A Meta-Analysis of Web-Delivered Tailored Health Behavior Change Interventions

Abstract

Web-based tailored intervention programs show considerable promise in effecting health-promoting behaviors and improving health outcomes across a variety of medical conditions and patient populations. This meta-analysis compares the effects of tailored versus nontailored web-based interventions on health behaviors and explores the influence of key moderators on treatment outcomes. Forty experimental and quasi-experimental studies (N = 20,180) met criteria for inclusion and were analyzed using meta-analytic procedures. The findings indicated that web-based tailored interventions effected significantly greater improvement in health outcomes as compared with control conditions both at posttesting, d = .139 (95% CI = .111, .166, p <.001, k = 40) and at follow-up, d = .158 (95% CI = .124, .192, p < .001, k = 21). The authors found no evidence of publication bias. These results provided further support for the differential benefits of tailored web-based interventions over nontailored approaches. Analysis of participant/descriptive, intervention, and methodological moderators shed some light on factors that may be important to the success of tailored interventions. Implications of these findings and directions for future research are discussed.

Full text

e Florida State University
DigiNole Commons
School of Library and Information Studies Faculty
Publications School of Library and Information Studies
6-1-2013
A Meta-Analysis of Web-Delivered, Tailored
Health Behavior Change Interventions
Mia A. Lustria
Florida State University, mlustria@fsu.edu
Seth M. Noar
University of North Carolina at Chapel Hill
Juliann Cortese
Florida State University
Stephanie K. Van Stee
University of Kentucky
Robert L. Glueckauf
Florida State University
See next page for additional authors
Follow this and additional works at: hp://diginole.lib.fsu.edu/slis_faculty_publications
Part of the Health Information Technology Commons, and the Library and Information Science
Commons
is Article is brought to you for free and open access by the School of Library and Information Studies at DigiNole Commons. It has been accepted
for inclusion in School of Library and Information Studies Faculty Publications by an authorized administrator of DigiNole Commons. For more
information, please contact lib-ir@fsu.edu.
Recommended Citation
Lustria, M. L. A., Noar, S. M., Cortese, J., van Stee, S., Glueckauf, R. L., & Lee, J. (2013). A meta-analysis of web-delivered tailored
health behavior change interventions. Journal of Health Communication, 18(9), 1039-1069. doi:10.1080/10810730.2013.768727

Authors
Mia A. Lustria, Seth M. Noar, Juliann Cortese, Stephanie K. Van Stee, Robert L. Glueckauf, and Junga Lee
is article is available at DigiNole Commons: hp://diginole.lib.fsu.edu/slis_faculty_publications/13

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
1
!
!
A!Meta'Analysis!of!Web'Delivered,!Tailored!Health!Behavior!Change!Interventions1!
,
1),
,
!+$,:+;$,&<,:=*#5+$3,>7<?<,@,
AB7--(,-.,:+05$5),$'2,8'.-5C$#+-',A#=2+"*,
D-(("E",-.,D-CC='+B$#+-',F,8'.-5C$#+-'3,G(-5+2$,A#$#",H'+9"5*+#),
IJ@,D-(("E+$#",:--K3,4$(($7$**""3,G:,L@LMN%@IMM,
>7-'"O,PQRMS,NJJ%N@LT,
C(=*#5+$U.*=<"2=,,
,
A"#7,!<,V-$53,>7<?<,
AB7--(,-.,W-=5'$(+*C,$'2,!$**,D-CC='+B$#+-',
H'+9"5*+#),-.,V-5#7,D$5-(+'$,$#,D7$K"(,6+((,
LNL,D$55-((,6$((,PD1,LLNRS3,D7$K"(,6+((3,VD,,@TRXX%LLNR,
'-$5U"C$+(<='B<"2=,
,
W=(+$'',D-5#"*"3,>7<?<,
AB7--(,-.,D-CC='+B$#+-',
D-(("E",-.,D-CC='+B$#+-',F,8'.-5C$#+-'3,G(-5+2$,A#$#",H'+9"5*+#),
@XN,D7$CK+-'*,/$)3,4$(($7$**""3,G:,L@LMN%@NNJ,
YB-5#"*"U.*=<"2=,,
,
A#"K7$'+",Z<,[$',A#""3,!<&<,
?"K$5#C"'#,-.,D-CC='+B$#+-'3,H'+9"5*+#),-.,Z"'#=B\),
@@T,]5"7$',1=+(2+'E3,:"^+'E#-'3,Z_,JMRMN%MMJ@,
,*\9$'*@U=\)<"2=,,
,
`-0"5#,:<,](="B\$=.3,>7<?<,
?"K$5#C"'#,-.,!"2+B$(,6=C$'+#+"*,F,A-B+$(,AB+"'B"*,
D-(("E",-.,!"2+B+'"3,G(-5+2$,A#$#",H'+9"5*+#),
IIIR,/<,D$((,A#<3,A=+#",ILIM,:3,4$(($7$**""3,G:,L@LMN%JLMM,
`-0"5#<](="B\$=.UC"2<.*=<"2=,,
,
W='E$,:""3,>7<?<,
AK-5#*,!"2+B+'",:$0-5$#-5)3,_-'*"+,H'+9"5*+#),
A"-=(3,A-=#7,Z-5"$,
Y='E$NILUEC$+(<B-C,
!
!
!
!
I,!"#$%#$%&'%()*"+,-$%.,#/#'&0%1&')$2,#3*%+4%&'%&,*#205%6"+$5%4#'&0%&'7%754#'#*#85%4+,9:%*"5%;5,$#+'%+4%<52+,7:%"&$%=55'%
3)=0#$"57%#'%*"5%>+),'&0%+4%?5&0*"%@+99)'#2&*#+'%ABCDEF%A2+3G,#/"*%!&G0+,%H%I,&'2#$FJ%K05&$5%7+%'+*%7#$*,#=)*5%6#*"+)*%
*"5%&)*"+,$L%35,9#$$#+'J%@#*&*#+'M%:=*#5+$3,!<,:<,&<3,V-$53,A<,!<3,D-5#"*"3,W<3,9$',A#""3,A<3,](="B\$=.3,`<,:<3,F,:""3,W<,P@MILS<,
&,C"#$%$'$()*+*,-.,a"0%2"(+9"5"2,#$+(-5"2,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-'*<,>+),'&0%+4%?5&0*"%@+99)'#2&*#+':%
DNPXS3,IMLX%IMNX<,2-+OIM<IMQMbIMQIMTLM<@MIL<TNQT@T,
@,D-55"*K-'2+'E,$=#7-5<,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
2
A!Meta'Analysis!of!Web'Delivered,!Tailored!Health!Behavior!Change!Interventions!
,
,
,
,
Abstract!
BackgroundO,/"0%0$*"23,#$+(-5"2,+'#"59"'#+-',K5-E5$C*,*7-a,B-'*+2"5$0(",K5-C+*",+',
".."B#+'E,7"$(#7%K5-C-#+'E,0"7$9+-5*,$'2,+CK5-9+'E,7"$(#7,-=#B-C"*,$B5-**,$,9$5+"#),-.,
C"2+B$(,B-'2+#+-'*,$'2,K$#+"'#,K-K=($#+-'*<,,PurposeO,47+*,C"#$%$'$()*+*,B-CK$5"*,#7",
".."B#*,-.,#$+(-5"2,9"5*=*,'-'%#$+(-5"23,a"0%0$*"2,+'#"59"'#+-'*,-',7"$(#7,0"7$9+-5*3,$'2,
"^K(-5"*,#7",+'.(="'B",-.,\"),C-2"5$#-5*,-',#5"$#C"'#,-=#B-C"*<,MethodsO,G-5#),
"^K"5+C"'#$(,$'2,c=$*+%"^K"5+C"'#$(,*#=2+"*,PO,d,@M3IQMS,C"#,B5+#"5+$,.-5,+'B(=*+-',$'2,
a"5",$'$();"2,=*+'E,C"#$%$'$()#+B,K5-B"2=5"*<,ResultsO,47",.+'2+'E*,+'2+B$#"2,#7$#,a"0%
0$*"23,#$+(-5"2,+'#"59"'#+-'*,".."B#"2,*+E'+.+B$'#(),E5"$#"5,+CK5-9"C"'#,+',7"$(#7,
-=#B-C"*,$*,B-CK$5"2,#-,B-'#5-(,B-'2+#+-'*,0-#7,$#,K-*#%#"*#+'E3,7%d,<ILX,PXRe,D8,d,<III3,
<INN3,3P<MMI3,Q,d,JMS,$'2,$#,.-((-a%=K3,7%d,<IRQ,PXRe,D8,d,<I@J3,<IX@3,3P<MMI3,Q,d,@IS<,V-,
"9+2"'B",-.,K=0(+B$#+-',0+$*,a$*,.-='2<,ConclusionsO,47"*",5"*=(#*,K5-9+2"2,.=5#7"5,
*=KK-5#,.-5,#7",2+.."5"'#+$(,0"'".+#*,-.,#$+(-5"2,a"0%0$*"2,+'#"59"'#+-'*,-9"5,'-'%#$+(-5"2,
$KK5-$B7"*<,&'$()*+*,-.,K$5#+B+K$'#b2"*B5+K#+9"3,+'#"59"'#+-'3,$'2,C"#7-2-(-E+B$(,
C-2"5$#-5*,*7"2,*-C",(+E7#,-',.$B#-5*,#7$#,C$),0",+CK-5#$'#,#-,#7",*=BB"**,-.,#$+(-5"2,
+'#"59"'#+-'*<,8CK(+B$#+-'*,-.,#7"*",.+'2+'E*,$'2,2+5"B#+-'*,.-5,.=#=5",5"*"$5B7,$5",
2+*B=**"2<,!
