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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Study protocol

‘Let’s Move It’ – a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial

Authors: Nelli Hankonen, Matti T. J. Heino, Vera Araujo-Soares, Falko F. Sniehotta, Reijo Sund, Tommi Vasankari, Pilvikki Absetz, Katja Borodulin, Antti Uutela, Taru Lintunen, Ari Haukkala

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Physical activity (PA) has been shown to decline during adolescence, and those with lower education have lower levels of activity already at this age, calling for targeted efforts for them. No previous study has demonstrated lasting effects of school-based PA interventions among older adolescents. Furthermore, these interventions have rarely targeted sedentary behaviour (SB) despite its relevance to health. The Let’s Move It trial aims to evaluate the effectiveness and the cost-effectiveness of a school-based, multi-level intervention, on PA and SB, among vocational school students. We hypothesise that the intervention is effective in increasing moderate-to-vigorous-intensity physical activity (MVPA), particularly among those with low or moderate baseline levels, and decreasing SB among all students.

Methods

The design is a cluster-randomised parallel group trial with an internal pilot study. The trial is conducted in six vocational schools in the Helsinki Metropolitan area, Finland. The intervention is carried out in 30 intervention classes, and 27 control classes retain the standard curriculum. The randomisation occurs at school-level to avoid contamination and to aid delivery.
Three of the six schools, randomly allocated, receive the ‘Let’s Move It’ intervention which consists of 1) group sessions and poster campaign targeting students’ autonomous PA motivation and self-regulation skills, 2) sitting reduction in classrooms via alterations in choice architecture and teacher behaviour, and 3) enhancement of PA opportunities in school, home and community environments. At baseline, student participants are blind to group allocation. The trial is carried out in six batches in 2015–2017, with main measurements at pre-intervention baseline, and 2-month and 14-month follow-ups. Primary outcomes are for PA, MVPA measured by accelerometry and self-report, and for SB, sedentary time and breaks in sedentary time (accelerometry).
Key secondary outcomes include measured body composition, self-reported well-being, and psychological variables. Process variables include measures of psychosocial determinants of PA (e.g. autonomous motivation) and use of behaviour change techniques. Process evaluation also includes qualitative interviews. Intervention fidelity is monitored.

Discussion

The study will establish whether the Let’s Move It intervention is effective in increasing PA and reducing SB in vocational school students, and identify key processes explaining the results.

