Conclusions This review identifies the positive outcomes of web-based dyadic interventions for post-treatment cancer survivors and caregivers. Further development and refinement of post-treatment cancer survivor-caregiver dyadic web-based interventions, with personalized online platforms and multiple components for supportive care needs, should be promoted.
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Affiliation(s)
- Meizhen Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jiali Gong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
- Corresponding author.
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Mikles SP, Griffin AC, Chung AE. Health information technology to support cancer survivorship care planning: A systematic review. J Am Med Inform Assoc 2021; 28:2277-2286. [PMID: 34333588 PMCID: PMC8449616 DOI: 10.1093/jamia/ocab134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/13/2021] [Accepted: 06/23/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The study sought to conduct a systematic review to explore the functions utilized by electronic cancer survivorship care planning interventions and assess their effects on patient and provider outcomes. MATERIALS AND METHODS Based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, studies published from January 2000 to January 2020 were identified in PubMed, CINAHL, EMBASE, PsychINFO, Scopus, Web of Science, and the ACM Digital Library . The search combined terms for cancer, survivorship, care planning, and health information technology (HIT). Eligible studies evaluated the effects of a HIT intervention on usability, knowledge, process, or health-related outcomes. A total of 578 abstracts were reviewed, resulting in 60 manuscripts describing 40 studies. Thematic analyses were used to define meta-themes of system functions, and Fisher's exact tests were used to examine associations between functions and outcomes. RESULTS Patients were the target end users for 18 interventions, while 12 targeted providers and 10 targeted both groups. Interventions used patient-reported outcomes collection (60%), automated content generation (58%), electronic sharing (40%), persistent engagement (28%), and communication features (20%). Overall, interventions decreased the time to create survivorship care plans (SCPs) and supported care planning knowledge and abilities, but results were mixed for effects on healthcare utilization, SCP sharing, and provoking anxiety. Persistent engagement features were associated with improvements in health or quality-of-life outcomes (17 studies, P = .003). CONCLUSIONS Features that engaged users persistently over time were associated with better health and quality-of-life outcomes. Most systems have not capitalized on the potential of HIT to share SCPs across a care team and support care coordination.
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Affiliation(s)
- Sean P Mikles
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley C Griffin
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Arlene E Chung
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Program on Health and Clinical Informatics, UNC School of Medicine, Chapel Hill, North Carolina, USA
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Abstract
PURPOSE OF REVIEW Cancer diagnosis and treatment can have long-lasting psychological and physical consequences that affect both patients and their intimate partners. Improved understanding of extant dyadic interventions in the context of cancer, and how access to these may be enhanced through web-based technologies, introduce new directions for how cancer-related psychological distress for couples may be ameliorated. RECENT FINDINGS Couples are negatively impacted by cancer, both individually, and as a dyad. Bolstering techniques to support effective communication about common cancer-related concerns and support for adjusting to new roles and responsibilities may help to strengthen the couple's relationship so partners are better able to cope with cancer. Although there are various intervention options available for couples dealing with cancer, many pose barriers to participation because of constraints on time and/or distance. However, online interventions have been shown to be effective, both in easing psychological distress and reducing participant burden. SUMMARY Couples dealing with cancer experience psychological distress and must learn to navigate changing roles and responsibilities in the face of the disease. Online interventions offer flexible and innovative platforms and programs that help to address couples' educational needs while strengthening dyadic coping.