KeywordsO,R'*5,'5*:%65=S=&$57:%*&#0+,#'/:%#'*5,85'*#+':%"5&0*"%=5"&8#+,%2"&'/5

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
3
INTRODUCTION,
8#,7$*,0""',$,B-CC-',C+*B-'B"K#+-',-.,K=0(+B,7"$(#7,K5-E5$C*,#7$#,7"$(#7,
C"**$E"*,$'2,C-2"*,-.,2"(+9"5),B$',.+#,$((,K-K=($#+-'*3,C"2+B$(,B-'2+#+-'*,-5,
B+5B=C*#$'B"*,PZ5"=#"53,A#5"B7"53,F,]($**C$'3,IXXXf,A=##-'3,1$(B73,F,:"."095"3,IXXRS<,&,
E5-a+'E,0-2),-.,5"*"$5B7,*7-a*,#7$#,K5"*"'#+'E,E"'"5$(,7"$(#7,+'.-5C$#+-',a+#7-=#,
B-'*+2"5+'E,+'2+9+2=$(,'""2*,-5,K"5*-'$(,5"("9$'B",C$),(+C+#,*=0*#$'#+$((),#7","^#"'#,-.,
7"$(#7,0"7$9+-5,B7$'E",PD$+$#$,g=.."5"),F,AB7=(;3,@MMXf,]$'*,"#,$(<3,@MMXf,:$C0"5#3,
:-+*"(("3,F,!$B2-'$(23,@MMXf,:=*#5+$3,D-5#"*"3,V-$53,F,](="B\$=.3,@MMXf,V"9+(("3,!+($#3,F,
hi6$5$3,@MMXf,V"9+(("3,hi6$5$3,F,!+($#3,@MMX$3,@MMX0f,V-$53,6$55+'E#-'3,F,&(25+B73,@MMXf,
A#5"B7"5,"#,$(<3,@MMQf,A=EE*,F,!B8'#)5"3,@MMXf,4",>-"(3,1-(C$'3,`"=0*$"#3,F,2",[5+"*3,@MMXf,
/$'E0"5E3,@MMQS<,,
4$+(-5+'E,+*,$,C=(#+%2+C"'*+-'$(,B-CC='+B$#+-',*#5$#"E),#7$#,+'9-(9"*,2"9"(-K+'E,
+'2+9+2=$(+;"2,C"**$E"*,0$*"2,-',K5"%$**"**C"'#,-.,\"),+'2+9+2=$(%2+.."5"'B",9$5+$0("*,-5,
B7$5$B#"5+*#+B*,(+'\"2,#-,#7",='2"5()+'E,C-2"(,-.,0"7$9+-5,B7$'E",PZ5"=#"53,G$55"((3,
h("9+#B73,F,15"''$'3,@MMMf,:=*#5+$3,"#,$(<3,@MMXS<,V=C"5-=*,*#=2+"*,7$9",.-='2,#7$#,
B-CK$5"2,#-,'-'%#$+(-5"2,C$#"5+$(*3,#$+(-5"2,7"$(#7,C"**$E"*,B-CC$'2,E5"$#"5,$##"'#+-'3,
$5",K5-B"**"2,C-5",+'#"'#()3,B-'#$+',("**,5"2='2$'#,+'.-5C$#+-'3,$'2,$5",K"5B"+9"2,C-5",
K-*+#+9"(),0),7"$(#7,B-'*=C"5*,P1$'2=5$3,IXXQf,15=E3,h"'"C$3,F,D$CK0"((3,@MMLf,Z5"=#"53,
D$0=5'$)3,D7"'3,F,?-'(+'3,@MMJf,Z5"=#"5,F,/5$)3,@MMLf,&<,D<,!$5B=*,"#,$(<3,@MMRf,AC""#*3,
15=E3,F,2",[5+"*3,@MMQf,/+((+$C*%>+"7-#$3,AB7'"+2"53,>+;$55-3,!-a$23,F,A$(-9")3,@MMLS<,,
4$+(-5+'E,a-5\*,0),+'B5"$*+'E,#7",K"5*-'$(,5"("9$'B",-.,7"$(#7,C"**$E"*,P6$a\+'*3,
Z5"=#"53,`"*'+B-a3,G+*70"+'3,F,?+Y\*#5$3,@MMQS<,&BB-52+'E,#-,#7",j($0-5$#+-',:+\"(+7--2,
!-2"(3,a7"',+'2+9+2=$(*,K"5B"+9",+'.-5C$#+-',#-,0",K"5*-'$((),5"("9$'#3,#7+*,C$),"'7$'B",

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
4
#7"+5,C-#+9$#+-',#-,"($0-5$#",-',#7",C"**$E"3,$'2,+'B5"$*",#7"+5,*"'*+#+9+#),#-,$5E=C"'#,
*#5"'E#7,P>"##),F,D$B+-KK-3,IXTXS<,&(#"5'$#+9"()3,+.,#7",$5E=C"'#*,K5"*"'#"2,$5",K"5B"+9"2,
#-,0",*#5-'E3,K"5B"+9"2,K"5*-'$(,5"("9$'B",B$',+'B5"$*",K"5*=$*+-'<,47=*3,#$+(-5+'E,C$),
K($),$',+CK-5#$'#,$(0"+#,+'2+5"B#,5-(",+',B5"$#+'E,$',+2"$(,"'9+5-'C"'#,.-5,K"5*=$*+-',$'23,
K-#"'#+$(()3,7"$(#7,0"7$9+-5,B7$'E",P?+Y\*#5$3,@MMRf,6$a\+'*3,"#,$(<3,@MMQf,`+C"5,F,Z5"=#"53,
@MMNS<,,
D-CK=#+'E,#"B7'-(-E+"*,7$9",B-'#5+0=#"2,*+E'+.+B$'#(),#-,#7",("9"(,-.,*-K7+*#+B$#+-',
-.,#$+(-5+'E<,A=B7,*)*#"C*,B$',.$B+(+#$#",#7"-5)%0$*"2,$**"**C"'#,#-,*=KK-5#,#$+(-5+'E,-',$,
'=C0"5,-.,\"),K"5*-'$(,B7$5$B#"5+*#+B*<,!-5"-9"53,C=(#+K(",+'#"5$B#+9",C-2$(+#+"*,B$',
"'7$'B",#7",2"(+9"5),-.,7"$(#7,C"**$E"*<,,8',$,C"#$%$'$()*+*,-.,TR,5$'2-C+;"2,B-'#5-(("2,
#5+$(*3,>-5#'-),"#,$(<,P@MMQS,.-='2,#7$#,B-CK=#"5%#$+(-5"2,+'#"59"'#+-'*,("2,#-,K-*#%
#5"$#C"'#,B7$'E"*,-',$,'=C0"5,-.,#7"-5"#+B$(()%5"("9$'#,$'#"B"2"'#,9$5+$0("*,P"<E<3,*"(.%
"..+B$B)3,\'-a("2E"3,$##+#=2"*3,K"5B"+9"2,'-5C*3,0"7$9+-5$(,+'#"'#+-'*3,$'2,5"$2+'"**,#-,
B7$'E"S,7)K-#7"*+;"2,#-,+CK5-9",B-'2+#+-'*,.-5,0"7$9+-5,B7$'E",P1$'2=5$3,IXXQf,G+*70"+',
F,D$KK"(($3,@MMNf,>5-B7$*\$,F,?+D("C"'#"3,IXQJS<,,Z5"0*,$'2,>5-B7$*\$,P@MIMS,
$EE5"E$#"2,#7",5"*=(#*,-.,QQ,#$+(-5"2,B-CK=#"5%3,K5+'#%,-5,#"("K7-'"%0$*"2,7"$(#7,
+'#"59"'#+-'*,#$5E"#+'E,.-=5,7"$(#7,0"7$9+-5*,P+<"<3,*C-\+'E,B"**$#+-'3,K7)*+B$(,$B#+9+#)3,
7"$(#7),"$#+'E3,$'2,05"$*#,*B5""'+'ES,$'2,.-='2,$,*+E'+.+B$'#,C"$',".."B#,*+;",PE,d,M<ITS,
$B5-**,#7"*",+'#"59"'#+-'*<,47"*",.+'2+'E*,7$9",0""',B-55-0-5$#"2,+',$,'=C0"5,-.,
*)*#"C$#+B,5"9+"a*3,*7-a+'E,2+.."5"'#+$(,K-*+#+9",".."B#*,.-5,B-CK=#"5%#$+(-5"2,
+'#"59"'#+-'*,-','=#5+#+-',$'2,2+"#$5),0"7$9+-5*,PZ5-";"3,/"5\C$'3,F,15=E3,@MMNf,1<,6<,
!$5B=*,"#,$(<3,@MMTf,V"9+(("3,!+($#3,"#,$(<3,@MMXf,V"9+(("3,hi6$5$3,"#,$(<3,@MMX$3,@MMX0S3,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
5
*C-\+'E,B"**$#+-'3,$'2,-#7"5,5+*\,0"7$9+-5*,P`"9"5",F,?='0$53,@MMIf,`+C"5,F,]($**C$'3,
