Health literacy research and practice最新文献

{"title":"Harnessing the Qualities and Principles of Adult Education for Health Literacy Learning.","authors":"Danielle Marie Muscat","doi":"10.3928/24748307-20240613-03","DOIUrl":"10.3928/24748307-20240613-03","url":null,"abstract":"","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 3","pages":"e121-e123"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Validation of a Health Literacy Assessment Tool for COVID-19 Among Iranian Workers.","authors":"Leila Ghahremani, Khadijeh Jafarpour, Kaveh Ghodrati, Mahin Nazari, Hamidreza Mokarami","doi":"10.3928/24748307-20240321-01","DOIUrl":"https://doi.org/10.3928/24748307-20240321-01","url":null,"abstract":"<p><strong>Background: </strong>The workforce is an organization's most important asset, and ensuring their health and safety is crucial for achieving the organization's mission and goals.</p><p><strong>Objective: </strong>The objective of this study was to design and validate a health literacy tool for COVID-19 among Iranian workers.</p><p><strong>Methods: </strong>This cross-sectional study involved a total of 201 participants. A personal information questionnaire was administered, and The Health Literacy Assessment (HLA) Tool was used to collect data specifically related to COVID-19. The HLA for COVID-19 was designed and developed, and the validity of the tool was evaluated through face, content, convergent, and construct validity analyses. To examine convergent validity, the Perceived Stress Scale was used. The reliability of the questionnaire was assessed using internal consistency measures, such as Cronbach's alpha coefficient.</p><p><strong>Key results: </strong>The mean content validity index was 0.93, indicating high content validity. Confirmatory factor analysis results supported the five-dimensional structure of the tool. Significant correlations were found between the HLA for COVID-19 and perceived stress levels. The Cronbach's alpha coefficient for all items was 0.84, indicating high internal consistency.</p><p><strong>Conclusion: </strong>The HLA for COVID-19 is a concise, reliable tool for measuring health literacy related to COVID-19 among Iranian workers. Assessing COVID-19 health literacy in this population can be useful in evaluating the effectiveness of government officials, the media, and the medical and scientific community in providing necessary information. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e62-e68.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e62-e68"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance with COVID-19 Physical Distancing Mandates in Oman: The Role of Health Literacy and Internal Health Locus of Control.","authors":"Amna Alabri","doi":"10.3928/24748307-20240424-01","DOIUrl":"10.3928/24748307-20240424-01","url":null,"abstract":"<p><strong>Background: </strong>Research indicates that the effectiveness of coronavirus disease 2019 (COVID-19) physical distancing mandates is influenced by several individual factors, including health literacy; internal health locus of control (IHLOC), the belief that physical distancing can reduce COVID-19 risk; social norms; self-efficacy; and perceptions of the benefits and barriers associated with distancing. However, further investigation is needed to understand the links between these factors and compliance intentions.</p><p><strong>Objective: </strong>This study investigates the mechanism linking these factors with the intentions to comply with physical distancing mandates.</p><p><strong>Methods: </strong>A total of 759 participants (Mean age = 29.13, standard deviation [<i>SD</i>] = 8.33; 68.5% women) were surveyed online from September 2020 to October 2020. Data were analyzed using ANOVA (analysis of variance) and structural equation modeling.</p><p><strong>Key results: </strong>Health literacy was associated with more perceived benefits (<i>β</i> = .175, <i>p</i> = .001), greater self-efficacy (<i>β</i> = .193, <i>p</i> < .001), and less perceived barriers (β = -.391, <i>p</i> < .001). IHLOC was significantly associated with greater perceived benefits (<i>β</i> = .156, <i>p</i> = .007) and self-efficacy (<i>β</i> = .294, <i>p</i> < .001). Family descriptive norms were significantly associated with fewer perceived barriers (β = -.276, <i>p</i> < .001), while injunctive norms were associated with more perceived benefits (<i>β</i> = .202, <i>p</i> = .001) and higher self-efficacy (<i>β</i> = .299, <i>p</i> < .001). Intentions to adhere to physical distancing mandates were significantly associated with past compliance (<i>β</i> = .427, <i>p</i> < .001) and perceived barriers (β = -.205, <i>p</i> < .001) and benefits (<i>β</i> = .295, <i>p</i> < .001). Post-hoc mediation analyses revealed several small yet significant indirect effects, highlighting the complex pathways shaping adherence intentions.