Trial registration

ISRCTN10979479. Registered: 31.12.2015
Appendix
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Literature
1.
go back to reference Hallal PC et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.CrossRefPubMed Hallal PC et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.CrossRefPubMed
3.
4.
go back to reference Elgar FJ et al. Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. Lancet. 2015;385(9982):2088–95.CrossRefPubMed Elgar FJ et al. Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. Lancet. 2015;385(9982):2088–95.CrossRefPubMed
5.
go back to reference van Sluijs EMF, McMinn AM, Griffin SJ. Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ. 2007;335(7622):703.CrossRefPubMedPubMedCentral van Sluijs EMF, McMinn AM, Griffin SJ. Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ. 2007;335(7622):703.CrossRefPubMedPubMedCentral
6.
go back to reference Crutzen R. Adding effect sizes to a systematic review on interventions for promoting physical activity among European teenagers. Int J Behav Nutr Phys Act. 2011;7:5. Crutzen R. Adding effect sizes to a systematic review on interventions for promoting physical activity among European teenagers. Int J Behav Nutr Phys Act. 2011;7:5.
8.
go back to reference Yildirim M et al. For whom and under what circumstances do school-based energy balance behavior interventions work? Systematic review on moderators. Int J Pediatr Obes. 2011;6(2-2):e46–57.CrossRefPubMedPubMedCentral Yildirim M et al. For whom and under what circumstances do school-based energy balance behavior interventions work? Systematic review on moderators. Int J Pediatr Obes. 2011;6(2-2):e46–57.CrossRefPubMedPubMedCentral
9.
go back to reference Hynynen ST et al. A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents. Int Rev Sport Exerc Psychol. 2016;9(1):22–44.CrossRefPubMed Hynynen ST et al. A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents. Int Rev Sport Exerc Psychol. 2016;9(1):22–44.CrossRefPubMed
10.
go back to reference Michie S et al. Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychol. 2009;28(6):690–701.CrossRefPubMed Michie S et al. Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychol. 2009;28(6):690–701.CrossRefPubMed
11.
go back to reference Peters LW et al. Effective elements of school health promotion across behavioral domains: a systematic review of reviews. BMC Public Health. 2009;9(1):1–14.CrossRef Peters LW et al. Effective elements of school health promotion across behavioral domains: a systematic review of reviews. BMC Public Health. 2009;9(1):1–14.CrossRef
12.
go back to reference Dadaczynski K, de Vries N. Quality based prevention of overweight in the school setting: the HEPS quality checklist. J Public Health. 2013;21(3):297–305.CrossRef Dadaczynski K, de Vries N. Quality based prevention of overweight in the school setting: the HEPS quality checklist. J Public Health. 2013;21(3):297–305.CrossRef
13.
go back to reference Kriemler S et al. Effect of school-based interventions on physical activity and fitness in children and adolescents: A review of reviews and systematic update. Br J Sports Med 2011; 45(11): 10.1136/bjsports-2011-090186. Kriemler S et al. Effect of school-based interventions on physical activity and fitness in children and adolescents: A review of reviews and systematic update. Br J Sports Med 2011; 45(11): 10.​1136/​bjsports-2011-090186.
15.
go back to reference Moore GF et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350. Moore GF et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350.
16.
go back to reference McEachan RRC et al. Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97–144.CrossRef McEachan RRC et al. Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97–144.CrossRef
17.
go back to reference Ng JYY et al. Self-Determination Theory Applied to Health Contexts: A Meta-Analysis. Perspect Psychol Sci. 2012;7(4):325–40.CrossRefPubMed Ng JYY et al. Self-Determination Theory Applied to Health Contexts: A Meta-Analysis. Perspect Psychol Sci. 2012;7(4):325–40.CrossRefPubMed
18.
go back to reference Matthews CE et al. Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc. 2012;44(1 Suppl 1):S68–76.CrossRefPubMedPubMedCentral Matthews CE et al. Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc. 2012;44(1 Suppl 1):S68–76.CrossRefPubMedPubMedCentral
19.
go back to reference Hankonen N, Heino MTJ, Araujo-Soares V, Absetz P, Sniehotta FF, Haukkala A. Using theory and evidence to increase physical activity: Let’s Move It school-based multi-level intervention. European Health Psychologist. In press. Hankonen N, Heino MTJ, Araujo-Soares V, Absetz P, Sniehotta FF, Haukkala A. Using theory and evidence to increase physical activity: Let’s Move It school-based multi-level intervention. European Health Psychologist. In press.