IXXQf,A#5"B7"53,IXXXf,A#5"B7"53,/$'E3,?"55)3,/+(2"'7$=*3,F,W-7'*-'3,@MM@S<,,
/"0%0$*"23,B-CK=#"5%#$+(-5"2,+'#"59"'#+-'*,7$9",C=(#+K(",$29$'#$E"*,-9"5,*+'E("%
C-2"3,*#$#+B,+'#"59"'#+-'*O,PIS,a+2"5,$BB"**,#-,"^K"5#,B$5",$'2,.""20$B\f,P@S,$0+(+#),#-,
#-EE(",0"#a""',C-2$(+#+"*,$'2,.-5C$#*,#-,*=+#",2+.."5"'#,("$5'+'E,*#)("*,$'2,(+#"5$B),("9"(*f,
PLS,-K#+-',#-,B-CC='+B$#",*)'B75-'-=*(),$'2,$*)'B75-'-=*(),#7=*,"'$0(+'E,B-'9"'+"'#,
*B7"2=(+'E,-.,+'#"5$B#+-'*,$'2,2"(+9"5),-.,5"C+'2"5*,$'2,C"**$E"*f,PJS,$,a+2",$55$),-.,
+'#"5$B#+9",B-CK-'"'#*,#-,"'7$'B",=*"5,"^K"5+"'B"*,$'2,*=KK-5#,*\+((*,2"9"(-KC"'#3,
0"7$9+-5bE-$(,C-'+#-5+'E3,$'2,K5-E5"**,#5$B\+'E,P"<E<3,"%Y-=5'$(*3,*+C=($#+-'*3,E$C"*3,"#B<S,
P:=*#5+$3,"#,$(<3,@MMXf,>-5#'-)3,"#,$(<3,@MMQS<,,
&*,*=B73,#7",K5-B"**,#-,2"9"(-K,#$+(-5"2,+'#"59"'#+-'*,B$',0",C-5",B-CK("^,#7$',
a7$#,a-=(2,0",+'9-(9"2,+',#7",2"9"(-KC"'#,-.,+'#"59"'#+-'*,2"(+9"5"2,9+$,#5$2+#+-'$(,
C-2"*,P"<E<3,K5+'#S<,&22+#+-'$(()3,#7",C=(#+%C-2$(3,+'#"5$B#+9",'$#=5",-.,a"0%0$*"2,#$+(-5"2,
+'#"59"'#+-'*,C$\"*,+#,2+..+B=(#,#-,#"$*",-=#,C-2"5$#-5*,-.,"..+B$B),B-CK$5"2,#-,#5$2+#+-'$(3,
*+'E("%C-2",$KK5-$B7"*<,D-'*"c="'#()3,"..+B$B),B$',0",+'.(="'B"2,0),$,'=C0"5,-.,.$B#-5*O,
P$S,#7",'$#=5",-.,#7",+'#"59"'#+-',P+<"<3,7"$(#7,.-B=*,$'2,'=C0"5,$'2,#)K"*,-.,#$5E"#,7"$(#7,
0"7$9+-5*Sf,P0S,C-2"*,-.,2"(+9"5)f,PBS,*#=2),B7$5$B#"5+*#+B*f,P2S,K$5#+B+K$'#,K-K=($#+-'f,P"S,
'=C0"5,-.,+'#"59"'#+-',B-'#$B#*f,$'2,P.S,$KK(+B$#+-',-.,#7"-5)%0$*"2,$**"**C"'#,P:=*#5+$3,
"#,$(<3,@MMXf,V-$53,"#,$(<3,@MMXS<,,,
/7+(",K5"9+-=*,C"#$%$'$()*"*,7$9","^$C+'"2,a"0%0$*"2,+'#"59"'#+-'*3,'-'",-.,
#7"*",7$9",.-B=*"2,*K"B+.+B$((),-',a"0%750#85,57,#$+(-5"2,K5-E5$C*<,47+*,*#=2)3,#7"5".-5"3,
.+((*,$,E$K,+',#7",(+#"5$#=5",E+9"',#7",($5E",$'2,5$K+2(),E5-a+'E,'=C0"5,-.,*#=2+"*,-',a"0%
2"(+9"5"2,#$+(-5"2,K5-E5$C*,P"<E<3,:=*#5+$3,"#,$(<3,@MMXf,V-$53,"#,$(<3,@MMXS<,>-5#'-),"#,$(<,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
6
P@MMQS,.-B=*"2,#7"+5,C"#$%$'$()*+*,-',B-CK=#"5%2"(+9"5"2,+'#"59"'#+-'*3,"^$C+'+'E,$'),
+'#"59"'#+-',2"(+9"5"2,9+$,B-CK=#"5,$'2,"^$C+'+'E,*7-5#%#"5C,".."B#*,-'()<,Z5"0*,"#,$(<,
P@MIMS,.-B=*"2,#7"+5,C"#$%$'$()*+*,-',B-CK=#"5%#$+(-5"2,K5-E5$C*,2"(+9"5"2,9+$,$'),
B7$''"(3,a+#7,C-*#,+'#"59"'#+-'*,PTReS,2"(+9"5+'E,K5+'#%0$*"2,5"K-5#*,$'2,-'(),IX,*#=2+"*,
P@@eS,2"(+9"5+'E,B-'#"'#,9+$,B-CK=#"5*,-5,#7",a"0<,/"00,"#,$(<,P@MIMS,"^$C+'"2,#7",05-$2,
a"0%0$*"2,+'#"59"'#+-',(+#"5$#=5",$'2,.-B=*"2,#7"+5,$'$()*+*,K5+C$5+(),-',#7",=*",-.,#7"-5),
$'2,0"7$9+-5,B7$'E",#"B7'+c="*<,,
47",B=55"'#,C"#$%$'$()*+*,.-B=*"*,-',a"0%0$*"23,B-CK=#"5%#$+(-5"2,7"$(#7,
+'#"59"'#+-',*#=2+"*3,$'2,"^$C+'"*,0-#7,*7-5#,$'2,(-'E"5%#"5C,".."B#*,-.,*=B7,
+'#"59"'#+-'*,-',0"7$9+-5$(,-=#B-C"*<,G-((-a+'E,C"#$%$'$()*"*,#7$#,7$9",.-B=*"2,-',
#$+(-5+'E,0=#,*-("(),-5,K5+C$5+(),-',K5+'#%0$*"2,B-'#"'#,2"(+9"5),PZ5"0*3,"#,$(<3,@MIMf,V-$53,
1"'$B3,F,6$55+*3,@MMTf,A-7(,F,!-)"53,@MMTS3,#7",B=55"'#,*#=2),"^$C+'"*,#7",K-#"'#+$(,-.,
#$+(-5+'E,*#5$#"E+"*,=*+'E,#7",a"0,$*,#7",K5+C$5),2"(+9"5),C"B7$'+*C<,AK"B+.+B$(()3,+#,
$**"**"*,#7","..+B$B),-.,a"0%0$*"23,B-CK=#"5%#$+(-5"2,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-',
*#=2+"*,=*+'E,C"#$%$'$()#+B,K5-B"2=5"*<,!-5"-9"53,#7+*,*#=2),B-CK$5"*,#7","..+B$B),-.,
#$+(-5"2,a"0%0$*"2,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-'*,#-,*#$'2$52,-5,E"'"5+B,
$KK5-$B7"*,$'2,"^K(-5"*,*"9"5$(,*"#*,-.,C-2"5$#-5*,#7$#,C$),+CK$B#,#7",".."B#*,-.,
#$+(-5+'E<,,,
47",*K"B+.+B,C-2"5$#-5*,$'2,5"*"$5B7,c="*#+-'*,#"*#"2,$5",$*,.-((-a*O,
I< K&,*#2#3&'*TU5$2,#3*#85%2"&,&2*5,#$*#2$O,6$9",-=#B-C"*,-.,#$+(-5"2,a"0%0$*"2,
0"7$9+-5$(,+'#"59"'#+-'*,9$5+"2,a+#7,5"E$52,#-,E"'2"53,$E"3,K-K=($#+-',#)K"3,B-='#5),
$'2,0"7$9+-5,*#=2+"2k,,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
7
@< R'*5,85'*#+'T*&#0+,#'/%2"&,&2*5,#$*#2$O,6$9",-=#B-C"*,-.,#$+(-5"2,a"0%0$*"2,0"7$9+-5$(,
+'#"59"'#+-'*,9$5+"2,a7"',2+.."5+'E,#$+(-5+'E,*#5$#"E+"*,7$9",0""',$KK(+"2k,47"*",
+'B(=2",#$+(-5+'E,*#5$#"E+"*,*=B7,$*,.5"c="'B),-.,#$+(-5+'E,$**"**C"'#,$'2,=*"5,B-'#5-(<,
L< 15*"+7+0+/#2&0%2"&,&2*5,#$*#2$O,6$9",-=#B-C"*,-.,#$+(-5"2,a"0%0$*"2,0"7$9+-5$(,