</p><p><strong>Conclusions: </strong>This study identifies how health literacy, IHLOC, social norms, perceived benefits and barriers, and self-efficacy intricately shape intentions to comply with physical distancing mandates. These findings offer valuable implications for public health policy and interventions. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e69-e78.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e69-e78"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Newest Vital Sign Survey: Addressing Concerns About This Health Literacy Assessment Tool.","authors":"Jordy Schol, Luca Ambrosio, Yoshiyuki Yamada, Daisuke Sakai","doi":"10.3928/24748307-20240515-02","DOIUrl":"10.3928/24748307-20240515-02","url":null,"abstract":"","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e91-e92"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy in Pediatric Consultations on Allergy Prevention.","authors":"Julia von Sommoggy, Eva-Maria Skiba, Jonas Lander, Christian Apfelbacher, Janina Curbach, Susanne Brandstetter","doi":"10.3928/24748307-20240320-01","DOIUrl":"https://doi.org/10.3928/24748307-20240320-01","url":null,"abstract":"<p><strong>Background: </strong>The first 3 years of life offer an opportunity to prevent allergic diseases. Pediatricians are an important source of health information for parents. However, a certain degree of health literacy is necessary to understand, appraise, and apply preventive behavior, which can be supported by health literacy (HL) sensitive consultations and a HL friendly environment.</p><p><strong>Objective: </strong>In this study, we want to shed light on how pediatricians in outpatient care in Germany advise on early childhood allergy prevention (ECAP) and how they consider parental HL.</p><p><strong>Methods: </strong>We conducted 19 semi-standardized telephone interviews with pediatricians from North-Rhine-Westphalia and Bavaria. The interviews were audio-recorded, transcribed, pseudonymized, and subjected to content analysis.</p><p><strong>Key results: </strong>Current ECAP recommendations were well known among our sample. Despite the shift of evidence from avoidance of allergens toward early exposure, providing advice on ECAP was considered non-controversial and it was widely assumed that recommendations were easy to understand and apply for parents. However, ECAP was treated as an implicit topic resonating among others like infant nutrition and hygiene. Regarding HL, our interview partners were not aware of HL as a concept. However, they deemed it necessary to somehow assess parental information level and ability to understand provided information. Formal HL screening was not applied, but implicit strategies based on intuition and experience. Concerning effective HL-sensitive communication techniques, interviewees named the adaptation of language and visual support of explanations. More advanced techniques like Teach Back were considered too time-consuming. Medical assistants were considered important in providing an HL-sensitive environment. Time constraints and the high amount of information were considered major barriers regarding HL-sensitive ECAP counseling.</p><p><strong>Conclusion: </strong>It seems warranted to enhance professional education and training for pediatricians in HL and HL-sensitive communication, to reach all parents with HL-sensitive ECAP counseling. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e47-e61.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e47-e61"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking Childhood Cultural Health Capital Factors with Adult Health Literacy.","authors":"Sasha A Fleary","doi":"10.3928/24748307-20240422-01","DOIUrl":"10.3928/24748307-20240422-01","url":null,"abstract":"<p><p>Adult health outcomes are linked to childhood factors such as socioeconomic status via cultural health capital (CHC). Specifically, these factors shape opportunities for developing skills for navigating health environments via experience and the intergenerational transfer of health-related knowledge and skills. Health literacy (HL) is considered a part of and/or result of CHC. HL develops similarly to CHC via opportunities and experiences. Most research to date has ignored the effect of childhood factors on adult HL. The purpose of this study was to explore how childhood factors are related to adult HL. Data were collected from adults (<i>N</i> = 736, mean age = 40.65 years, standard deviation [<i>SD</i>] = 15.39; 52% female; 53.8% White, 31.3% Hispanic and Latino/a/e) in the United States using Qualtrics Panel. Multivariate ordinal and binary logistic regressions predicting HL (as measured by the Newest Vital Sign and Single-Item Literacy Scale) from childhood factors and accounting for demographic covariates were estimated. After accounting