Content area
This paper reflects the narratives of families receiving a monthly unconditional cash transfer in addition to targeted child protection services. Using a participatory monitoring and evaluation method, the program recorded how the participating families defined domains of child and family well-being. After 15 months, the families reported experiencing lower stress, providing more nutritious meals, and spending more time with children, and gave specific examples of using what they had learned in the program about more effective parenting.
This paper reflects the narratives of families receiving a monthly unconditional cash transfer in addition to targeted child protection services. Using a participatory monitoring and evaluation method, the program recorded how the participating families defined domains of child and family well-being. After 15 months, the families reported experiencing lower stress, providing more nutritious meals, and spending more time with children, and gave specific examples of using what they had learned in the program about more effective parenting.
The success of unconditional cash transfers (UCT) in reducing poverty around the world has prompted an uptick in utilization across the United States (Shah & Gennetian, 2024; West et al., 2021). Child welfare specialists and advocates for families and children had already recommended that U.S. programs address poverty directly through cash transfers, given the large majority of child welfare cases that are indicated on the basis of findings resulting exclusively from the consequences of poverty (Conrad et al., 2020; Freidman & Rohr, 2023; Grinnell et al., 2023; Dettlaff, 2021; Webb, 2021). UCT are payments given without conditions that do not interfere with any other services or benefits that a family receives (Yoshino et al., 2023). They are distinct from other types of cash assistance that reward families for specific behaviors such as school attendance. COVID-19-related programs providing cash for families with children in the United States found great success in reducing child poverty and led to a proliferation of such programs from 2021 onward (Shah & Gennetian, 2024). What had not been studied was the question of whether families recovering from such experiences as intimate partner violence, physical and sexual abuse, or other specific harms could also benefit from the addition of unconditional cash to the services that they already receive.
The leadership of Forestdale, Inc., a midsized family service and child welfare agency in Queens, New York, was eager to address this question. Supported by a private donor, the organization decided to add UCT to the services received by families who had been affected by violence and were living in poverty. They also added a participatory monitoring and evaluation exercise to learn whether and how UCT affected the families.
Based on the cost of living in Queens, New York, and the funds allocated, recipients were slated to receive $1,000 per month for 15 months.1 Families who had social security numbers were provided with a check each month. Forestdale subsequently learned that the agency could not legally issue checks to families without social security numbers and therefore began to provide them with gift cards instead.
Methodology
In order to maximize learning from the UCT program, Forestdale engaged the Silberman School of Social Work at Hunter College to monitor, evaluate, and learn from the program, as well as to be accountable to participants using a method known as Monitoring, Evaluation, Accountability,and Learning, referred to by the acronym MEAL (Bragin et al., 2021; Sphere, 2015). The MEAL methodology monitors programs undertaken by agencies working for people in need to be sure that the programs are delivered as intended. MEAL evaluators try to ensure that programs are accountable to participants through recording participant views on how they believe that the program is affecting them (both positively and negatively). Evaluators also seek to provide institutional learning to providers and donors as well as mutual learning with program participants (Sphere, 2015). This proved to be a particularly interesting method for this project, as the thinking of families affected by child welfare about the experience of receiving time-limited UCT, or even "cash plus" programs, has not been recorded in other literature as of this writing.
The primary purpose of the Forestdale MEAL program, along with observing the regularity and effectiveness of the program's administration (monitoring), was to hear the clients voices and find out from them whether and how they found the program helpful, and any ways that it was not helpful or could be improved. Information was collected at two time points: the first at the programs initiation and the second at its scheduled end.· The procedures that we followed are recorded in detail below so that others might replicate the process.
Participant Selection
Due to restrictions in the United States regarding who can receive public benefits, the program was limited to families who would not lose such benefits were they to accept the cash transfer and to those not in the midst of acute crises (such as loss of housing or an active episode of serious mental or physical illness). Eighteen families were found to meet these criteria at the time.
As the funds were unconditional, families were assured that participation in the interview process was voluntary and not a requirement of the UCT program. Fifteen of the 18 families agreed to participate in the process.
Procedures
Prior to the interviews, Forestdale made aggregated and de-identified information available to the research team regarding reasons that families were referred to Forestdale and services that were offered and required for program completion. None of this information could be associated with any specific family.