+'#"59"'#+-'*,9$5+"2,a+#7,5"E$52,#-,*#=2),2"*+E'3,#)K",-.,B-CK$5+*-',B-'2+#+-'3,("'E#7,
-.,.-((-a%=K3,$'2,*#=2),5"#"'#+-'k,
!j46h?,
V5&,2"%V*,&*5/G%
/",B-'2=B#"2,B-CK5"7"'*+9",*"$5B7"*,-.,#7",1570#'5,$'2,K$G2ROI.,2$#$0$*"*,.-5,
K-#"'#+$((),"(+E+0(",*#=2+"*,+',K""5%5"9+"a"2,Y-=5'$(*,$'2,0--\,B7$K#"5*,K=0(+*7"2,.5-C,
W$'=$5),IXXX,#-,?"B"C0"5,@MMX<,&',+'+#+$(,*B$',-.,#7",(+#"5$#=5",5"9"$("2,#7$#,*#=2+"*,
K5"2$#+'E,IXXX,2+2,'-#,C""#,#7",.=((,B5+#"5+$,.-5,B-CK=#"5%#$+(-5"23,a"0%2"(+9"5"2,
+'#"59"'#+-'*3,#7=*,#7+*,)"$5,a$*,*"#,$*,#7",*#$5#+'E,K-+'#,.-5,-=5,*"$5B7<,A"$5B7,c="5+"*,
a"5",.-5C=($#"2,=*+'E,2+.."5"'#,B-C0+'$#+-'*,-.,#7",.-((-a+'E,#"5C*O,lB-CK=#"5m3,l/"0m3,
l8'#"5'"#m3,l#$+(-5"2m3,l7"$(#7m,$'2,l+'#"59"'#+-'<m,&((,K-#"'#+$((),"(+E+0(",$5#+B("*,a"5",
"^$C+'"2,#-,2"#"5C+'",#7","^#"'#,-.,5"("9$'B"<,/",$(*-,"^$C+'"2,5"9+"a,$5#+B("*,$'2,
5"."5"'B",(+*#*,-.,*"("B#"2,$5#+B("*,PZ5-";"3,"#,$(<3,@MMNf,:=*#5+$3,"#,$(<3,@MMXf,V-$53,"#,$(<3,
@MMTf,>-5#'-)3,"#,$(<3,@MMQf,`+B7$52*,"#,$(<3,@MMTf,A=EE*,F,!B8'#)5"3,@MMXf,!$5(""',6<,9$',
2"',1"5E3,AB7--'"*3,F,[(+"($'23,@MMTf,/"+'*#"+'3,@MMNS,#-,"'*=5",-=5,*"$5B7,K5-B"**,a$*,
"^7$=*#+9"<,/",-'(),+'B(=2"2,a-5\,K=0(+*7"2,+',K""5%5"9+"a"2,Y-=5'$(*3,0--\*3,-5,0--\,
B7$K#"5*<,,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
8
8'+#+$(,*"$5B7"*,5"*=(#"2,+',Q@R,$0*#5$B#*,#7$#,a"5","^$C+'"2,.-5,5"("9$'B"<,A#=2+"*,
a"5",*B5""'"2,+',*"9"5$(,*#$E"*,=*+'E,"^K(+B+#,+'B(=*+-',$'2,"^B(=*+-',B5+#"5+$,P*"",G+E=5",
ISO,
• K=0(+*7"2,.5-C,W$'=$5),IXXX,#-,?"B"C0"5,@MMX,+',j'E(+*7%($'E=$E"3,K""5%5"9+"a"2,
Y-=5'$(*,
• 5$'2-C+;"2,B-'#5-(("2,#5+$(*,-5,c=$*+%"^K"5+C"'#$(,*#=2+"*,
• "..+B$B),*#=2+"*,-.,-'(+'",7"$(#7,+'#"59"'#+-'*3,#7$#O,
o 7$2,$#,("$*#,-'",a"0%0$*"2,B-CK-'"'#,P2"(+9"5"2,-9"5,#7",8'#"5'"#3,"<E<3,=*+'E,"%
C$+(3,a"0*+#"3,"#B<S,
o =*"2,$,B-CK=#"5,$(E-5+#7C,.-5,#$+(-5+'E,
o "9$(=$#"2,$#,("$*#,-'",7"$(#7,0"7$9+-5,-5,B(+'+B$(,-=#B-C",C"$*=5",,
o K5+C$5+(),#$5E"#"2,K$#+"'#*,-5,E"'"5$(,7"$(#7,B-'*=C"5*,$'2,Vh4,B$5"E+9"5*,-5,
K5-9+2"5*,
n8VAj`4,G8]H`j,Io
, D+#$#+-'*,a"5","9$(=$#"2,$'2,+'"(+E+0(",*#=2+"*,P+<"<3,*#=2+"*,$0-=#,-'(+'",7"$(#7,
+'.-5C$#+-',*""\+'E3,$'2,a"0%0$*"2,B-'#+'=+'E,C"2+B$(,"2=B$#+-'f,-5,2=K(+B$#"2,
K=0(+B$#+-'*S,a"5","^B(=2"2,P'WJQQS<,&0*#5$B#*,-.,#7",5"C$+'+'E,K-#"'#+$((),"(+E+0(",*#=2+"*,
a"5",(-B$#"2,$'2,B(-*"(),"^$C+'"2,.-5,5"("9$'B",P'WLLTS<,A#=2+"*,#7$#,2+2,'-#,7$9",$,a"0,
B-CK-'"'#,-5,2+2,'-#,.-B=*,-',K$#+"'#*,P'WIL@S3,-5,a"5",5"9+"a,$5#+B("*,P'WJMS,a"5",
*=0*"c="'#(),"^B(=2"2<,A+'B",a",a"5",+'#"5"*#"2,+',B-2+'E,$'2,B-CK$5+'E,*#=2+"*,$B5-**,$,
a+2",5$'E",-.,B7$5$B#"5+*#+B*3,a",$(*-,B-'*+2"5"2,#7",B-CK5"7"'*+9"'"**,-.,5"K-5#+'E,+',
*"("B#+'E,$5#+B("*<,,/",$(*-,"^B(=2"2,*#=2+"*,#7$#O,P$S,2+2,'-#,=*",B-CK=#"5%0$*"2,
$**"**C"'#,$'2,#$+(-5+'E,P'WIRS3,P0S,2+2,'-#,C"$*=5",$'),0"7$9+-5$(,-=#B-C"*,P'WLIS3,-5,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
9
PBS,a"5",'-#,5$'2-C+;"2,B-'#5-(("2,#5+$(*,-5,7$2,'-,C"$'+'E.=(,B-CK$5+*-',E5-=K*,P'WQMf,
#7"*",+'B(=2"2,."$*+0+(+#),*#=2+"*3,K5-K-*$(*3,=*$0+(+#),*#=2+"*3,$'2,c=$(+#$#+9",*#=2+"*S<,&*,$,
5"*=(#3,$,.+'$(,*"#,-.,LX,$5#+B("*,PIIeS,C"#,B5+#"5+$,PG+E=5",IS<,1"B$=*",-'",$5#+B(",5"K-5#"2,
2$#$,.5-C,@,*#=2+"*3,#7",.+'$(,*"#,-.,*#=2+"*,+',#7",C"#$%$'$()*+*,a$*,Q,d,JM,P4$0(",IS<,,
n8VAj`4,4&1:j,Io,
(,*#205%@+7#'/%&'7%R'*5,2+75,%<50#&=#0#*G%
&5#+B("*,a"5","9$(=$#"2,.-5,"(+E+0+(+#),0),#a-,+'2"K"'2"'#,B-2"5*<,j(+E+0(",*#=2+"*,
a"5",B-2"2,-',#7",.-((-a+'E,9$5+$0("*O,2"C-E5$K7+B,$'2,*$CK(",B7$5$B#"5+*#+B*f,
+'#"59"'#+-',B7$5$B#"5+*#+B*,P+<"<3,7"$(#7,B-'#"'#3,#$+(-5+'E,B5+#"5+$,$'2,*#5$#"E+"*3,$'2,
C-2$(+#+"*b2"(+9"5),C-2"Sf,$'2,C"#7-2-(-E+B$(,B7$5$B#"5+*#+B*,P+<"<3,5"B5=+#C"'#,
K5-B"2=5"3,B-CK$5+*-',B-'2+#+-'*3,+'#"59"'#+-',("'E#73,+'#"59"'#+-',2-*"3,("'E#7,-.,.-((-a,
=K3,$'2,*#=2),5"#"'#+-'S<,hK"5$#+-'$(,2".+'+#+-'*,a"5",*=CC$5+;"2,+',$,B-2"0--\,#-,"'*=5",
#7$#,B$#"E-5+;$#+-',a$*,B-'*+*#"'#(),$'2,$BB=5$#"(),$KK(+"2,#75-=E7-=#,#7",B-2+'E,K5-B"**<,
4a-,B-2"5*,#"*#"2,$'2,C-2+.+"2,#7+*,B-2"0--\,=*+'E,$',+#"5$#+9",K5-B"**,-.,2$#$,5"9+"a3,
B-'*=(#$#+-'3,$'2,B-'*"'*=$(,9$(+2$#+-'<,,