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Pot M, Paulussen TG, Ruiter RA, Mollema L, Hofstra M, Van Keulen HM. Dose-Response Relationship of a Web-Based Tailored Intervention Promoting Human Papillomavirus Vaccination: Process Evaluation of a Randomized Controlled Trial. J Med Internet Res 2020; 22:e14822. [PMID: 32520718 PMCID: PMC7395256 DOI: 10.2196/14822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/04/2019] [Accepted: 05/14/2020] [Indexed: 01/17/2023] Open
Abstract
Background In the Netherlands, human papillomavirus (HPV) vaccination uptake remains low. To improve informed decision making (IDM) and HPV vaccination acceptability, we systematically developed an interactive, web-based tailored intervention to which mothers of Dutch girls were invited to participate. Objective The aim of this study was to provide insight into the intervention’s working mechanisms by evaluating (1) program use, (2) program acceptability, and (3) the relationship of program use with program acceptability and intervention effects (ie, dose-response relationship). Methods Only mothers from the intervention arm of a randomized controlled trial that assessed the effectiveness of the web-based, tailored intervention were included in this study. They were invited to visit the website of the web-based intervention between baseline (January 2015, just before access to the intervention) and follow up (March 2015, prior to the first HPV vaccination). Indicators for program use were time of website use (ie, duration of intervention exposure) and completeness (ie, proportion of all available web pages visited). HPV vaccination uptake registered by Praeventis was used as the primary outcome. Secondary outcomes were IDM, decisional conflict, and social-psychological determinants of HPV vaccination uptake. Results Among the 3995 invited mothers, 2509 (62.80%) logged on to the website, 2239 of whom (89.24%) visited at least one page of the intervention components. On average, mothers spent 21.39 minutes (SD 12.41) on the website and completed 50.04% (SD 26.18%) of the website components. Participants rated the website 7.64 (SD 1.39) on a 10-point scale. Program acceptability was significantly associated with completeness (β=4.36, P<.001), but not with time of website use (β=–.07, P=.77). Intention-to-treat analysis (N=3995) showed a significant positive effect of completeness on all outcome measures (all P<.003; Bonferroni-corrected α=.05/15 factors), including on HPV vaccination uptake. Time of website use had a significant positive effect on all outcomes (all P<.003), except for uptake (P=.20), risk perception when not vaccinated (P=.14), subjective norms (P=.03), and habit (P=.01). Conclusions Program use and acceptability of the intervention were adequate. Completeness was positively associated with acceptability. Furthermore, positive effects (ie, dose-response effects) were found for completeness and time of website use on the mothers’ IDM, decisional conflict, and almost all of the social-psychological determinants of HPV vaccination acceptability. In addition, the extent to which mothers completed the intervention had a positive impact on their daughters’ vaccination uptake. This indicates that the web-based, tailored intervention fits well with the mothers’ needs, and that completeness of use is essential for improving HPV vaccination uptake, acceptability, and IDM. Program use should therefore be promoted. Trial Registration Netherlands Trial Register NTR4795; https://www.trialregister.nl/trial/4795
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Affiliation(s)
- Mirjam Pot
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Theo Gwm Paulussen
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Robert Ac Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Liesbeth Mollema
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, Netherlands
| | - Miranda Hofstra
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Hilde M Van Keulen
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
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Karim H, Choobineh H, Kheradbin N, Ravandi MH, Naserpor A, Safdari R. Mobile health applications for improving the sexual health outcomes among adults with chronic diseases: A systematic review. Digit Health 2020; 6:2055207620906956. [PMID: 32128234 PMCID: PMC7036501 DOI: 10.1177/2055207620906956] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022] Open
Abstract
Aims Chronic diseases may affect sexual health as an important factor for well-being. Mobile health (m-health) interventions have the potential to improve sexual health in patients with chronic conditions. The aim of this systematic review was to summarise the published evidence on mobile interventions for sexual health in adults with chronic diseases. Methods Five electronic databases were searched for English language peer-reviewed literature from 1 January 2009 to 31 December 2019. Appropriate keywords were identified based on the study's aim. Study selection was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The full texts of potential studies were reviewed, and final studies were selected. The m-health evidence reporting and assessment (mERA) checklist was used to assess the quality of the selected studies. After data extraction from the studies, data analysis was conducted. Results Nine studies met the inclusion criteria. All interventions were delivered through websites, and a positive effect on sexual problems was reported. Prostate and breast cancer were considered in most studies. Interventions were delivered for therapy, self-help and consultation purposes. Quality assessment of studies revealed an acceptable quality of reporting and methodological criteria in the selected studies. Replicability, security, cost assessment and conceptual adaptability were the criteria that had not been considered in any of the reviewed studies. Conclusions Reviewed studies showed a positive effect of mobile interventions on sexual health outcomes in chronic patients. For more effective interventions, researchers should design web-based interventions based on users' needs and consider the m-health essential criteria provided by mERA. Additionally, mobile interventions can be more effective in combination with smartphone apps.
