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Teaching Teens About Sex

Teaching Teens About Sex
Do you think your kids are getting a good education about sexual health and responsibility in school? We discuss teenage pregnancy and find out the good news and some bad news.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. From an adult's point of view, it might seem that today's teenagers are more sophisticated about sexual matters than previous generations. But, health educators will be quick to point out that's not always true. Misinformation about sex and pregnancy is not a thing of the past, and sex education in schools has sometimes become a casualty in our nation's ongoing culture wars. There are programs, though, that are addressing both changing attitudes about sex and the appropriate behavior of young people in an effort to keep kids healthy and avoid teenage pregnancy. Here to give us an update on efforts underway here in San Diego are my guests. Dr. Elizabeth Hernandez, she’s vice president of Social Services for Neighborhood House Association. She oversees Connection, a teen pregnancy prevention program. Dr. Hernandez, welcome to These Days.

DR. ELIZABETH HERNANDEZ (Vice President of Social Services, Neighborhood House Association): Thank you so much for having me.

CAVANAUGH: Connie Burke is Director of Philanthropy for Neighborhood Healthcare. She's here to talk about their teen wellness program, Teens Take Care. Connie, good morning.


CONNIE BURKE (Director of Philanthropy, Neighborhood Healthcare): Thank you. Nice to be here.

CAVANAUGH: Now we invite our listeners to join the conversation. Do you think your kids are getting a good education about sexual health and responsibility in school? Give us a call with your questions and comments about sex education in San Diego. 1-888-895-5727, that’s 1-888-895-KPBS. Dr. Hernandez, is the rate of teenage pregnancy increasing or decreasing in San Diego?

DR. HERNANDEZ: You know, we are very proud to share that throughout California the teenage pregnancy rates has definitely been decreasing steadily throughout 1991. In fact, in 1991 for every thousand females, 71 teenage mothers gave birth to babies. Now, in 2008, actually it’s 35 for every 1,000 mothers. So it’s a half drop since 1991.

CAVANAUGH: That is impressive. So how does California compare with the nation?

DR. HERNANDEZ: California actually is a little lower than the rest of the nation. We have – There’s 20 other states that are lower than California, so you can imagine that the other states are higher than California.


CAVANAUGH: Exactly right. But it’s my understanding that overall, the United States has a rather high rate of teen pregnancy when it’s compared to other, as they call it, rich nations of the world. You know, first world nations, industrialized nations. Is that correct?

DR. HERNANDEZ: Yes, we do have a little higher than the other industrialized nations, absolutely.

CAVANAUGH: Do we know why?

DR. HERNANDEZ: You know, there’s a lot of different theories and a lot of different hypotheses. It could be our efforts in teenage pregnancy prevention, our efforts in sex education in the schools, our efforts to talk to our children about sex. So there’s a lot of different hypotheses. There’s not an exact explanation on exactly why we’re a little higher than the rest of the industrial nations.

CAVANAUGH: Because I know most people might look at those statistics and be really surprised by them. Do we pattern what we teach kids in schools on any of the programs they have in other countries? Do we take any hints from what they’re doing?

DR. HERNANDEZ: You know, I’m not sure. At Neighborhood House Association, we really work to encourage and involve curriculum-based, evidence-based curriculum into our teachings. So we really get curriculum that has been research-based and proven to work. And so we take that curriculum and we take it to the charter school systems and we teach youth about teenage pregnancy prevention and we focus on abstinence, we focus on contraceptive use, we focus on condom use so that we don’t just focus on one or the other, which is sometimes not as popular.

CAVANAUGH: Exactly. Dr. Hernandez, I want you to tell us more about your Connections program at Neighborhood House.

DR. HERNANDEZ: Well, our Connection program is our teenage pregnancy prevention program. It’s a proactive prevention program that we go out to the charter school systems in San Diego and we focus on the high school youth there. We use, like I said before, research-based curriculum called Reducing the Risk and it’s been tested and it is evidence-based and it’s been shown to actually reduce unintended teenage pregnancy births and it also’s been shown to actually encourage and increase contraceptive use.

CAVANAUGH: Now where did the Neighborhood House – where did you start this program?