8'#"5B-2"5,5"(+$0+(+#),a$*,B$(B=($#"2,.-5,"$B7,B7$5$B#"5+*#+B,=*+'E,Z5+KK"'2-5..p*,
$(K7$,P6$)"*,F,Z5+KK"'2-5..3,@MMTf,Z5+KK"'2-5..3,@MMJS3,a7+B7,B$',B$(B=($#",5"(+$0+(+#),.-5,
B$#"E-5+B$(,$'2,B-'#+'=-=*,9$5+$0("*<,Z5+KK"'2-5..p*,$(K7$,5$'E"2,.5-C,$,(-a,-.,M<X@,#-,$,
7+E7,-.,I<M3,a+#7,$,C"$',$(K7$,-.,M<XXQ<,,>"5B"'#$E",-.,$E5""C"'#,.-5,"$B7,B-2+'E,B$#"E-5),
a$*,$(*-,B$(B=($#"2,0),2+9+2+'E,#7",'=C0"5,-.,$E5""2,=K-',B-2+'E,+'*#$'B"*,0),#7",#-#$(<,
>"5B"'#$E",-.,$E5""C"'#,5$'E"2,.5-C,$,(-a,-.,QT<Re,#-,$,7+E7,-.,IMMe3,a+#7,$,C"$',
K"5B"'#,$E5""C"'#,-.,XX<Ne,PC-*#,B$#"E-5+"*,7$2,IMMe,$E5""C"'#S<,47"*",B-"..+B+"'#*,
+'2+B$#"2,9"5),E--2,$E5""C"'#,0"#a""',#7",B-2"5*<,,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
10
X4452*%V#Y5%XZ*,&2*#+'%&'7%@&02)0&*#+'%
47",*#$'2$52+;"2,C"$',2+.."5"'B",*#$#+*#+B,P+<"<3,#7",2+.."5"'B",+',#5"$#C"'#,$'2,
B-'#5-(,C"$'*,2+9+2"2,0),#7",K--("2,*#$'2$52,2"9+$#+-'S,a$*,=*"2,$*,#7",".."B#,*+;",
+'2+B$#-5,PD$5(*-',F,AB7C+2#3,IXXXf,:+K*"),F,/+(*-'3,@MMIS<,1"B$=*",#7+*,".."B#,*+;",+'2"^,
7$*,0""',*7-a',#-,0",=Ka$52(),0+$*"2,a7"',0$*"2,=K-',*C$((,*$CK(",*+;"*,P6"2E"*,F,
h(\+'3,IXQRS3,#7",5"B-CC"'2"2,*#$#+*#+B$(,B-55"B#+-',.-5,#7+*,0+$*,a$*,$KK(+"2,P:+K*"),F,
/+(*-'3,@MMIS<,j.."B#,*+;"*,a"5",B$(B=($#"2,.5-C,2$#$,5"K-5#"2,+',#7",$5#+B("*,P"<E<3,*%#"*#3,
*=CC$5),*#$#+*#+B*S,=*+'E,$KK5-K5+$#",.-5C=($*,P:+K*"),F,/+(*-'3,@MMIf,`-*"'#7$(3,IXXIS<,
&2Y=*#"2,*#$#+*#+B*,a"5",=*"2,+',B$(B=($#+'E,".."B#,*+;"*,#-,"'*=5",#7$#,$'),0$*"(+'",
2+.."5"'B"*,+',E5-=K*,a"5",#$\"',+'#-,$BB-='#<,/7"',$2Y=*#"2,*#$#+*#+B*,a"5",'-#,5"K-5#"23,
0=#,0$*"(+'",2$#$,a"5",$9$+($0("3,a",$2Y=*#"2,.-5,0$*"(+'",2+.."5"'B"*,+',B-CK=#+'E,".."B#,
*+;"*<,,
8',C-*#,B$*"*3,-'(),-'",B-CK$5+*-',B-'2+#+-',"^+*#"2,$'2,a$*,=*"2,a7"',
B-CK=#+'E,".."B#,*+;","*#+C$#"*<,8',$,."a,B$*"*3,0-#7,'-,#5"$#C"'#,B-'#5-(,$'2,'-'%#$+(-5"2,
a"0*+#",B-'#5-(,B-'2+#+-'*,"^+*#"2<,A+'B",#7",E-$(,-.,#7",*#=2),a$*,#-,"^$C+'",#7",5"($#+9",
+CK$B#,-.,*&#0+,57%K5-E5$C*3,+',#7"*",B$*"*,#7",'-'%#$+(-5"2,B-'2+#+-',a$*,B7-*"',P-9"5,#7",
'-%#5"$#C"'#,B-'#5-(,B-'2+#+-'S<,&22+#+-'$(()3,("**,#7$',7$(.,-.,#7",*#=2+"*,PQ,d,IXS,5"K-5#"2,
7$9+'E,B-(("B#"2,K-*##"*#,2$#$,-'()<,>-*##"*#,$'2,K-*##"*#+'E,5"."5,#-,#7",$2C+'+*#5$#+-',-.,
2"K"'2"'#,C"$*=5"*,B(-*"(),$.#"5,#7",#"5C+'$#+-',-.,#5"$#C"'#<,8',#7-*",B$*"*3,".."B#,*+;"*,
a"5",B-CK=#"2,.5-C,#7$#,*+'E(",#+C",K-+'#<,47",-9"5$((,2$#$*"#,+'B(=2"2,JM,*#=2+"*3,a+#7,
"$B7,*#=2),K5"*"'#+'E,2$#$,.-5,#7",K-*##"*#+'E,K7$*",$#,$,C+'+C=C<,47",-#7"5,*"#,-.,*#=2+"*,
PQ,d,@IS,5"K-5#"2,7$9+'E,B-(("B#"2,2$#$,.5-C,-'",-5,C-5",.-((-a%=K,K"5+-2*,$.#"5,
K-*##"*#+'E<,8',-52"5,#-,C$^+C+;",#7",=*",-.,#7",2$#$,5"K-5#"23,$,*"B-'2,2$#$*"#,a$*,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
11
B5"$#"2,P=*+'E,#7"*",@I,*#=2+"*S,$'2,a",B-2"2,#7",(-'E"*#,.-((-a%=K,#+C",K-+'#,#7$#,a$*,
5"K-5#"2<,8',#7+*,a$)3,a",a"5",$0(",#-,$**"**,#7",+CK$B#,-.,#$+(-5"2,K5-E5$C*,$#,K-*##"*#+'E,
$'2,$#,$,(-'E"5%#"5C,.-((-a%=K,K7$*"<,6"5"$.#"53,.-5,B($5+#)3,a",a+((,5"."5,#-,#7"*",#a-,
2$#$*"#*,$*,#7-*","^$C+'+'E,3+$**5$*#'/,$'2,4+00+6S)3,".."B#*3,5"*K"B#+9"()<,
G=5#7"53,E+9"',#7$#,-'(),-'",".."B#,*+;",K"5,-=#B-C",B-=(2,0",+'B(=2"2,+',#7",C"#$%
$'$()*+*3,a7"',$5#+B("*,5"K-5#"2,#a-,*+C+($5,-=#B-C",C"$*=5"*,P"<E<3,#a-,2+.."5"'#,
C"$*=5"*,-.,2+"#$5),B7$'E"S3,".."B#,*+;"*,a"5",B$(B=($#"2,.-5,0-#7,$'2,*=0*"c="'#()3,
$9"5$E"2,#-E"#7"5<,A+C+($5()3,a7"',$5#+B("*,5"K-5#"2,-=#B-C"*,-',C=(#+K(",7"$(#7,
0"7$9+-5*3,".."B#,*+;"*,a"5",B$(B=($#"2,.-5,"$B7,0"7$9+-5,$'2,#7"',$9"5$E"2,#-E"#7"5<,8',
$22+#+-'3,+',-52"5,#-,\""K,".."B#,*+;"*,B-'*+*#"'#,$'2,+'#"5K5"#$0("3,$((,*#=2+"*,+',a7+B7,#7",
#$+(-5"2,B-'2+#+-',-=#K"5.-5C"2,#7",B-CK$5+*-',B-'2+#+-',a"5",E+9"',$,K-*+#+9",*+E',PqS3,
a7"5"$*,$,'"E$#+9",*+E',P%S,+'2+B$#"2,#7$#,#7",5"9"5*",-.,#7+*,a$*,#5="<,,
15*&S('&0G*#2%(33,+&2"%
j.."B#,*+;"*,a"5",a"+E7#"2,0),#7"+5,+'9"5*",9$5+$'B",$'2,B-C0+'"2,=*+'E,*#$'2$52,
.+^"2,".."B#*,C"#$%$'$()#+B,K5-B"2=5"*,P:+K*"),F,/+(*-'3,@MMIS<,47",[,*#$#+*#+B,a$*,=*"2,#-,
"^$C+'",a7"#7"5,*+E'+.+B$'#,7"#"5-E"'"+#),-0#$+'"2,$C-'E,#7",".."B#,*+;"*<,j.."B#,*+;"*,.-5,