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Affiliation(s)
- Hesam Karim
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran
| | - Hamid Choobineh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran.,Zeoonosis Research Centre, Tehran University of Medical Sciences, Iran
| | - Niloofar Kheradbin
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran
| | - Mohammad Hosseini Ravandi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran
| | - Ahmad Naserpor
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran
| | - Reza Safdari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Iran
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Luo X, Gao L, Li J, Lin Y, Zhao J, Li Q. A critical literature review of dyadic web-based interventions to support cancer patients and their caregivers, and directions for future research. Psychooncology 2019; 29:38-48. [PMID: 31702839 DOI: 10.1002/pon.5278] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/23/2019] [Accepted: 10/27/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE With the rapid development of the Internet, e-health interventions are becoming popular and are showing positive impacts. Cancer affects not only patients but also their caregivers, leading to a recognition that cancer patient-caregiver dyads cope with cancer as a unit rather than as individuals. The objectives of this paper are to explore web-based interventions for cancer patient-caregiver dyads coping with cancer from the aspects of intervention content, delivery format, outcome measurements, and outcomes and to provide recommendations on developing patient-caregiver dyadic web-based interventions for future research. METHODS Literature focused on cancer patient-caregiver dyadic web-based interventions, published in English or Chinese from the launch of five databases (CINAHL, PsycINFO, EMBase, Medline, Science Citation Index Expanded) to April 2019, was systematically searched. Manual searching through the references of full-text articles was also conducted. RESULTS Of a total of 812 articles, 17 articles met the inclusion criteria. The content of these web-based dyadic interventions mainly included information support, communication and support, skills-building, and psycho-education. These web-based interventions reported a small to large positive impact on patients with cancer and their caregivers in terms of physical health (d = 0.17-0.75), psychological health (d = 0.04-0.80), overall quality of life (d = 0.20-0.68), and dyadic relationship (d = 0.30-0.95). CONCLUSIONS Web-based dyadic interventions can be designed for tailored content, which benefits both patients and their caregivers. Future research on cancer patient-caregiver web-based interventions should be conducted in diverse cultures.
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Affiliation(s)
- Xingjuan Luo
- Wuxi Medical School, Jiangnan University, Wuxi, China
| | - Lihong Gao
- Department of Nursing, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jieyu Li
- Wuxi Medical School, Jiangnan University, Wuxi, China
| | - Yi Lin
- Wuxi Medical School, Jiangnan University, Wuxi, China
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Qiuping Li
- Wuxi Medical School, Jiangnan University, Wuxi, China
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Mendes-Santos C, Weiderpass E, Santana R, Andersson G. A guided internet-delivered individually-tailored ACT-influenced cognitive behavioural intervention to improve psychosocial outcomes in breast cancer survivors (iNNOVBC): Study protocol. Internet Interv 2019; 17:100236. [PMID: 30949435 PMCID: PMC6430035 DOI: 10.1016/j.invent.2019.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Internet-delivered interventions can provide remarkable opportunities in addressing breast cancer survivors' unmet support care needs, as they present an effective strategy to improve care coordination and provide access to efficacious, cost-efficient and convenient survivorship care. Nevertheless, research focusing on improving survivors' psychosocial needs using internet-based tools is scarce and its practical implementation is limited. OBJECTIVES To study the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, a 10 weeks guided internet-delivered individually-tailored Acceptance and Commitment Therapy (ACT)-influenced cognitive behavioural (CBT) intervention developed to improve mild to moderate anxiety and depression in Breast cancer survivors when compared to treatment as usual (TAU) in a waiting list control group (WLC). METHODS A two-arm, parallel, open label, multicentre, waiting list randomized controlled trial will be conducted to investigate the efficacy and cost-effectiveness of INNOVBC. The primary outcomes in this research will be anxiety and depression. Secondary outcomes will include psychological flexibility, fatigue, insomnia, sexual dysfunction and Health Related Quality of Life (HRQoL). ETHICAL APPROVAL This study has been reviewed and approved by Comissão Nacional de Proteção de Dados; Instituto Português de Oncologia do Porto Francisco Gentil; Unidade Local de Saúde de Matosinhos, EPE; Centro Hospitalar de São João and Ordem dos Psicólogos ethical committees. EXPECTED RESULTS It is anticipated that iNNOVBC will show to be an efficacious and cost-effective program in improving the outcomes of interest in this study, as opposed to a WLC under TAU. The results of this research will be published in accordance with CONSORT-EHEALTH guidelines. CONCLUSIONS This study will inform on the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, in improving psychosocial outcomes in breast cancer survivors when compared to TAU in a WLC. Its conclusions will contribute to understand the idiosyncrasies of designing and implementing internet-delivered interventions in breast cancer survivors.Trial Registration code: INNOVBC (NCT03275727).