DR. HERNANDEZ: This started back in 1997 so this has – program has been going on for almost 15 years. And we primarily focus with the charter school system in southeast central San Diego. We’ve also outreached with other partners like the YMCA, San Diego Youth Services. So those organizations have also infused the Reducing the Risk curriculum into their organizations as well.

CAVANAUGH: I’m speaking with Dr. Elizabeth Hernandez. She’s vice president of Social Services for Neighborhood House Association, overseeing Connection, a teen pregnancy prevention program. My other guest is Connie Burke. She’s director of Philanthropy for Neighborhood Healthcare. She's here to talk about their teen wellness program, Teens Take Care. And we’re taking your calls, your questions and comments about sex education in San Diego at 1-888-895-5727. Connie, tell me a little bit about Teens Take Care.

BURKE: Well, last fall we started a program called Teens Take Care and it’s where the adolescents, teenagers, come to our health centers. We teach these classes in El Cajon, Escondido, Temecula, and soon to be Poway, when we open our new health center in a couple of years there. And we go to the school nurses, school counselors and get the word out. Some of the teenagers who have attended the classes really appreciate it and they text and they Facebook other teenagers. So the class is 2:30 to 5:00 on Thursday afternoons and there’s three classes and they learn everything about birth control including abstinence.


BURKE: And also about STDs, and also at each class they have an opportunity to meet with a doctor.

CAVANAUGH: Now, I’m interested, this is not – even though you’re talking with school nurses and so forth, this isn’t a direct – this doesn’t have a direct link with the school curriculum or any particular school, is that right?

BURKE: Not at all. We just want to provide that information that these classes are available if they want to refer someone to them.

CAVANAUGH: I’m wondering, Connie, why – where did you see the need for this? Is it something that the schools are not doing? Or are these kids just falling through the cracks?

BURKE: Well, in California, Hispanic teens continue to have the highest birth rate, and we have five health centers in Escondido and we have – we care for a lot of teenagers who are pregnant. Matter of fact, in addition to this program, we just started a class for pregnant teenagers. It doesn’t – We do a depression screening. It has a mental health component. And we teach them the importance of prenatal care. So within our health centers, we’re seeing more pregnant teens and providing that care and then providing care to their babies once – their wellness care. So it’s a definite need. And it’s just – our Teens Take Care and our wellness program, they fall under our efforts to get adolescents and provide a medical home. Many haven’t seen a doctor for years.

CAVANAUGH: That’s interesting. Dr. Hernandez, I know that one of the innovative things about the Connections program is your peer education program. Tell me a little bit about that.

DR. HERNANDEZ: That’s actually a new component that we’re super excited about starting in July. And we’re partnering with Planned Parenthood to do that because, as you know, the health physical part of sex education is super important. And so what we’re doing is getting a selected few of those kids who went through the Reducing the Risk classes, which is 16 hours of curriculum, and identifying those that have leadership abilities, role modeling abilities, and pushing them through and involving them through a peer education training program. It’s a 14-week program. It’s led by Planned Parenthood and their curriculum. And really excited about it because kids are going to have a chance to actually learn the curriculum, teach the curriculum, give the presentations, connect with other teens, and we’ve seen that teens actually respond better when they’re educated and talked to by other teens. So very excited about that component.

CAVANAUGH: So these teenagers who go through this peer education program are actually going to be holding classes for other teenagers in sex education?

DR. HERNANDEZ: They’re going to be going out with our facilitators…


DR. HERNANDEZ: …to the charter school systems, to other organizations where there’s groups of kids and also partner with them to teach these classes.

CAVANAUGH: We are taking your calls about sex education in San Diego. We’re learning about a new program being sponsored by Neighborhood House Association and Neighborhood Healthcare with their new program, Teens Take Care. We’re taking your calls at 1-888-895-5727, that’s 1-888-895-KPBS. Let’s hear from Carolyn calling from Poway. Good morning, Carolyn. Welcome to These Days.

CAROLYN (Caller, Poway): Hi. Thanks so much for taking my call. You were referencing earlier numbers of reduced teen pregnancy but then you referenced teen births so I was wondering if you had the numbers on teen pregnancies total, not only those that resulted in births and whether that number has gone (audio dropout)…

CAVANAUGH: I understand the question. Thank you, Carolyn.