for covariates, such as the presence of an employed adult in a white-collar (odds ratio [OR] = 3.34) or blue-collar (<i>OR</i> = 3.68) occupation (versus unknown/not employed) increased the odds of being categorized as possible limited literacy and adequate literacy (versus limited literacy) as measured by the Newest Vital Sign. Similarly, having an employed adult during childhood who had a blue-collar occupation (vs. unknown/not employed) increased the odds of being categorized as adequate literacy (<i>OR</i> = 2.06) as measured by the Single-Item Literacy Scale. Because the adult's employment played a role in the child's adult HL after accounting for other factors and demographics, these findings support using a lifespan approach to assess and identify risk factors for lower HL. This study contributes to the growing body of evidence of how HL is interconnected with social determinants of health across the lifespan and the need to address HL skills in those with poor social determinants of health. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e79-e88.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e79-e88"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Obesity With Health Literacy and Weight Perception Among Women Merchants in Abidjan, Côte d'Ivoire: A Cross-Sectional Study.","authors":"Rui Usui, Maki Aomori, Shogo Kanamori, Bi Tra Jamal Sehi, Setsuko Watabe","doi":"10.3928/24748307-20240521-01","DOIUrl":"10.3928/24748307-20240521-01","url":null,"abstract":"<p><strong>Background: </strong>In Abidjan, Côte d'Ivoire's largest city, obesity rates among women are increasing, posing a major health challenge, especially for the working generation. Merchants represent 64.3% of working women and are a typical occupation for women with low- and middle-income. Health literacy is used to prevent and overcome chronic diseases and can be used as anti-obesity measures.</p><p><strong>Objective: </strong>The aim of this study was to examine the relationship between obesity, health literacy, and weight perception among women merchants in Abidjan.</p><p><strong>Methods: </strong>In this cross-sectional study, we conducted a complete enumeration survey among women merchants in a market in Abidjan from December 2020 to December 2021. In addition to anthropometric measurements, structured face-to-face interviews were conducted. The participants were asked about their weight perception, weight management behaviors, and sociodemographic attributes. They also responded to the Health Literacy Questionnaire (HLQ). Data were tabulated using descriptive statistics, and multiple logistic regression analysis was performed to examine obesity's association with HLQ scales, weight perception, and weight management behaviors.</p><p><strong>Key results: </strong>Of the 873 participants, 259 (29.7%) were obese; 82% of them underestimated their weight. Obesity was associated with a higher rate of HLQ1 (Feeling understood and supported by health care providers) (odds ratio [OR] = 2.926, confidence interval [CI]:1.450-5.901, <i>p</i> = .03), a lower score of HLQ3 (Actively managing my health) (<i>OR</i> = 0.343, CI:0.165-0.716, <i>p</i> = 0.004), a lower rate of accurate weight perception (<i>OR</i> = 0.145, CI: 0.093-0.224, <i>p</i> < .001), and a lower rate of eating at least three meals per day (<i>OR</i> = 0.401, CI:0.260-0.617, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Findings from this study of Abidjan women merchants include obese participants' lack of a proactive attitude toward personal health management, and the association of factors such as inaccurate weight perception and eating fewer than three meals per day with obesity. These finding have important implications for future anti-obesity measures. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e102-e112.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e102-e112"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's New About the Newest Vital Sign?","authors":"Barry D Weiss","doi":"10.3928/24748307-20240515-01","DOIUrl":"10.3928/24748307-20240515-01","url":null,"abstract":"","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e89-e90"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Digital Health Literacy Program on Sufficient Health Behavior Among Thai Working-Age People With Risk Factors for Noncommunicable Diseases.","authors":"Ungsinun Intarakamhang, Khwanying Sriprasertpap, Araya Chiangkhong, Niwat Srisawasdi, Supitcha Wongchan, Piya Boocha","doi":"10.3928/24748307-20240520-01","DOIUrl":"10.3928/24748307-20240520-01","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases (NCDs) account for more than 75% of deaths in Thailand, which is higher than the global average of 71%.