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Communication (IKK), Linköping University, Linköping, Sweden
- Public Health Research Center (CISP), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rui Santana
- Public Health Research Center (CISP), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Bandong AN, Mackey M, Leaver A, Ingram R, Sterling M, Ritchie C, Kelly J, Rebbeck T. An Interactive Website for Whiplash Management (My Whiplash Navigator): Process Evaluation of Design and Implementation. JMIR Form Res 2019; 3:e12216. [PMID: 31452515 PMCID: PMC6732967 DOI: 10.2196/12216] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 05/02/2019] [Accepted: 05/20/2019] [Indexed: 12/24/2022] Open
Abstract
Background Whiplash is a health and economic burden worldwide. Contributing to this burden is poor guideline adherence and variable management by health care professionals (HCPs). Web-based tools that facilitate clinical pathways of care are an innovative solution to improve management. Objective The study aimed to develop, implement, and evaluate a Web-based tool to support whiplash management following a robust process. Methods This study followed the first 3 processes of a research translation framework (idea generation, feasibility, and efficacy) to inform the development, implementation, and evaluation of a website that supports HCPs in whiplash management. Development followed the idea generation and feasibility processes to inform the content, design, features, and functionality of the website. This involved stakeholder (eg, industry partners, website developers, and HCPs) consultations through face-to-face meetings, surveys, and focus group discussions. Implementation followed the feasibility process to determine the practicality of the website for clinical use and the most effective strategy to promote wider uptake. Implementation strategies included classroom education, educational meetings, educational outreach, reminders, and direct phone contact. The analysis of website use and practicality of implementation involved collection of website metrics. Evaluation followed the feasibility and efficacy processes to investigate the acceptability and extent to which the website assisted HCPs in gaining knowledge about whiplash management. Surveys were conducted among student, primary, and specialist HCPs to explore ease of access, use, and satisfaction with the website, as well as self-rated improvements in knowledge of risk assessment, management, and communication between HCPs. Website logs of specialist management decisions (eg, shared care, specialist care, and referred care) were also obtained to determine actual practice. Results The development process delivered an interactive, user-friendly, and acceptable website, My Whiplash Navigator, tailored to the needs of HCPs. A total of 260 registrations were recorded from June 2016 to March 2018, including 175 student, 65 primary, and 20 specialist HCPs. The most effective implementation strategies were classroom education for students (81% uptake, 175/215) and educational meetings for primary HCPs (43% uptake, 47/110). Popular pages visited included advice and exercises and risk assessment. Most HCPs agreed that their knowledge about risk management (79/97, 81%) and exercises (85/97, 88%) improved. The specialists’ most common management decision was shared care, an improvement from a previous cohort. Areas to improve were navigation and access to outcome measures. Conclusions A robust process resulted in an innovative, interactive, user-friendly, and acceptable website, the My Whiplash Navigator. Implementation with HCPs was best achieved through classroom education and educational meetings. Evaluation of the website showed improved knowledge and practice to be more consistent with a risk-based clinical care pathway for whiplash. The positive results provide sufficient evidence to scale implementation nationally and involve other target markets such as people with whiplash, insurers, and insurance regulators.