Interviews were conducted by specifically trained Forestdale staff in the preferred language of the participants.' The interviews were recorded before being translated to English and coded by the Silberman research team. The responses were aggregated and sorted by question electronically, and then read together by the coding team in an iterative process until themes emerged. Individual statements were included in the de-identified and aggregated data; however, the specific authors could not be identified. The aggregate themes that emerged from the initial interviews were reviewed with participants at the 15-month mark in a process known as qualitative concept validation (Bragin et al., 2021).
There were four types of questions:
1. Basic demographic questions, including race, gender, ethnicity, and language used at home.
2. Detailed financial questions regarding household income in relation to the family size, how many others lived in the household, and if participants were sending remittances to family members living in their home countries. At the end, we asked about how they used the funds.
3. Questions regarding the program itself, including regularity and reliability of administration, and more general experience of receiving the funds at both time points. We specifically asked participants if there were any difficulties related to the way that participants received or could utilize the funds and how any negative effects could be avoided or mitigated.
4. Questions regarding essential factors for child protection and well-being that we hoped might be associated with the program, based on current literature (Biggeri & Cuesta, 2021; Breitenberg et al., 2021). We were particularly interested in three factors attributed to the difference in school success between children living in poverty and their classmates with higher income-namely, nutritious food, time spent with parents, and level of stress in the home (Tomasi & Volkow, 2021).
As an essential element of participatory monitoring and evaluation, we also asked the participants to define the terms that we were studying and describe their situation at the program's inception, then returned to ask about changes after receiving the funds for 15 months. The study terms included making ends meet, meeting children's basic needs, effective parenting, stress, and perceived well-being. This procedure allowed us to base our program evaluation on participants reported changes along the domains that they self-identified as mattering to their families'livelihoods and well-being; in the key takeaway section, the families' definitions tions of well-being is compared with child well-being
Limitations
Seven of the families who agreed to participate in the MEAL had a social security number and thus were able to receive their UCT via check. Eight of the families did not have social security numbers and, therefore, due to regulatory limitations, Forestdale learned that agencies could not provide those families with cash or checks. Forestdale only learned that some of the participants did not have social security numbers after the program had begun, and since they were unable to distribute cash payments to those families, they provided gift cards instead. However, they continued to treat this as one program. The MEAL team specifically asked about difficulties with receiving or utilizing funds. Three families reported that they could not use the gift cards to pay rent or creditors. Therefore, outcomes varied depending on whether the family received cash or gift cards. These differences are reported in the results section of this paper and accounted for in the discussion and recommendations sections.
Due to the small size of this program, the absence of a quantitative component, the inability to factor in the differential effect of the gift cards, and the fact that it was part of a MEAL program rather than a research study, the extrapolation of the results is extremely limited. Much more could be learned about this population from a large-scale application of the program in the near future, accompanied by a mixed method study of its effects.
Family Demographics: Who were these Families?
The participating families reflected the ethnic, racial, and linguistic diversity of New York City. Their self-identified race and ethnicity is broken down in Table 1. Eight families primarily spoke Spanish at home, five families primarily spoke English, one Lithuanian, and one French.
Participants self-reported household size and income. The majority of the participants (14) were single-parent households, with 12 headed by mothers and two by fathers. At the start of the program, household size ranged from two to nine with a mode and median of four. The number of adults in each household ranged from one to six, with a mode and median of two. The number of children in each household ranged from one to five, with a mode and median of two.
All 15 families were considered to have extremely low income, both at inception and at the 15-month mark, according to the scale used by New York City's Housing Preservation and Development (2022). This measure takes income into account in relation to household size on a scale from middle, moderate, low, very low, and extremely low. Details of participants self-reported income is presented
below. Monthly
Income At the inception of the program, the lowest monthly income was $0 and highest was $3,750. At the 15-month review of the program, the lowest monthly income was $1,000 and the highest was $4,100 with a mode of $1,000. The median income was
Reasons for Referral to Forestdale
Families had been referred to Forestdale for reasons involving children's exposure to physical or sexual violence in the family, affecting, in some cases, children's mental health and school attendance. Two families reported fleeing their country of origin with their children to protect them from perpetrators. Other families separated from the abusers of their children while remaining in the United States.