</p><p><strong>Objective: </strong>The aim of this study was to investigate the effects of the Digital Health Literacy (DHL) and Sufficient Health Behavior (SHB) Program on Thai working-age adults age 20 to 65 years with risk factors for NCDs (i.e., overweight and lacking physical activity), and compare the health literacy (HL) and SHB of participants living in urban and semi-urban areas at posttest.</p><p><strong>Methods: </strong>Using the lottery method, this one-group pretest-posttest quasi-experimental design randomly selected 200 participants and assigned them to two equally sized groups. The data were gathered through surveys with an item discrimination power between .20 and .86 and a reliability of 0.94 and were statistically analyzed using <i>t</i>-test and F-test.</p><p><strong>Key results: </strong>The DHL and SHB Program comprises six sessions over a 12-week period, and activities designed to enhance knowledge of NCDs, HL, health communication, and health behavior modification. It was conducted by health care workers from urban and semi-urban public hospitals via Zoom using various digital toolkits such as YouTube, animations, infographics, role-play videos, clips, and e-books. At the posttest, the participants had higher HL (<i>t</i> = 2.67, <i>p</i> = .001) and SHB (<i>t</i> = 3.36, <i>p</i> = .001). There was a difference in SHB scores (<i>F</i> = 4.640, <i>p</i> = .032) between those living in urban and those in semi-urban areas, but no difference in HL scores (<i>F</i> = 1.436, <i>p</i> = .232).</p><p><strong>Conclusions: </strong>The DHL and SHB Program improved HL and SHB in Thai working-age adults with risk factors for NCDs in both urban and semi-urban communities. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(2):e93-e101.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 2","pages":"e93-e101"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outreach for Young Adult African Americans with Risk Factors for Stroke.","authors":"Iris Feinberg, Dawn M Aycock, Elizabeth L Tighe, Delaney Detamore","doi":"10.3928/24748307-20240220-01","DOIUrl":"10.3928/24748307-20240220-01","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that younger adult African American people (age 18-35 years) have more than double the risk of having a stroke than White people. Stroke risk education is lacking for this cohort; there is a dearth of materials that are targeted and focused for young adult African Americans. There is also little research on developing and testing age and culturally appropriate health literate materials that may help this population better understand personal risk factors for stroke.</p><p><strong>Objective: </strong>The aim of this study was to understand factors to guide creating and disseminating plain language health messages about stroke risk awareness among young adult African Americans.</p><p><strong>Methods: </strong>African American participants age 18 years and older completed an online survey (<i>N</i> = 413). Descriptive statistics, one-way analysis of variance, and two-step cluster analyses were used to evaluate stroke risk awareness, perceived risk of stroke, message creation factors, and online health information seeking behavior. Open-ended survey items described modifiable and non-modifiable reasons for perceived risk of stroke.</p><p><strong>Key results: </strong>Participants reported differences on overall stroke risk factor awareness by perceived risk of stroke was significant (F[2, 409] = 4.91, <i>p</i> = .008) with the <i>very low/low</i> group (<i>M</i> = 1.66, <i>p</i> < .01), showing significantly lower overall stroke risk factor awareness compared to the <i>moderate</i> and <i>high/very high</i> groups. Both respondents who thought their stroke risk was <i>very low/low</i> and <i>moderate/high/very high</i> commented about family history (54.1% and 45.9%, respectively) as the reason and 88.2% of <i>very low/low</i> commented that they did not have risk factors for stroke because they were young. Cluster analysis indicated the Mostly Clear Preferences cluster was more likely to select <i>mostly/very</i> on positive, informational, and long-term messages and medical authority sources. The largest of three clusters reported medical sources as the highest rated source for both finding and trusting health information (47.2%, <i>n</i> = 195).</p><p><strong>Conclusion: </strong>Young adult African Americans have a scarce understanding of modifiable stroke risk factors; health education materials should focus on positive information messaging that shows a long-term result and is presented by a medical authority. We did not observe any age or sex differences among the data, which suggests different message modalities may not be needed. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2024;8(1):e38-e46.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 1","pages":"e38-e46"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}