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Affiliation(s)
- Aila Nica Bandong
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.,Department of Physical Therapy, College of Allied Medical Professions, The University of the Philippines, Manila, Philippines
| | - Martin Mackey
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Andrew Leaver
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Rodney Ingram
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Michele Sterling
- Recover Injury Research Centre, The University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia
| | - Carrie Ritchie
- Recover Injury Research Centre, The University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia
| | - Joan Kelly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Trudy Rebbeck
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.,Kolling Institute, John Walsh Centre for Rehabilitation Research, The University of Sydney, Sydney, Australia
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Snyder K, Paulson P, Bergen S. A website assessment tool for patient engagement: A verification. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1616385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yi RHP, Rezende LF, Huynh J, Kramer K, Cranmer M, Schlager L, Dearfield CT, Friedman SJ. XRAYS (eXamining Relevance of Articles to Young Survivors) Program Survey of Information Needs and Media Use by Young Breast Cancer Survivors and Young Women at High-Risk for Breast Cancer. HEALTH COMMUNICATION 2018; 33:1525-1530. [PMID: 28956616 DOI: 10.1080/10410236.2017.1372051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Women age 45 years or younger with breast cancer, or who are at high-risk for breast cancer due to previously having the disease or to genetic risk, have distinct health risks and needs from their older counterparts. Young women frequently seek health information through the Internet and mainstream media, but often find it does not address their particular concerns, that it is difficult to evaluate or interpret, or even misleading. To help women better understand media coverage about new research, Facing Our Risk of Cancer Empowered (FORCE) developed the CDC-funded XRAYS (eXamining Relevance of Articles to Young Survivors) program. To assure that the XRAYS program is responsive to the community's needs, FORCE launched a web-based survey to assess where young women seek information about breast cancer, and to learn their unmet information needs. A total of 1,178 eligible women responded to the survey. In general, the breast cancer survivors and high-risk women between ages 18-45 years who responded to this survey, are using multiple media sources to seek information about breast cancer risk, prevention, screening, and treatment. They place trust in several media sources and use them to inform their medical decisions. Only about one-third of respondents to this survey report discussing media sources with their health care providers. Current survey results indicate that, by providing credible information on the quality of evidence and reporting in media reports on cancer, XRAYS is addressing a key need for health information. Results suggest that it will be useful for XRAYS to offer reviews of articles on a broad range of topics that can inform decisions at each stage of risk assessment and treatment.
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Affiliation(s)
| | | | - Julie Huynh
- b Facing Our Risk of Cancer Empowered (FORCE)
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Brett J, Boulton M, Watson E. Development of an e-health app to support women prescribed adjuvant endocrine therapy after treatment for breast cancer. Patient Prefer Adherence 2018; 12:2639-2647. [PMID: 30587936 PMCID: PMC6294163 DOI: 10.2147/ppa.s187692] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Adjuvant endocrine therapy (AET) is prescribed to women for 5-10 years after treatment for estrogen receptor positive (ER+ve), early-stage breast cancer. AET has proven effectiveness in reducing the risk of recurrence of breast cancer and mortality. However, adherence is known to be suboptimal with around 20% discontinuing by 2 years and up to 50% discontinuing by 5 years. Interventions are needed to support women taking AET after breast cancer. The aim of this study was to develop and pilot test an e-health app for this population. METHODS Two focus groups (n=15) and five interviews were conducted with women following treatment for early-stage breast cancer to assess the likely acceptability of an e-health app and to inform the content (Phase I). Following development of a prototype e-health app, a simple heuristic usability test was completed by five women in order to identify any design usability problems (Phase II). A further 18 women used the app for 1 month between July and August 2016, after which they were interviewed by telephone to collect their experiences and views of the app (Phase III). RESULTS The prototype e-health app included evidence-based information on effectiveness of AET, an electronic side-effects diary, a peer support forum, a repeat prescription reminder, suggested strategies for facilitating adherence and managing any side effects that occur, and a link to further evidence and useful organizations for further information and support. The app was received positively by women. Women found the app useful as it emphasized the importance of taking AET, helped them manage their side effects and provided details of support organizations, while offering empathy and exchange of suggestions for self-management strategies through the peer support forum. CONCLUSION Overall, findings suggest that this novel e-health app has potential as a feasible medium for promoting adherence to AET. Future research should evaluate the efficacy of the app in supporting women and promoting adherence.