20.
go back to reference Hankonen N, Heino MTJ, Hynynen S, Laine H, Araujo-Soares V, Sniehotta FF, Vasankari, Absetz P, Lintunen T, Haukkala A. Use of behavior change techniques in a school-based physical activity intervention: Feasibility study results. European Health Psychologist. 2015;17(S1):411. Hankonen N, Heino MTJ, Hynynen S, Laine H, Araujo-Soares V, Sniehotta FF, Vasankari, Absetz P, Lintunen T, Haukkala A. Use of behavior change techniques in a school-based physical activity intervention: Feasibility study results. European Health Psychologist. 2015;17(S1):411.
21.
go back to reference Imai K, King G, Nall C. The Essential Role of Pair Matching in Cluster-Randomized Experiments, with Application to the Mexican Universal Health Insurance Evaluation. Stat Sci. 2009;24(1):29–53.CrossRef Imai K, King G, Nall C. The Essential Role of Pair Matching in Cluster-Randomized Experiments, with Application to the Mexican Universal Health Insurance Evaluation. Stat Sci. 2009;24(1):29–53.CrossRef
22.
go back to reference de Bruin M, McCambridge J, Prins JM. Reducing the risk of bias in health behaviour change trials: improving trial design, reporting, or bias assessment criteria? Psychol Health. 2014;30:1–43.CrossRef de Bruin M, McCambridge J, Prins JM. Reducing the risk of bias in health behaviour change trials: improving trial design, reporting, or bias assessment criteria? Psychol Health. 2014;30:1–43.CrossRef
23.
go back to reference Ryan RM, Deci EL. Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being. Am Psychol. 2000;55(1):68–78.CrossRefPubMed Ryan RM, Deci EL. Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being. Am Psychol. 2000;55(1):68–78.CrossRefPubMed
24.
go back to reference Carver CS, Scheier MF. Control theory: A useful conceptual framework for personality–social, clinical, and health psychology. Psychol Bull. 1982;92(1):111–35.CrossRefPubMed Carver CS, Scheier MF. Control theory: A useful conceptual framework for personality–social, clinical, and health psychology. Psychol Bull. 1982;92(1):111–35.CrossRefPubMed
25.
go back to reference Hagger MS et al. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. Psychol Health. 2016:1–26. [Epub ahead of print]. Hagger MS et al. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. Psychol Health. 2016:1–26. [Epub ahead of print].
26.
go back to reference Lally P, Gardner B. Promoting habit formation. Health Psychol Rev. 2013;7(sup1):S137–58.CrossRef Lally P, Gardner B. Promoting habit formation. Health Psychol Rev. 2013;7(sup1):S137–58.CrossRef
27.
go back to reference Naar-King S, Suarez M, editors. Motivational Interviewing With Adolescents and Young Adults. New York: Guilford Press; 2011. Naar-King S, Suarez M, editors. Motivational Interviewing With Adolescents and Young Adults. New York: Guilford Press; 2011.
28.
go back to reference Wagner CC, Ingersoll KS, editors. Motivational Interviewing in Groups. New York: Guilford Press; 2013. Wagner CC, Ingersoll KS, editors. Motivational Interviewing in Groups. New York: Guilford Press; 2013.
29.
go back to reference Miller WR, Rollnick S. Motivational interviewing: Helping people change. New York, NY: Guilford press. 2012. Miller WR, Rollnick S. Motivational interviewing: Helping people change. New York, NY: Guilford press. 2012.
30.
go back to reference Michie S et al. The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. Ann Behav Med. 2013;46(1):81–95.CrossRefPubMed Michie S et al. The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. Ann Behav Med. 2013;46(1):81–95.CrossRefPubMed
31.
go back to reference Bellg AJ et al. Enhancing Treatment Fidelity in Health Behavior Change Studies: Best Practices and Recommendations From the NIH Behavior Change Consortium. Health Psychol. 2004;23(5):443–51.CrossRefPubMed Bellg AJ et al. Enhancing Treatment Fidelity in Health Behavior Change Studies: Best Practices and Recommendations From the NIH Behavior Change Consortium. Health Psychol. 2004;23(5):443–51.CrossRefPubMed
32.
go back to reference Vähä-Ypyä H et al. A universal, accurate intensity-based classification of different physical activities using raw data of accelerometer. Clin Physiol Funct Imaging. 2014;35(1):64-70. doi:10.1111/cpf.12127. Vähä-Ypyä H et al. A universal, accurate intensity-based classification of different physical activities using raw data of accelerometer. Clin Physiol Funct Imaging. 2014;35(1):64-70. doi:10.​1111/​cpf.​12127.
33.
go back to reference Eldridge S, Kerry S. A Practical Guide to Cluster Randomised Trials in Health Services Research. Chichester, UK: Wiley-Blackwell. 2012. Eldridge S, Kerry S. A Practical Guide to Cluster Randomised Trials in Health Services Research. Chichester, UK: Wiley-Blackwell. 2012.