DR. HERNANDEZ: You know, that’s a great questions (sic) and actually just have the data on the rate of births among mothers in the age range of 15 and 19. I don’t have the rate of actual pregnancies of teenage women.

CAVANAUGH: Right, and it does – it is a measure of births to births, though, from ’91 to 2005, right?

DR. HERNANDEZ: Absolutely.


DR. HERNANDEZ: Teen birthrates.

CAVANAUGH: Let’s take another call. Maria is calling from La Jolla. Good morning, Maria. Welcome to These Days.

MARIA (Caller, La Jolla): Good morning. Thank you for taking my call. I think there’s something very basic that we have to look at when we consider any form of education. The United States has the worst K-thru-12 education system of any of the developed countries and it’s worse than one-third of the underdeveloped countries. Only 70% of native born Americans finish high school. And as we found out with the high school exit exam, usually about 20% of seniors in high school are illiterate anyway. So it makes it very difficult to teach sex education or for kids to be able to seek out information from books, even from the internet, if they can’t read.


MARIA: Another point that I wanted to bring up with regards to the birth rate. California, because it has a more liberal population, does not focus on clinics that provide abortions the way that they do in many other states. Therefore, it’s easier to obtain an abortion, you know, following up on the previous question, which was what’s the abortion rate in California for teenagers.

CAVANAUGH: Right. I’m not quite sure that I understand the connection, Maria. The – I understand her point about kids – She was saying the schools are failing children across the board and sex education being one of those areas. Let me address that part of her question and we’ll get to a question about abortion later in our show. What is – how is your program, Dr. Hernandez, different from the traditional sex education programs that are either, as Maria would tell us, are failing in some schools. I don’t know if everyone would agree with that.

DR. HERNANDEZ: Well, our – what makes Reducing the Risk, I think, different from other sex education programs is that it’s research-based, it’s proven that it’s worked. It also focuses on abstinence as well as condom use as well as contraceptive, and I think that is one of the main reasons what sets us apart from traditional sex education programs. You know, we are – this program is funded by the state. State dollars are very slim, so we want to make sure we use the state dollars as best as possible and make sure we use empirically based curriculums. And this curriculum actually shows post-18 months after the program has completed, teens are still – still have that knowledge, teens still have that attitude about delaying intercourse, about using contraception, about using condom use, so that’s – I think that’s one of the main things that sets us apart from traditional sex education programs, in addition to, you know, the other types of topics that we talk about: role modeling, decision making, positive goals in your life. Those are all things that are infused in the program.

CAVANAUGH: One of the things I was reading about your program, Dr. Hernandez, is the emphasis on the right to say no. The right to say no to sex in general, and the right to say no to unprotected sex, and I think those are two things that are really emphasized in your Connections program.

DR. HERNANDEZ: Absolutely. Refusals and delaying tactics is definitely a couple of topics that we talk about in the program and, really, how to say no in a manner that doesn’t really jeopardize a good relationship but at the same time leaves no ambiguity about the intent not to have sex or not to have unprotected sex.

CAVANAUGH: Do you, Connie, the kids that come to the Teens Take Care program, do they – since they haven’t been to see any health professional for quite some time, do they know how to talk about their bodies and what’s ailing them? Is this a new and different experience for them?

BURKE: I think for many of them it is new but since there’s peer, the same age, and it’s – first they have an anatomy discussion and education and they’re – all questions are welcome. So by the time they’ve gone through three classes and they play games and they have pizza and they get prizes, so we’re trying to make it as non-threatening as possible for – so they can really learn and feel comfortable. And then if they do need HIV testing or they’re concerned about something or they would like birth control, we provide that medical link to a doctor during those three classes. So that’s made a big difference. And, matter of fact, some of the teens want to continue to come because it becomes social and fun and the educators tease and say, okay, well, our three sessions are over. And, likewise, we do Something New is the peer-to-peer, so with their parents’ permission a teen can learn the curriculum and then will be teaching the other teens and we’re – started that in El Cajon.

CAVANAUGH: My guests are Dr. Elizabeth Hernandez. She is vice president of Social Services for Neighborhood House Association, overseeing Connection, a teen pregnancy prevention program. And Connie Burke, she’s Director of Philanthropy for Neighborhood Healthcare. She's here to talk about the teen wellness program, Teens Take Care. We’re taking your calls about sex education, good education about sexual health and responsibility, whether or not your kids are learning it in school, should they be learning in the school. Give us a call with your questions and your comments at 1-888-895-5727. We have to take a short break. We’ll be back in just a few moments here on KPBS.

CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. My guests are Dr. Elizabeth Hernandez and Connie Burke. We are talking about how and where San Diego kids are getting an education about sexual health and responsibility. And we are taking your calls at 1-888-895-5727. Let’s take a call right now. Alfredo is calling us from Chula Vista. Good morning, Alfredo. Welcome to These Days.

ALFREDO (Caller, Chula Vista): Hello. Welcome. Thank you.

CAVANAUGH: You’re welcome.

ALFREDO: Thanks for having me. Well, I have – I have opposing views to this peer-to-peer curriculum because, first off, I think, where are the parent – well, I want to know where are the parents at? Shouldn’t it be a private matter? And I’m against this peer-to-peer curriculum because I don’t think kids should be teaching other kids about having sex. Maybe they shouldn’t be justifying it and by offering prizes and pizza, trying to make it social. But other than that, isn’t that justifying kids having sex with kids and babies making babies?

CAVANAUGH: Let me ask you something before you go, Alfredo. Where – Do you think kids should learn about sex, sexual health in school?

ALFREDO: No. I think they should learn about it at home with their parents teaching them about the – with the – about, well, about sex…


ALFREDO: …because I think especially when it comes to kids teaching kids, there’s too much room for them not being taught the right – the right stuff because they’re being taught by a child.

CAVANAUGH: Gotcha. Thank you for the call, Alfredo. I appreciate it. I want to give you both a chance to respond and since you talked about pizza, Connie, I’ll let you go first.

BURKE: Well, he makes some good points. They’re not teaching them how to have sex or encouraging them to have sex. They’re teaching them about their health, about learning how to prevent pregnancy, about learning how to make good decisions that will affect the rest of their life and the consequences if they don’t. They’re teaching them about risky behaviors can lead to HIV, STDs. So when we talk about the prizes and the pizza, you know, it’s 2:30 when they get – they’re after school, they’re hungry, so a snack is great. And the prizes are really when they have games and they show that they’ve learned the subject.

CAVANAUGH: Right, I understand. Dr. Hernandez, let me ask you, is – do you find that there are any problems in the idea of having teenagers after they’ve gone through this program teach other teenagers about sexual health and about sexual activity?

DR. HERNANDEZ: I do agree that teenagers need to be adequately trained just like professionals and health educators need to be adequately trained. I do agree with the caller that peers should not go out and teach other peers when they haven’t been properly trained because there’s a lot of myths, there’s a lot of, you know, just not factual information out there. So I think after they’ve gone through a training like we provide, a 14-week training with healthcare professionals, practices throughout the training, I think it would be valuable for teens to go out and educate them. And it’s not just educating other teens on having sex. That’s not exactly what we’re focusing on and what we’re trying to preach. What we’re trying to preach is dispelling the myths. What we’re trying to preach is self-esteem. What we’re trying to peer – preach is education on STDs and HIV AIDS. What we’re trying to preach is goal setting. What we’re trying to preach is abstinence. What we’re trying to preach is condom use. So all of those things together is what we try to teach other teens.

CAVANAUGH: That’s sort of full – a full curriculum on sex education. You make the point, Dr. Hernandez, that it’s abstinence plus condom use plus a whole variety of different things to enable kids to have good sexual education. I’m wondering, are some school districts still finding that aspects of sex education is too controversial for them to touch?

DR. HERNANDEZ: You know, I wish I could answer that. I’m not sure as far as what the school district believes or what their opinion are. We focus primarily on the charter school system, more nontraditional type of system.

CAVANAUGH: Right, right.

DR. HERNANDEZ: And so – and at the same time, we also focus on the parents. We really encourage the teens to go home and have those conversations with the parents because the caller’s absolutely right. Those conversations need to happen at home as well. Unfortunately, because of cultural norms and other factors, that doesn’t always happen. So where else can these teens get the education? And that’s the main point of our program, is just empowering teens with education.

CAVANAUGH: We’re taking your calls at 1-888-895-5727. Elizabeth is on the line from San Diego. Good morning, Elizabeth. Welcome to These Days.