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Affiliation(s)
- Jo Brett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
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Post KE, Flanagan J. Web based survivorship interventions for women with breast cancer: An integrative review. Eur J Oncol Nurs 2016; 25:90-99. [PMID: 27865259 DOI: 10.1016/j.ejon.2016.10.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/23/2016] [Accepted: 10/19/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE Breast cancer survivors' experience a range of negative sequelae post-treatment including depression, anxiety, physical side effects from treatment, sexuality concerns and decreased quality of life. Survivorship care is recommended by the IOM to meet the post treatment needs of survivors but implementation is variable and barriers to delivery such as time and resource restraints have been identified. Web-based interventions may be a way to overcome some barriers to providing quality survivorship care that is efficacious, cost efficient and convenient. The purpose of this integrative review is to summarize and synthesize the current research on web-based interventions for breast cancer survivorship care and evaluate the data to determine potential implications for practice. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this integrative review. Key search terms included breast cancer, survivor, intervention, web, internet and technology. Articles evaluating web-based survivorship interventions (n = 405) for early stage breast cancer patients who completed active therapy were included. RESULTS Fifteen studies met inclusion criteria: six randomized controlled trials, six survey based studies, one qualitative study, one retrospective chart review and one mixed methods study. Studies evaluating cognitive behavioral therapy provided the strongest data. Other studies evaluated exercise and lifestyle interventions, symptom management programs and pilot/exploratory work. Findings suggest that web-based survivorship interventions are feasible and acceptable to breast cancer survivors. CONCLUSIONS Web-based survivorship interventions have the potential to meet the needs of breast cancer survivors while possibly overcoming some of the documented barriers to survivorship care implementation.
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Affiliation(s)
- Kathryn E Post
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Jane Flanagan
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
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Can sexual outcomes be enhanced after cancer using online technology? Curr Opin Support Palliat Care 2016; 10:81-6. [DOI: 10.1097/spc.0000000000000189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Miller SM, Hudson SV, Hui SKA, Diefenbach MA, Fleisher L, Raivitch S, Belton T, Roy G, Njoku A, Scarpato J, Viterbo R, Buyyounouski M, Denlinger C, Miyamoto C, Reese A, Baman J. Development and preliminary testing of PROGRESS: a Web-based education program for prostate cancer survivors transitioning from active treatment. J Cancer Surviv 2015; 9:541-53. [PMID: 25697335 DOI: 10.1007/s11764-015-0431-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/22/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE This formative research study describes the development and preliminary evaluation of a theory-guided, online multimedia psycho-educational program (PROGRESS) designed to facilitate adaptive coping among prostate cancer patients transitioning from treatment into long-term survivorship. METHODS Guided by the Cognitive-Social Health Information Processing Model (C-SHIP) and using health communications best practices, we conducted a two-phase, qualitative formative research study with early stage prostate cancer patients (n = 29) to inform the Web program development. Phase 1 included individual (n = 5) and group (n = 12) interviews to help determine intervention content and interface. Phase 2 employed iterative user/usability testing (n = 12) to finalize the intervention. Interview data were independently coded and collectively analyzed to achieve consensus. RESULTS Survivors expressed interest in action-oriented content on (1) managing treatment side effects, (2) handling body image and comorbidities related to overweight/obesity, (3) coping with emotional and communication issues, (4) tips to reduce disruptions of daily living activities, and (5) health skills training tools. Patients also desired the use of realistic and diverse survivor images. CONCLUSIONS Incorporation of an established theoretical framework, application of multimedia intervention development best practices, and an evidence-based approach to content and format resulted in a psycho-educational tool that comprehensively addresses survivors' needs in a tailored fashion. IMPLICATIONS FOR CANCER SURVIVORS The results suggest that an interactive Web-based multimedia program is useful for survivors if it covers the key topics of symptom control, emotional well-being, and coping skills training; this tool has the potential to be disseminated and implemented as an adjunct to routine clinical care.
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Affiliation(s)
- Suzanne M Miller
- Department of Psychosocial and Behavioral Medicine, Fox Chase Cancer Center/Temple University Health System, Robert C. Young Pavilion, 333 Cottman Avenue-4th Floor, Philadelphia, PA, 19111, USA,
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Ornes LL, Paulson P, Snyder K. A tool to evaluate your website for patient engagement. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2014. [DOI: 10.1179/2047971913y.0000000066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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