34.
go back to reference Aittasalo M et al. Mean amplitude deviation calculated from raw acceleration data: a novel method for classifying the intensity of adolescents’ physical activity irrespective of accelerometer brand. BMC Sports Sci Med Rehab. 2015;7(1):1–7.CrossRef Aittasalo M et al. Mean amplitude deviation calculated from raw acceleration data: a novel method for classifying the intensity of adolescents’ physical activity irrespective of accelerometer brand. BMC Sports Sci Med Rehab. 2015;7(1):1–7.CrossRef
35.
go back to reference Vähä-Ypyä H et al. Validation of Cut-Points for Evaluating the Intensity of Physical Activity with Accelerometry-Based Mean Amplitude Deviation (MAD). PLoS ONE. 2015;10(8):e0134813.CrossRefPubMedPubMedCentral Vähä-Ypyä H et al. Validation of Cut-Points for Evaluating the Intensity of Physical Activity with Accelerometry-Based Mean Amplitude Deviation (MAD). PLoS ONE. 2015;10(8):e0134813.CrossRefPubMedPubMedCentral
36.
go back to reference Sedentary Behaviour Research, N. Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012;37(3):540–2.CrossRef Sedentary Behaviour Research, N. Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012;37(3):540–2.CrossRef
37.
go back to reference Sievänen H et al. A Universal Method For Accurate Classification Of Physical Activity And Sedentary Behavior With Triaxial Accelerometry (abstract). Med Sci Sports Exerc. 2014;46(5S):567. Sievänen H et al. A Universal Method For Accurate Classification Of Physical Activity And Sedentary Behavior With Triaxial Accelerometry (abstract). Med Sci Sports Exerc. 2014;46(5S):567.
38.
go back to reference Rasmussen LB. Nordic monitoring of diet, physical activity and overweight: First collection of data in all Nordic Countries 2011. Copenhagen: Nordic Council of Ministers. 2012. Rasmussen LB. Nordic monitoring of diet, physical activity and overweight: First collection of data in all Nordic Countries 2011. Copenhagen: Nordic Council of Ministers. 2012.
39.
go back to reference Hankonen N et al. Which Behavior Change Techniques are Associated with Changes in Physical Activity, Diet and Body Mass Index in People with Recently Diagnosed Diabetes? Ann Behav Med. 2015;49(1):7–17.CrossRefPubMed Hankonen N et al. Which Behavior Change Techniques are Associated with Changes in Physical Activity, Diet and Body Mass Index in People with Recently Diagnosed Diabetes? Ann Behav Med. 2015;49(1):7–17.CrossRefPubMed
41.
go back to reference Craig P et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337. Craig P et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337.
42.
go back to reference Fagt S et al. Nordic monitoring on diet, physical activity and overweight: Validation of indicators. Copenhagen: Nordic Council of Ministers. 2011. Fagt S et al. Nordic monitoring on diet, physical activity and overweight: Validation of indicators. Copenhagen: Nordic Council of Ministers. 2011.
44.
go back to reference Borodulin K et al. Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health. 2015;25(3):539–46.CrossRefPubMed Borodulin K et al. Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health. 2015;25(3):539–46.CrossRefPubMed
45.
go back to reference Dunstan DW et al. The Australian diabetes, obesity and lifestyle study (AusDiab)—methods and response rates. Diabetes Res Clin Pract. 2002;57(2):119–29.CrossRefPubMed Dunstan DW et al. The Australian diabetes, obesity and lifestyle study (AusDiab)—methods and response rates. Diabetes Res Clin Pract. 2002;57(2):119–29.CrossRefPubMed
46.
go back to reference Lynch BM et al. Development and testing of a past year measure of sedentary behavior: the SIT-Q. BMC Public Health. 2014;14(1):1.CrossRef Lynch BM et al. Development and testing of a past year measure of sedentary behavior: the SIT-Q. BMC Public Health. 2014;14(1):1.CrossRef
48.
go back to reference Karvonen S, Vikat A, Rimpelä M. The role of school context in the increase in young people’s health complaints in Finland. J Adolesc. 2005;28(1):1–16.CrossRefPubMed Karvonen S, Vikat A, Rimpelä M. The role of school context in the increase in young people’s health complaints in Finland. J Adolesc. 2005;28(1):1–16.CrossRefPubMed
49.
go back to reference Merikanto I et al. Late bedtimes weaken school performance and predispose adolescents to health hazards. Sleep Med. 2013;14(11):1105–11.CrossRefPubMed Merikanto I et al. Late bedtimes weaken school performance and predispose adolescents to health hazards. Sleep Med. 2013;14(11):1105–11.CrossRefPubMed
50.