ELIZABETH (Caller, San Diego): Hi. Good morning. A very interesting program, very interesting conversation. It seems to me it’s extraordinarily necessary and I know it’s a conversation that people take very – are very careful about nowadays because it falls into the culture war camp, you know.


ELIZABETH: So I want to ask three questions, actually.


ELIZABETH: One, the doctor just sort of answered but I’d like for her to go into it a little more. What is the influence of the parents’ sexual culture and sexual understanding of sexuality…


ELIZABETH: …on the ability for them to teach their children about sex. That’s one. And the other is what is sexual pleasure? Is that a component in your education about sex?

CAVANAUGH: That’s a question. Okay.

ELIZABETH: Okay. And there’s a third one, and that is if abortion is considered as an ultimate possibility in the education of what to do if a child gets pregnant, if a teenager gets pregnant.

CAVANAUGH: Elizabeth, thank you so much for those questions. And I’m going to start with you, Dr. Hernandez. What about the sexual culture of the parents and whether or not they are comfortable talking about sexual matters with their children.

DR. HERNANDEZ: I think that’s a great point. And absolutely the sexual cultural (sic) of a parent has a huge impact on having that conversation with your child. The absolutely – the bottom line is these are tough topics to have with your child and it’s an uncomfortable conversation to have with your child as well for some parents. Some parents are able to have this conversation and they’re fine. Other parents aren’t. I think we talked about the rates of pregnancy in Latinas. Well, that’s definitely – speaks to that as well. In the Latino culture, you know, you don’t have sex and you don’t talk about sex and you wait until marriage. And, unfortunately, that’s not the reality that we are – they’re in right now. So that’s an example of how a parent’s view on sexuality can influence their child. So that’s why I think it’s important not only to educate your – the parent on how to have the conversation with the child but also educate the child on how to start that conversation with the parent as well. We have a workbook as part of our curriculum so we encourage the teens to go home, fill out the workbook, partner with your parent to answer the questions as well, so that creates a dialogue and starts that conversation in a safe way.

CAVANAUGH: And I want to ask you both, too, where, if anywhere, does abortion figure into your curriculum about sexual education? I’m wondering, Connie, does it figure into what you talk with the kids about?

BURKE: Not in the class about Teens Take Care or the teen wellness programs. If they were seeing a provider, the provider would give them medical information about options.

CAVANAUGH: Sure, I understand.

BURKE: And we do not provide that service at Neighborhood Healthcare.

CAVANAUGH: I understand. So, in other words, if, indeed, a teenager comes to your classes and says, you know, I really need to see a doctor, I need to see – I need to get more information from a nurse or a doctor, that’s where they would get that information.

BURKE: Yes, and, again, I wanted to repeat that this – these classes, they’re a gateway to allow teens to have a medical home, to be able to see a counselor if their family is dealing – What we’ve found, which has been a surprise, because of the economy and people losing their homes and jobs, we see teens come to these classes and we identify anxiety and depression and we’re able to help them beyond the – which is our goal, is to give teens access to a medical home.

CAVANAUGH: Exactly. And, Dr. Hernandez, where does abortion figure into your curriculum?

DR. HERNANDEZ: It’s not a part of the curriculum. What we do is we refer kids, if they want further information, to clinics in the area. And should they want to pursue that further, that’s where they would talk to a medical provider who can explain all of the options, pros and cons on everything.

CAVANAUGH: I see. So contraception is part of the program but abortion is not.

DR. HERNANDEZ: Right. Contraceptive, condom use, birth control, those type of topics.

CAVANAUGH: Let’s take another call. Glenn is calling from San Diego. Good morning, Glenn. Welcome to These Days.

GLENN (Caller, San Diego): …morning. Thank you for taking my call. I have a question. Very good debate this morning. My question is kind of what age and what grade level do these programs start to reach out to the youth? I know I think there probably is an increasing number of like the middle school community who becomes more curious about sexuality but then, you know, so my question is targeted towards how early are they hitting these – this community while they’re in this, you know, curiosity stage about sex and before they actually start to explore that curiosity.

CAVANAUGH: Gotcha. Thank you for the call. And I’m going to give that to you, Dr. Hernandez.