To address these serious issues, participating families engaged in a range of services including psychotherapy for the sequelae of traumatic events, counseling for survivors of intimate partner violence (ТРУ) substance use treatments, medical monitoring, treatment for serious mental illness, and psychotherapy and counseling for grief and loss. Despite their low income, none of the families was referred exclusively for proxies of poverty-i.e., for lack of food, clothing, shelter, or medical care (Bragin et al., 2024).
Results
This section includes all of the material learned from coding the participant interviews. It includes participants' definitions of key terms, reported living situation along those domains at inception and after 15 months, and reactions to the UCT program. It also includes summary data on how participants reported using the monthly UCT.
Participants' Definitions of Key Terms
We present the qualitative findings below, beginning each section with participant quotes followed by our summary of findings.
Defining the Phrase "Making Ends Meet"
"For me, the main thing is to have enough food. I try to organize myself so that I have enough food and that it is food that lasts."
"Whatever I have, I stop eating it so that my kids can have enough."
"Not having to wait for extra work if you need a jacket for the kids or even hygiene supplies."
"Making ends meet" meant that there was enough money for necessities each month. Their aspiration was "live paycheck to paycheck," meaning that they had enough money for necessities from one paycheck to last to the next paycheck; they described this as a dream that for many came true when they received the UCT. The families considered the regular provision of food the most important necessity, with rent coming in second and bills for heat, electricity, and phone services being next.
Taking Care of Children's Basic Needs
"Yeah, I wish I could work enough to have enough money to let her go to, you know, to after school, you know, like, kind of activities this summer. Yeah, but those for me, its like, its like a luxury. I mean, for other parents, those are basic, you know, but for me, its only a dream..."
Once they had envisioned enough money for food, rent, and bills, participants considered their children's other needs and wishes. Shoes and clothing for the children were described as "a treat" and came up quite often. Getting children's hair done was also mentioned by more than one participant. Books, formal educational activities, and play items for the children were mentioned by one participant each. One mother envisioned some "treats for herself": getting her nails or hair done.
Defining Effective Parenting
An effective parent is definitely someone who is like, you know, intertwined with every single kid, like you know, their daily activities or playing with their friends or like be on top of everything, like who their friends are, you know, how their mood is that theres something that's bothering them or not, so it's basically being super attentive to each and every one equally."
"I would love to have a stable job in a reasonable timeframe where 1 could be with my children in the evening, dedicate my children time, watch them do their homework, be able to think that they can be safe in the home, with me."
"Be included in their lives, talk a lot about their problems, and give them advice on how to protect themselves from bad things."
All of the participants described effective parenting in detail. The first requirement for all was to have time to spend with their children, after providing shelter and food. It also meant understanding their children in depth. For 12 of the 15 families, that meant being a friend and supporter of their child and also being able to explain and teach their family's beliefs and values. One family stated that correcting children's errors immediately was essential, but that it required doing so in a calm state of mind.
Participants found that the biggest barrier to effective parenting was lack of time with their children. They were rarely able to spend the amount of time with their children that they considered optimal because they were shuttling between irregular and low-paying jobs, seeking additional work, in school with the hope of earning enough money to care for their children in the future, or exploring other means to provide food and necessities.
Defining Emotional Stress
"Feeling all alone and so small, with problems too big for me to solve alone. I am the parent, and I must... but what if I cannot?"
"Feeling I cannot care for my children. 1 feel tired and like I cant go on. Trying to stay calm and logical but I just can't."
"I start to worry about the day. Will I find work? Will I be able to feed my children? What will I cook? How can I goon ..."
"The children try to study; they try hard, but they tell me that they need things, and I don't have them and cant get them, and I just fall into low self-esteem... I blame myself."
We asked participants what "emotional stress" looked like for them and their families. Stress was characterized most as being a dark and frightening place. It meant being alone with insurmountable problems and unable to find a way to solve them, whether material or emotional. When they could not solve problems themselves, they felt the lack of family and community support in their daily lives, leading to despair. The three families affected by food insecurity reported deep emotional suffering, noting that due to their constant anxiety about feeding their families, other life problems were never addressed. Two additional families felt that they were on the brink of falling into depression and would become unable to go on.