7)K-#7"*+;"2,B$#"E-5+B$(,C-2"5$#-5*,a"5",B$(B=($#"2,$(-'E,a+#7,#7"+5,XRe,B-'.+2"'B",
+'#"59$(*3,$'2,#7-*",".."B#,*+;"*,a"5",*#$#+*#+B$((),B-CK$5"2,=*+'E,#7"%[=%%*#$#+*#+B<,
&22+#+-'$(()3,+',#7",B$*",-.,B-'#+'=-=*,P+<"<3,+'#"59$(%("9"(S,C-2"5$#-5,9$5+$0("*3,
B-55"($#+-'*,a"5",B$(B=($#"2,0"#a""',K$5#+B=($5,C-2"5$#-5,9$5+$0("*,$'2,".."B#,*+;"*<,&((,
$'$()*"*,a"5",B-'2=B#"2,=*+'E,D-CK5"7"'*+9",!"#$%&'$()*+*,*-.#a$5"3,["5*+-',@<@<MJN3,
$'2,A>AA,["5*+-',IT<,
, ,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
12
`jAH:4A,
47",Q,d,JM,*#=2+"*,+'B(=2"2,+',#7",C"#$%$'$()*+*,7$2,$,B=C=($#+9",O,d,@M3IQM,
PC"2+$',O,K"5,*#=2),d,IXNf,5$'E",O,d,L3JTTS3,$'2,a"5",K=0(+*7"2,.5-C,W$'=$5),IXXX,#-,
?"B"C0"5,@MMX3,a+#7,$,C"2+$',K=0(+B$#+-',)"$5,-.,@MMN<,4$0("*,@,$'2,L,K5-9+2",
*=CC$5+"*,-.,#7","(+E+0(",*#=2+"*<,47+5#)%.+9",*#=2+"*,PQQeS,+'B(=2"2,B-C0+'"2,
C$("b."C$(",*$CK("*3,a7"5"$*,#7",5"C$+'+'E,*#=2+"*,.-B=*"2,-',."C$("*,-'(),PQ%d,R3,I@eS<,
&C-'E,#7",B-C0+'"2,C$("b."C$(",*#=2+"*3,#7",C"$',K5-K-5#+-',-.,."C$("*,a$*,NJe<,,
!"$',$E",$B5-**,#7",*#=2+"*,a$*,LJ<LN,PA?,d,IR<NXS<,G+'$(()3,Q,d,@@,*#=2+"*,PRReS,+'9-(9"2,
H<A<,*$CK("*3,a7"5"$*,Q,d,IQ,PJReS,+'9-(9"2,*$CK("*,.5-C,*"9"5$(,-#7"5,B-='#5+"*<,
n8VAj`4,4&1:jA,@,F,Lo,
!$Y-5+#),-.,#7",*#=2+"*,PQ,d,@X,f,TLeS,a"5",*+'E("%0"7$9+-5,*#=2+"*3,#7",5"C$+'2"5,
P@TeS,#$5E"#"2,C=(#+K(",0"7$9+-5*<,47",C-*#,.5"c="'#(),*#=2+"2,0"7$9+-5*,a"5",K7)*+B$(,
$B#+9+#),PJ@e,-.,$((,0"7$9+-5*S3,.-((-a"2,0),'=#5+#+-'b2+"#,P@ReS3,$'2,*C-\+'Eb#-0$BB-,
PIQeS<,6-a"9"53,C$'),-.,#7"*",0"7$9+-5*,a"5",*#=2+"2,+',#7",B-'#"^#,-.,C=(#+K(",0"7$9+-5,
+'#"59"'#+-'*<,G-5,"^$CK("3,-.,#7",@L,*#=2+"*,#7$#,+'B(=2"2,K7)*+B$(,$B#+9+#),$*,$,.-B=*3,
IIb@L,PJTeS,a"5",*+'E("%0"7$9+-5,*#=2+"*,.-B=*+'E,-'(),-',K7)*+B$(,$B#+9+#)<,47",
5"C$+'2"5,"^$C+'"2,K7)*+B$(,$B#+9+#),K(=*,-#7"5,7"$(#7,0"7$9+-5*<,,
G+'$(()3,Q,d,IQ,*#=2+"*,PJReS,5"K-5#"2,'-,"^K(+B+#,#7"-5),E=+2+'E,#7",+'#"59"'#+-',
"..-5#<,47",5"C$+'+'E,@@,*#=2+"*,"$B7,5"K-5#"2,-'",-5,C-5",#7"-5+"*,=*"2,#-,E=+2",#7",
+'#"59"'#+-'<,47",C-*#,B-CC-',#7"-5+"*,=*"2,a"5"O,45$'*#7"-5"#+B$(,!-2"(3,A-B+$(,
D-E'+#+9",47"-5)3,$'2,#7",6"$(#7,1"(+".,!-2"(<,h#7"5,#7"-5+"*,=*"23,0=#,C=B7,("**,-.#"'3,
a"5"O,47"-5),-.,`"$*-'"2,&B#+-'3,47"-5),-.,>($''"2,1"7$9+-53,>5"B$=#+-',&2-K#+-',
>5-B"**,!-2"(3,$'2,A-B+$(,D-CK$5+*-',47"-5),P*"",4$0(",LS<,,
% %

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
13
X44#2&2G%+4%R'*5,85'*#+'$%%
47",.+5*#,c="*#+-',"^$C+'"2,a$*,#7",-9"5$((,C$E'+#=2",-.,".."B#<,,47",a"+E7#"2,
C"$',".."B#,*+;",.-5,#7",K-*##"*#,".."B#*,-.,+'#"59"'#+-'*,a$*,7%d,<ILX,PXRe,D-'.+2"'B",
8'#"59$(,nD8od,<III3,<INN3,3P<MMI3,Q,d,JMS<,47=*3,#$+(-5"23,a"0%0$*"2,+'#"59"'#+-'*,7$2,$,
*+E'+.+B$'#(),E5"$#"5,+CK$B#,-',7"$(#7,0"7$9+-5,-=#B-C"*,#7$',#7",B-CK$5+*-'bB-'#5-(,
B-'2+#+-'*,P*"",G+E=5",@S<,,
n8VAj`4,G8]H`j,@o,
/",#7"',B$(B=($#"2,#7",$9"5$E",".."B#,*+;",.-5,@I,*#=2+"*,a+#7,.-((-a%=K,
$2C+'+*#5$#+-'*,-.,#7",2"K"'2"'#,C"$*=5"*<,47",a"+E7#"2,C"$',".."B#,*+;",-.,*#=2+"*,
B-CK$5+'E,#7",.-((-a%=K,".."B#*,-.,#$+(-5"2,9"5*=*,'-'%#$+(-5"2,a"0%0$*"2,+'#"59"'#+-'*,
a$*,7%d,<IRQ,PXRe,D8,d,<I@J3,<IX@3,3P<MMI3,Q,d,@IS<,6"'B"3,#7",2+.."5"'#+$(,K-*+#+9",".."B#*,-.,
#$+(-5"2,a"0%0$*"2,9"5*=*,'-'%#$+(-5"2,a"0%0$*"2,+'#"59"'#+-'*,a"5",C$+'#$+'"2,-9"5,#7",
(-'E"5,#"5C3,a+#7,'-,-0*"59$0(",2"B$),+',".."B#*,-9"5,#+C",P*"",G+E=5",LS<,4-,"'*=5",#7$#,
#7"*",*+C+($5,".."B#,*+;"*,a"5",'-#,2=",#-,#7",2+.."5"'#+$(,C$\"%=K,-.,*#=2+"*,+',#7",#a-,
*"K$5$#",$'$()*"*,PJM,*#=2+"*,9"5*=*,@I,*#=2+"*S3,a","^$C+'"2,#7",+CC"2+$#",K-*##"*#,
".."B#*,-.,#7",@I,*#=2+"*<,47",C"$',".."B#,*+;",a$*,.-='2,#-,0"3,7%d,<ILR,PXRe,D8,d,<IMM3,
<INX3,3P<MMI3,Q,d,@IS3,$,9$(=",$(C-*#,+2"'#+B$(,#-,#7",7,d,<ILX,5"K-5#"2,$0-9"<,,
,n8VAj`4,G8]H`j,Lo,
8',-52"5,#-,"^$C+'",#7",K-**+0+(+#),-.,K=0(+B$#+-',0+$*3,.$+(%*$.",V,9$(="*,a"5",
B$(B=($#"2,$'2,#7",#5+C,$'2,.+((,K5-B"2=5",a$*,$KK(+"2,P:+K*"),F,/+(*-'3,@MMIS<,h5a+'p*,
PIXQLS,C"#7-2,#-,B$(B=($#",.$+(%*$.",V,+'2+B$#"2,#7$#,TI,*#=2+"*,a+#7,'-'%*+E'+.+B$'#,
.+'2+'E*,a-=(2,'""2,#-,"^+*#,#-,5"2=B",#7",2,d,<ILX,K-*##"*#,".."B#,#-,$,#5+9+$(,".."B#,-.,2,d,