DR. HERNANDEZ: Great question, Glenn. Thank you. The Reducing the Risk curriculum, because it’s been tested on the high school age group, that is what we focus on, is the high school age group. However, we do have another component of our program called Life Skills and in Life Skills we focus in the six to eighth grader – sixth to eighth grade range. And in Life Skills we basically talk about self-esteem, goal setting, decision making skills, the decisions on making friends, the type of friends you make, those type of things that are a little bit more age appropriate.

CAVANAUGH: And the age range that teens – your teenage program aims at?

BURKE: They’re open to teens ages 12 through 19.

CAVANAUGH: Okay. All right. Let’s take another call. Julie is calling from Point Loma. Good morning, Julie. Welcome to These Days.

JULIE (Caller, Point Loma): Thank you so much. I would like to say that I have never heard in any of this type of program that they only mention the teenagers but they don’t mention why doesn’t give classes to the boys not to get these ladies pregnant.

CAVANAUGH: I got you, Julie.

JULIE: It never comes up in any conversation. They are the ones and they always – the responsibility’s on the woman, on the woman. But what about the boys? Even grown up men that get somebody pregnant, they don’t even want to pay for child support.

CAVANAUGH: Julie, thank you. Thank you, a very important point, and I know that you have a – You’re very proud of part of your Connections program that addresses that, Dr. Hernandez.

DR. HERNANDEZ: Absolutely. Another part of our Connection program, we have – our main part is Reducing the Risk but we have smaller subsets and one of the things that Julie might be interested in is our male involvement component where we just focus on males. And we have a candid conversation, male-to-male, about the responsibilities in relationship, about the responsibility to be a gentleman, about the responsibility to show respect to ladies, to show respect in relationships overall, and this is done just focusing on male youth and is conducted by a male facilitator and we sometimes partner with local fraternities to bring in male role models to add to that conversation as well.

CAVANAUGH: And you actually have some Chargers players that are taking advantage of that and being role models and showing up at these classes as well.

DR. HERNANDEZ: Absolutely. We are incredibly excited because this past year we partnered with the San Diego Chargers to have a work experience program and one of the Chargers, his name is Gary Banks, has gone out with our facilitator to actually have these conversations and do the male involvement component. And, obviously, as you can imagine, the boys are just – they love it. To see a positive role model making positive choices and providing these same messages is really a powerful situation.

CAVANAUGH: Now when your peer-to-peer group concludes – I know you’re starting it this summer, when it concludes, these kids are going to go to Sacramento. What are they going to do there?

BURKE: Yes, so they’re going to have a day trip to Sacramento and they’re going to visit the capitol there and they’re going to be exposed to policy and legislative and because a part of teen pregnancy prevention is the policy component as well. So we want to definitely expose them to, again, another level of leadership, another – probably another experience that they wouldn’t, in the first place, been experienced in the first place.

CAVANAUGH: Well, I tell you, I – We have to end it here so I want to give you both a chance to talk a little bit more about the times and the things that are coming up for your programs. Connie Burke, when will people be able to take part in the Teens Take Care program? When does that run?

BURKE: That runs Thursday afternoons in a series of three, so if they go to our website we’ll have information for them.

CAVANAUGH: And that website is…?


CAVANAUGH: Okay, and I know, Dr. Hernandez, you have a workshop coming up this Saturday, is that right?

DR. HERNANDEZ: Absolutely. For teens who are interested in taking part of the Reducing the Risk workshop, we’re holding one this and next Saturday. It is a 16 week curriculum so we’re doing 8 hours this Saturday, 8 hours the following Saturday. And for teens who complete both sessions, they will actually get Padre tickets. So there’s always nice to have that incentive to support them in showing up. And should you want additional information on this workshop, I’m going to give a quick phone number, if you don’t mind, 619-263-7761, about the Connection teen workshop.

CAVANAUGH: And you’ll be able to find those numbers and that website on our website, If we didn’t get a chance to take your call, please go online and comment, I want to thank Connie Burke and Dr. Elizabeth Hernandez. Thank you both so much.

BURKE: Thank you.

DR. HERNANDEZ: Thank you. Thank you for having us.

CAVANAUGH: Stay with us for hour two of These Days coming up in just a few minutes here on KPBS.

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