Participants also discussed the issue of stress as a factor that affected their ability to be effective parents. lhey especially noted the sense that they were alone with problems that they could not solve and that were interfering with their ability to parent effectively. Under these pressures, participants stated that they found themselves angry, prone to yelling instead of listening, demanding instead of discussing, and as exhausted people in whom their children could not confide. They had been counseled on ways to manage stress, such as breathing or taking a time out, but described that their extremely demanding lives made it hard to use those techniques effectively.
Defining Well-being: What is it Like When Your Family is Doing Well?
"Time is good. The more time you take, you know, it's good. Time is very important for me."
"When you have control, you feel calm. You are able to help other people. You are patient. Feeling good. When you are able to handle difficult situations."
"Like showing affection for one another, do activities. You know, would put bliss in each other you know sometimes we do dance parties, so random but definitely do dance parties..."
Well-being was described by most as time spent with extended family, other loved ones, and children. It was a joyful time if they knew their children had enough to eat, their rent was paid, and they could be in the moment, spending time playing with their children, sharing feelings, and discussing their children's lives and dreams. Well-being also encompassed the ability to feel in control and find the solution to difficult problems. Often, participants solved problems with the support of extended or chosen family members.
Reactions to the UCT Program: Initial Thoughts, Hopes, and Worries
"I want to do some shopping for my kids. Right now, I'm going to cook for them with that money they gave me."
"I can go back to work. My daughter is special, she has Down syndrome, and apart from Down syndrome, she has many health diffreulties. Now I can get someone to take care of her and I can work."
"My son is going to wear new shoes."
"The worry that it's going to finish. That has really had me worried thinking the program is going to end. And when I do not receive it any longer. what am I going to do?"
When initially learning of the UCT project, most participants were simply happy and disclosed no concrete plans, some mentioned plans to get out of debt, and one hoped to save money. Several wished that the program were not finite. Three mentioned the problematic nature of the gift cards, as they stated that landlords and creditors sometimes refused to accept them.
Although few participants expressed apprehension about the UCT, several were concerned about how they would manage at program's end.
How Families Spent the UCT Funds
At 15 months, when the program had been scheduled to end for this first cohort, we asked how participants spent the funds. Table 2 categorizes the number of families (bottom row) that reported using their payments for each category of expenses (top row).
The families that had been most food insecure prioritized food almost exclusively. They used the remainder of the money on various items ranging from shoes and warm clothing to utilities and hygiene products. Families that were able to afford food, but struggled with rent, hygiene and school clothes for children prioritized food as well, but then were able to consider other items to a greater degree. Three families reported that they could not always use gift cards that they received for rent or debt, but at least one of the eight found a way to do so. Almost every family found a way to buy something that their children wanted for fun (e.g., video games, art supplies) or for school (e.g., school clothes, backpacks). Most found a way to unite with extended family for brief trips or short outings such as to the movies. Two families traveled to their home country after years of being away. Two were able to spend money on tuition to advance their education and one began saving.
Participants' Reported Experience and Changes after 15 Months of UCT
We were especially eager to learn whether participants identified changes to their capacity to make ends meet, be effective parents, and feel a sense of family well-being using the definitions and key indicators that they had described in our initial interviews. We share selected participant quotes and our coded summaries below, including participants'concluding reflections about the UCT program and ways to improve it.
'Making Ends Meet," Food Insecurity, and the Provision of Nutritious Meals
"My children love fish. I used to buy salmon one time a year. Now I can cook salmon one time a week."
"Even at the end of the month I can still serve vegetable stew."
We define the experience of food insecurity as including insufficient food quantity, inadequate food quality, uncertainty, worry, and concerns about the ability to obtain sufficient or acceptable food (Frongillo, 2022). At inception, three families considered the ability to provide enough food for their children to eat every day the only priority with all else coming second. Two additional families reported parents skipping meals and going to bed hungry so that their children could eat. Finding nutritious foods they could afford was not an option.
After 15 months of UCT, all families reported having enough to eat for all family members, every day. Families reported pleasure in letting the children fill grocery baskets with food they liked and that they felt competent being able to feed their families. Families boasted about being able to have vegetables at the end of the month and being able to serve fresh fish every week.
Time with Children
"An effective parent is a calm parent, who can listen to her children."
'I dont accept shifts when the children are home so that I can be with them."
"We sit together and talk about the day. I learned about the friends they have and what they do."
Saying "Yes" to Children
"My child likes to read and to draw. I bought her some books and some paint."