<MR3,a7+(",JN,'-'%*+E'+.+B$'#,*#=2+"*,a-=(2,'""2,#-,"^+*#,#-,5"2=B",#7",2,d,<IRQ,.-((-a%=K,
".."B#,#-,$,#5+9+$(,".."B#,-.,2,d,<MR<,G=''"(,K(-#*,-.,#7"*",".."B#*,a"5",$(*-,"^$C+'"2<,A=B7,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
14
K(-#*,a"5",.-='2,#-,0",c=+#",*)CC"#5+B$(,$'2,#7",#5+C,$'2,.+((,$'$()*+*,*=EE"*#"2,'-,
$2Y=*#C"'#,#-,#7"*",C"$',".."B#,*+;"*,P?=9$(,F,4a""2+"3,@MMMS<,47"*",5"*=(#*,+'2+B$#",'-,
"9+2"'B",-.,K=0(+B$#+-',0+$*,$C-'E,#7",B=55"'#,*"#,-.,*#=2+"*<,
V"^#3,7"#"5-E"'"+#),-.,#7",a"+E7#"2,C"$',".."B#,*+;"*,a$*,"^$C+'"2<,A#$#+*#+B$(,
#"*#+'E,+'2+B$#"2,*+E'+.+B$'#,7"#"5-E"'"+#),$#,K-*##"*#+'E,P[E\,d,INQ<ML3,3P<MMI3,RB,d,TN<TXS3,
$*,a"((,$*,$#,.-((-a%=K,P[BC,d,TN<MX3,3P<MMI3,RB,d,TL<T@S3,*=EE"*#+'E,#7",K5"*"'B",-.,
C-2"5$#-5,9$5+$0("*<,47",'"^#,*"#,-.,$'$()*"*,"^K(-5"2,#7",+'.(="'B",-.,#7",&%3,#+,#,
2"#"5C+'"2,C-2"5$#-5*,-',B7$'E"*,+',7"$(#7,0"7$9+-5,-=#B-C"*<,1"B$=*",#7",K-*##"*#,
".."B#*,2$#$*"#,+'B(=2"2,$((,JM,*#=2+"*3,#7"*",2$#$,a"5",=*"2,+',#7",C-2"5$#-5,$'$()*"*,
0"(-a,P"^B"K#,+',-'",B$*",$*,'-#"2,0"(-aS<,
1+75,&*+,%!5$*#'/%
K&,*#2#3&'*TU5$2,#3*#85%9+75,&*+,$J,>$5#+B+K$'#b2"*B5+K#+9",C-2"5$#-5*,a"5",
E"'2"5,PK5-K-5#+-',-.,."C$("*,+',#7",*$CK("*S3,$E"3,#$5E"#,K-K=($#+-'3,B-='#5),$'2,7"$(#7,
0"7$9+-5<,47",B-55"($#+-',0"#a""',E"'2"5,PK5-K-5#+-',."C$("S,$'2,".."B#,*+;",a$*,,,PLXS,d,%
<@X3,3d<IM3,a7"5"$*,#7",B-55"($#+-',0"#a""',$E",$'2,".."B#,*+;",a$*,,,PLRS,d,%<MR3,3d<QM<,47+*,
+'2+B$#"2,#7$#,'"+#7"5,-.,#7"*",K$5#+B+K$'#,9$5+$0("*,a$*,*+E'+.+B$'#(),$**-B+$#"2,a+#7,
+'#"59"'#+-',-=#B-C"*<,`"*=(#*,-.,#7",5"C$+'+'E,C-2"5$#-5,$'$()*"*,+'2+B$#"2,#7$#,
+'#"59"'#+-'*,7$2,*+E'+.+B$'#(),E5"$#"5,".."B#*,a7"',.-B=*"2,-',E"'"5$(,K-K=($#+-',E5-=K*,
P5"."55+'E,#-,+'2+9+2=$(*,'-#,*B5""'"2,.-5,$'),K$5#+B=($5,B75-'+B,+(('"**,-5,-#7"5,2+*"$*",
.$B#-5S,$'2,a7"',.-B=*"2,-',H<A<,*$CK("*,P9"5*=*,'-'%H<A<,*$CK("*S,P0-#7,3r<MRS,P*"",
4$0(",JS<,V-,*+E'+.+B$'#,2+.."5"'B"*,a"5",.-='2,a7"',B-CK$5+'E,C+^"2,#-,."C$("%-'(),
*$CK("*3,*+'E(",9"5*=*,C=(#+K(",0"7$9+-5,+'#"59"'#+-'*3,$'2,a7"',B-CK$5+'E,7"$(#7,
0"7$9+-5*,#$5E"#"2,0),#7",+'#"59"'#+-',P3s<MRS<,
n8VAj`4,4&1:j,Jo,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
15
R'*5,85'*#+'%9+75,&*+,$J%8'#"59"'#+-',C-2"5$#-5*,.-B=*"2,-',.5"c="'B),-.,#$+(-5+'E,
$**"**C"'#,$'2,=*"5,B-'#5-(,P*"",4$0(",RS<,/","9$(=$#"2,a7"#7"5,B-'2=B#+'E,#7",#$+(-5+'E,
$**"**C"'#,$#,0$*"(+'",-'(),-5,C=(#+K(",#+C"*,#75-=E7-=#,#7",+'#"59"'#+-',a$*,5"($#"2,#-,
"..+B$B)<,A+'B",#7+*,*#5$#"E),B$',-'(),7$9",$',+CK$B#,-9"5,#+C"3,a",=*"2,#7",Vd@I,.-((-a%=K,
2$#$,.-5,#7+*,K$5#+B=($5,$'$()*+*<,`"*=(#*,2"C-'*#5$#"2,'-,*+E'+.+B$'#,2+.."5"'B",$C-'E,
*#=2+"*,#7$#,$2C+'+*#"5"2,C=(#+K(",$**"**C"'#*,-9"5,#7",B-=5*",-.,#7",+'#"59"'#+-',#-,
B5"$#",#$+(-5"2,C"**$E"*,P'WIMS,B-CK$5"2,#-,#7-*",#7$#,"CK(-)"2,$,*+'E(",#$+(-5+'E,
$**"**C"'#,$#,0$*"(+'",P'WIIS<,&22+#+-'$(()3,a","^$C+'"2,a7"#7"5,#7",$C-='#,-.,=*"5,
B-'#5-(,P"<E<3,a7"#7"5,#7",#$+(-5"2,+'#"59"'#+-',+'9-(9"2,*=0*#$'#+$(,"^K"5#,E=+2$'B",-5,a$*,
($5E"(),*"(.%E=+2"2S,+'.(="'B"2,-=#B-C"*3,0=#,-=5,$'$()*"*,5"9"$("2,'-,*+E'+.+B$'#,
2+.."5"'B"*,P3s<MRS,P*"",4$0(",RS<,
n8VAj`4,4&1:j,Ro,
15*"+7+0+/#2&0%9+75,&*+,$J%!"#7-2-(-E+B$(,C-2"5$#-5*,a"5",*#=2),2"*+E'3,#)K",-.,
B-CK$5+*-',B-'2+#+-'3,("'E#7,-.,.-((-a%=K3,$'2,*#=2),5"#"'#+-',P*"",4$0(",NS<,h=5,$'$()*+*,
*7-a"2,#7$#,5$'2-C+;"2,B-'#5-(("2,#5+$(*,-0#$+'"2,*+E'+.+B$'#(),E5"$#"5,".."B#,*+;"*,P7%W%<IN3,
3P<MMI3,Q,d,LIS,#7$',c=$*+%"^K"5+C"'#$(,2"*+E'*,P7%d,<MT3,3P<MR3,Q,d,XS<,/+#7,5"E$52,#-,
B-CK$5+*-',B-'2+#+-'3,C-*#,*#=2+"*,=*"2,"+#7"5,$,'-'%#$+(-5"2,a"0*+#",PQdIQS,-5,$,'-,
#5"$#C"'#,B-'#5-(,PQdIQS,B-CK$5+*-'<,G-=5,*#=2+"*,B-CK$5"2,#$+(-5"2,a"0*+#"*,#-,'-'%
#$+(-5"2,K5+'#,C$#"5+$(*<,&'$()*+*,-.,B-CK$5+*-',B-'2+#+-'*,5"9"$("2,#7$#,#$+(-5"2,a"0*+#"*,
*+E'+.+B$'#(),-=#K"5.-5C"2,'-'%#$+(-5"2,a"0*+#"*,-',7"$(#7,0"7$9+-5,-=#B-C"*,P7%W%<IQQ3,
3P<MMIS<,A#=2+"*,#7$#,B-CK$5"2,#$+(-5"2,a"0*+#"*,#-,'-%#5"$#C"'#,B-'#5-(,B-'2+#+-'*,
$B7+"9"2,*+E'+.+B$'#(),*C$(("5,".."B#,*+;"*3,7%W%<MT3,3P<MI3,$*,2+2,*#=2+"*,#7$#,B-CK$5"2,
#$+(-5"2,a"0*+#"*,#-,'-'%#$+(-5"2,K5+'#,C$#"5+$(*3,7,d,<MQ3,3,d,<LR3,Q,d,J,P*"",4$0(",NS<,&(*-3,