go back to reference Ståhl MK, El-Metwally AAS, Rimpelä AH. Time trends in single versus concomitant neck and back pain in finnish adolescents: results from national cross-sectional surveys from 1991 to 2011. BMC Musculoskelet Disord. 2014;15(1):1–7.CrossRef Ståhl MK, El-Metwally AAS, Rimpelä AH. Time trends in single versus concomitant neck and back pain in finnish adolescents: results from national cross-sectional surveys from 1991 to 2011. BMC Musculoskelet Disord. 2014;15(1):1–7.CrossRef
51.
go back to reference Hoppu U et al. Yläkoululaisten ravitsemus ja hyvinvointi. In: Kansanterveyslaitoksen julkaisuja B30. Helsinki: National Public Health Institute, Finland; 2008. Hoppu U et al. Yläkoululaisten ravitsemus ja hyvinvointi. In: Kansanterveyslaitoksen julkaisuja B30. Helsinki: National Public Health Institute, Finland; 2008.
52.
go back to reference Hoppu U et al. The diet of adolescents can be improved by school intervention. Public Health Nutr. 2010;13(6A):973–9.CrossRefPubMed Hoppu U et al. The diet of adolescents can be improved by school intervention. Public Health Nutr. 2010;13(6A):973–9.CrossRefPubMed
53.
go back to reference Francis J et al. Constructing questionnaires based on the theory of planned behavior. A manual for health services researchers. United Kingdom: University of Newcastle; 2004. Francis J et al. Constructing questionnaires based on the theory of planned behavior. A manual for health services researchers. United Kingdom: University of Newcastle; 2004.
54.
go back to reference Hagger MS et al. The processes by which perceived autonomy support in physical education promotes leisure-time physical activity intentions and behavior: a trans-contextual model. J Educ Psychol. 2003;95(4):784.CrossRef Hagger MS et al. The processes by which perceived autonomy support in physical education promotes leisure-time physical activity intentions and behavior: a trans-contextual model. J Educ Psychol. 2003;95(4):784.CrossRef
55.
go back to reference Fishbein M, Ajzen I. Predicting and changing behavior: The reasoned action approach. New York, NY: Taylor & Francis. 2011. Fishbein M, Ajzen I. Predicting and changing behavior: The reasoned action approach. New York, NY: Taylor & Francis. 2011.
56.
go back to reference Markland D, Tobin V. A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. J Sport Exerc Psychol. 2004;26(2):191–6.CrossRef Markland D, Tobin V. A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. J Sport Exerc Psychol. 2004;26(2):191–6.CrossRef
57.
go back to reference Wilson PM et al. “It’s Who I Am … Really!’ The Importance of Integrated Regulation in Exercise Contexts1. J Appl Biobehav Res. 2006;11(2):79–104.CrossRef Wilson PM et al. “It’s Who I Am … Really!’ The Importance of Integrated Regulation in Exercise Contexts1. J Appl Biobehav Res. 2006;11(2):79–104.CrossRef
58.
go back to reference Gardner B et al. Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. Int J Behav Nutr Phys Act. 2012;9:102–2. Gardner B et al. Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. Int J Behav Nutr Phys Act. 2012;9:102–2.
59.
go back to reference Sniehotta FF et al. Action planning and coping planning for long‐term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35(4):565–76.CrossRef Sniehotta FF et al. Action planning and coping planning for long‐term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35(4):565–76.CrossRef
60.
go back to reference Gosling SD, Rentfrow PJ, Swann Jr WB. A very brief measure of the Big-Five personality domains. J Res Pers. 2003;37(6):504–28.CrossRef Gosling SD, Rentfrow PJ, Swann Jr WB. A very brief measure of the Big-Five personality domains. J Res Pers. 2003;37(6):504–28.CrossRef
61.
go back to reference Richer S, Vallerand R. Construction and validation of the Perceived Relatedness Scale. Revue Européene de Psychologie Appliquée. 1998;48:129–37. Richer S, Vallerand R. Construction and validation of the Perceived Relatedness Scale. Revue Européene de Psychologie Appliquée. 1998;48:129–37.
62.
go back to reference Hagger MS et al. The perceived autonomy support scale for exercise settings (PASSES): Development, validity, and cross-cultural invariance in young people. Psychol Sport Exerc. 2007;8(5):632–53.CrossRef Hagger MS et al. The perceived autonomy support scale for exercise settings (PASSES): Development, validity, and cross-cultural invariance in young people. Psychol Sport Exerc. 2007;8(5):632–53.CrossRef
Metadata
Title
‘Let’s Move It’ – a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial
Authors
Nelli Hankonen
Matti T. J. Heino
Vera Araujo-Soares
Falko F. Sniehotta
Reijo Sund
Tommi Vasankari
Pilvikki Absetz
Katja Borodulin
Antti Uutela
Taru Lintunen
Ari Haukkala
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3094-x

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