"When they wanted something to eat, I was so happy to say yes instead of no all the time... [to] wait for another time. I could just get them the food that they liked. Even meat and chicken like those boys like so much..."
Positive Discipline
We can talk and tell stories and that helps them to understand things. I can take time and just talk things out..."
'I don't just react. I take my time, and then we talk. Its hard to do that when you are just looking for food and hoping to not be in the street."
The families took time to be together with their children, to listen to them, to talk with them, to have fun with them and address their problems. Some reported taking time off from work and using the UCT supplement in order to spend time with children when they were at home from school or had special events such as graduations. Other parents had more time because they were not rushing from one "gig" to another or trying to find affordable food. They reported making sure that they had more discussions with their children, including asking children about problems at school and at home. They described getting to know their children better and finding out more about their friends, their tastes, their worries, and their ambitions. They made time to play games with them, do homework with them, and have fun with them.
Stress
Participants stated that knowing that the funds would come every month reliably made them feel less stressed. They would eat; food money was protected. Those who received checks personally from the agency talked about feeling accompanied and the feeling that they could rely on Forestdale. They felt that the funds gave them the capability to solve their problems and that being accompanied by the UCT program and Forestdale made them feel confident.
Because their stress was reduced, they reported being able to refrain from yelling at their children when they were upset and instead took time to think. They found that they were less frequently upset and that when they were, they found ways to relax and enjoy time to themselves and with their children. Every family added that delicious and plentiful meals helped too.
Well-being
"This money meant everything. 1 did not feel alone and frightened because I knew the check would come."
"To be well is to have time to breathe, to think. With the money, I could breathe."
"Hours of being able to sit at peace and then a plate of food that you can really enjoy. this is something very beautiful."
"I had not seen my family for many years. We went together to Coney Island and the kids all together had a wonderful time."
"We went to the park and had a wonderful day. We can do this often now, and my family members can come too... I went to see my family (in the home country) and they gave us all love and good advice. Now we can talk by phone sometimes."
"We can take a break and forget about the terrible things from the past."
Three distinct participants mentioned "tranquility," "peace," and "joy." The relief that the money offered them allowed them to know that they could manage necessities, lifting a burden. In addition, participants emphasized the idea of taking a real break. Most chose some hours at the park. Five went to Coney Island, one to another park, and one to the zoo. Two families returned to their home country and reconnected with family there. Fourteen had taken at least one time to be with their children together with important extended family members. They used these outings to genuinely have fun with their children. This enabled them to be at peace.
The UCT Program: Experience and Preparation for the Time When Funds Would Cease
"There is no greater blessing for a parent than to provide for their children's wants and needs."
Twill have completed my degree and earn more money."
"We will economize somehow and save more. Buy less meat and fish."
"I hope that even when money stops Forestdale will not desert us."
The seven families who picked up their check from Forestdale valued their visits, expressing that they felt understood and cared about by the coordinator of the program. Three participants who received the UCT via gift card expressed that this limited their ability to put the funds toward rent and debt. All of the families expressed gratitude for the funds and said that they benefited, but did hope that the program would continue. They described fears and questions regarding how the end of the UCT program would impact their ability to continue making ends meet, including covering food staples and treats for their children. They described budgeting and employment preparations for managing financially afterwards, including one participant whose daughter had graduated and now planned to join the Marines to help support the family. Several participants voiced hope that Forestdale would continue to offer other support and services. We explicitly asked participants to report any negative consequences to receiving the funds. None were noted.
Discussion
Key Takeaways
Our hope in creating this participatory MEAL activity was to uplift the voices of the participants regarding their experience of a time-limited UCT program-including both positive and negative reactions. We also wanted to learn from their perceptions of the relationship of UCT to the needs of families affected by child welfare who had experienced family violence and abuse, a group not specifically addressed by other published reports.
The most important thing that the money bought families was time, which they assessed improved their parenting. Parents already had a clear definition of "effective parenting," but they did not have the means and time to act on these definitions. After receiving the income every month, families reported just sitting down every day to listen to their children, learning about their friends and activities, speaking to teachers about their children's progress and monitoring attendance more closely. They also reported taking time together for dancing in the living room or having an all-important day at the beach with extended family. Perhaps most poignant was their expression of time to simply experience events and not react thoughtlessly. They stated that time to calm down and reflect enabled them to better support their children.
All of the families were categorized as extremely low income (NYC Housing Preservation and Development, 2022) and remained in that category, even with the addition of the UCT. Three families met the definition of "food insecure" at the inception of the program; two others, or a total of five, skipped at least one meal to feed their children every day. An additional three struggled to provide for their children's basic needs. At the end, all families were able to serve their children nutritious meals every day, boasting about cooking fish and other foods their family craved every week. They had time to shop for affordable ingredients and time to cook.
The families defined "stress" as the feeling of being alone with insurmountable problems. Many parents also found themselves experiencing recurring memories of times when abusers harmed them and their children. The feeling of being alone without means to solve their children's problems brought deep despair. However, receiving the funds made most families feel that they were not so alone, that Forestdale was there beside them and would not let them fall. Knowing that they had some money that they could rely on every month for whatever was most urgently needed took away more stress than they imagined.
The families believed that their sense of well-being improved at the end of the 15-month UCT program, and that there was an association between their well-being and the reliability of the money every month. Parents reported feeling harmony, joy, and calm. They reported that those feelings increased their experience of control over their lives. Reaching out to family members and getting together regularly also helped them feel part of a community where problems could be discussed and solutions found. Being able to say "yes" to their children from time to time, whether buying school shoes that fit at the beginning of the school year, paints for a talented child, or as much food as their children wanted in a grocery basket was profound.
Families noted that the receipt of funds in the form of a gift card limited their ability to use them as they saw fit, as these could not always be used to pay rent or debts.
Potential Contributions to Theory
Three factors are said to account for the difference between the school success of children living below the poverty line, and their classmates with middle- or high income-namely, regular nutritious meals, time spent with parents, and level of stress in the home (Tomasi & Volkow, 2021). Parents reported being able to spend more time with their children, experiencing lower stress in the home, and providing regular nutritious meals. They had the pleasure of sending children to school in shoes that fit and were comfortable-some for the very first time.
In addition, the respondents reported that they had grown to feel that they could indeed create and imagine a good life, not only for themselves, but also for their children, both now and in the future. This is the very definition of subjective well-being, a key component of economic and social growth for families worldwide (Anand et al., 2005 p.3; Robeyns, 2021).
These results challenged assumptions that a time-limited UCT would not make a significant difference in the lives of families who had experienced serious violence (Font & Maguire-Jack, 2020). Instead, the parents reported concrete examples of meaningful change. Once everyone was fed every day, the money bought them time to reflect, time to listen, and time to think through and solve problems. They splurged on outings with with their children, family members, and friends-all key factors in parental well-being (Gennetian & Gassman-Pines, 2023). Feeling less stressed, they were able to visit schools, engage with teachers, and solve problems with struggling teens.
Concluding Recommendations
The positive results of this experience make a compelling case for adding UCTS to the supports offered to families involved in child welfare who have endured child protection difficulties beyond those attributed to poverty alone. Much could be learned by accompanying such a program with a rigorous mixed method study examining whether and how the UCT component affected child and family well-being. Such a study could ensure that all participants received the funds in the form of a gift card, as has been done in other large-scale UCT studies (West et al., 2021). Learning from the experience of parents taught us that the UCT format, allowing other services to remain in place, made those services even more useful to the families in the program, as they had the mental space to reflect on and implement the recommendations of service providers. By not imposing restrictions on how parents used the funds, they demonstrated how their agency and creativity could be engaged toward their own and their children's protection and well-being. It would be valuable if there were a way to provide all families with cash, but that problem has not yet been solved through large-scale studies (Shah & Gennetian, 2024). We hope that such a program might lead to a policy change that includes UCTs in the package of services provided to all families affected by child welfare.
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1 To address Forestdale's ethical concerns about delaying the start of the program until baseline information could be collected in all areas of interest, funds were distributed as soon as families were identified. with the baseline information collected following inception.
2 As findings indicated that families were benefitting in important ways, and funds were available to continue, Forestdale as a matter of ethics, continued to support these 18 families for 30 months, and added a second cohort, bringing the total number of participating families to 27 (William Weisberg, personal communication, 2024; Mitchell, 2023).
3 One family received services in English and was interviewed in English because their preferred language was not available.
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