#7",B-55"($#+-',0"#a""',.-((-a%=K,#+C",K-+'#,$'2,".."B#,*+;",a$*,,,PLXS,d,<MMJ3,3d<XQ3,.-5,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
16
K-*##"*#,".."B#*3,$'2,,,P@MS,d,%<ITN3,3d<RM3,.-5,.-((-a%=K,".."B#*<,47+*,*=EE"*#*,#7$#,("'E#7,-.,
.-((-a%=K,2+2,'-#,*+E'+.+B$'#(),+'.(="'B",+'#"59"'#+-',-=#B-C"*<,47",B-55"($#+-',0"#a""',
*#=2),5"#"'#+-',$'2,".."B#,*+;",a$*,,,PLXS,d,<MIT3,3d<X@3,+'2+B$#+'E,#7$#,5"#"'#+-',2+2,'-#,
+'.(="'B",*#=2),-=#B-C"*<,,
n8VAj`4,4&1:j,No,
?8ADHAA8hV,
D-CK$5"2,#-,*+'E("%C-2",#$+(-5"2,+'#"59"'#+-'*3,a"0%0$*"2,#$+(-5"2,+'#"59"'#+-'*,
C$),+'B(=2",-#7"5,C-2$(+#+"*,P+<"<3,9+2"-3,$=2+-3,2+*B=**+-',.-5=C*3,B7$#3,"#B<S,#7$#,K5-9+2",
E5"$#"5,+'#"5$B#+9+#),$'2,2+.."5"'#,\'-a("2E"3,*\+((*,0=+(2+'E3,$'2,*"(.%C$'$E"C"'#,#--(*,
P"<E<3,0(--2,E(=B-*",C-'+#-5+'E,#--(*f,"("B#5-'+B,Y-=5'$(+'E3,"#B<S<,47",C=(#+%C-2$(,$'2,
+'#"5$B#+9",'$#=5",-.,a"0%0$*"2,#$+(-5"2,+'#"59"'#+-'*,C$),+CK5-9",#7"+5,".."B#+9"'"**,0),
"'7$'B+'E,K$#+"'#,K$5#+B+K$#+-',$'2,"'E$E"C"'#3,0=#,#7",B-'.(="'B",-.,C-2$(+#+"*,$'2,
."$#=5"*,C$\"*,+#,2+..+B=(#,#-,#"$*",-=#,#7",2+.."5"'#+$(,".."B#*,-.,#7"*",B-CK-'"'#*,-',
+'#"59"'#+-',"..+B$B)<,
47+*,C"#$%$'$()*+*,+*,#7",.+5*#,#-,"^K(-5",#7","..+B$B),-.,B-CK=#"5%#$+(-5"23,a"0%
0$*"2,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-'*,$B5-**,$,a+2",5$'E",-.,7"$(#7,.-B+<,,8',
K$5#+B=($53,a","^$C+'"2,#7","..+B$B),-.,#$+(-5"23,a"0%0$*"2,$KK5-$B7"*,-',7"$(#7,0"7$9+-5,
-=#B-C"*,$'2,"^K(-5"2,C-2"5$#-5*,-.,+'#"59"'#+-',"..+B$B)<,47+*,$'$()*+*,-.,JM,*#=2+"*,
PB=C=($#+9",O,d,@M3IQMS,5"9"$("2,#7$#,#7"*",+'#"59"'#+-'*,+CK$B#"2,7"$(#7,0"7$9+-5,
-=#B-C"*,$#,K-*##"*#+'E,Pa"+E7#"2,C"$',".."B#,*+;",-.,7,d,<ILXS<,,&'$()*+*,-.,.-((-a%=K,
".."B#*,-.,#$+(-5"2,+'#"59"'#+-'*,a$*,$(*-,K5-C+*+'E,P".."B#,*+;","*#+C$#",-.,7,d,<IRQS<,
&(#7-=E7,C$+'#"'$'B",-.,0"7$9+-5,B7$'E",7$*,(-'E,0""',$,C$Y-5,B7$(("'E",.-5,7"$(#7,
B-CC='+B$#+-',K5-E5$C*,P`-#7C$'3,@MMMS3,#7",5"*=(#*,+'2+B$#"2,#7$#,#$+(-5"2,
+'#"59"'#+-'*,C$),7"(K,+'2+9+2=$(*,C$+'#$+',B7$'E"*,-9"5,#+C"<,&,='+c=",$29$'#$E",-.,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
17
a"0%0$*"2,2"(+9"5),+*,#7",B$K$B+#),#-,#$+(-5,+'#"59"'#+-'*,#-,#$5E"#,K-K=($#+-',
B7$5$B#"5+*#+B*,P"<E<3,*K"B+.+B,5+*\,.$B#-5*S<,D-CK$5"2,#-,+'#"59"'#+-'*,5"c=+5+'E,.$B"%#-%.$B",
B-'#$B#,a+#7,#7",7"$(#7B$5",K5-9+2"53,#$+(-5"2,a"0%0$*"2,K5-E5$C*,C$),.$B+(+#$#",a+2"5,
$BB"**,$'2,"'B-=5$E",*"(.%B$5"3,a7+B7,C$),+CK5-9","..+B$B),$'2,C$+'#"'$'B",-.,E$+'*,-9"5,
#+C"<,47+*,B$',0"'".+#,+'2+9+2=$(*,a7-,(+9",+',5=5$(,$5"$*3,$5","B-'-C+B$((),2+*$29$'#$E"23,
-5,7$9",*+E'+.+B$'#,C-0+(+#),+CK$+5C"'#*<,4-,#7+*,K-+'#3,6"$(#7),>"-K(",@M@M,PH<A<,
?"K$5#C"'#,-.,6"$(#7,$'2,6=C$',A"59+B"*3,@MIIS,*#5-'E(),"'2-5*"*,#7",a+2"*K5"$2,
2"K(-)C"'#,-.,+'#"5$B#+9"3,B-CC='+B$#+-',#"B7'-(-E+"*,E"$5"2,#-a$52*,C$\+'E,7"$(#7,
"2=B$#+-',$'2,*"59+B"*,C-5",$BB"**+0(",#-,$'2,"'E$E+'E,.-5,#7",K=0(+B<,
1+75,&*+,$%+4%X44#2&2G%
/",$(*-,"^$C+'"2,#7",".."B#*,-.,$,*"#,-.,K$5#+B+K$'#b2"*B5+K#+9"3,+'#"59"'#+-'3,$'2,
C"#7-2-(-E+B$(,C-2"5$#-5*,-',+'#"59"'#+-',"..+B$B)<,G5-C,#7",9+"aK-+'#,-.,0=+(2+'E,$,
B=C=($#+9",*B+"'B",-.,#$+(-5+'E3,*=B7,$'$()*"*,$5",B5+#+B$(,+',$29$'B+'E,#7",.+"(2p*,
='2"5*#$'2+'E,-.,7-a,#$+(-5+'E,"^"5#*,+#*,".."B#*,P6$a\+'*3,"#,$(<3,@MMQf,V-$53,"#,$(<3,@MMXS<,,
`"*=(#*,+'2+B$#"2,#7$#,#$+(-5"23,a"0%0$*"2,+'#"59"'#+-'*,7$9",0""',C-*#,*=BB"**.=(,
a7"',#$5E"#+'E,E"'"5$(,K-K=($#+-'*,B-CK$5"2,#-,*K"B+.+B,K$#+"'#,E5-=K*,P"<E<3,B75-'+B$((),+((,
K$#+"'#*,-5,C+'-5*S<,8'#"59"'#+-'*,#$5E"#+'E,E"'"5$(,7"$(#7,B-'*=C"5*,a"5",($5E"(),
K5"9"'#+9",+','$#=5",$'2,2+2,'-#,5"c=+5",*=KK-5#,.-5,B-CK("^,#$*\*,+'9-(9"2,+',C$'$E+'E,
B75-'+B,B-'2+#+-'*<,47"*",.+'2+'E*,2-,'-#,'"B"**$5+(),+CK(),#7$#,a"0%0$*"2,#$+(-5"2,
$KK5-$B7"*,a-=(2,0",("**,".."B#+9",.-5,B75-'+B$((),+((,K$#+"'#*<,`$#7"53,#7"*",.+'2+'E*,C$),
+'2+B$#",#7$#,#7"*",K$#+"'#*,C$),*=.."5,.5-C,$,7-*#,-.,B-'2+#+-'*,#7$#,B$',C$\",+#,K7)*+B$(()3,
"C-#+-'$((),$'2,C"'#$((),2+..+B=(#,#-,.=((),"'E$E",+',#7"*",+'#"59"'#+-'*,P"<E<3,9+*+-',-5,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
18
C-0+(",+CK$+5C"'#*,B$',$.."B#,#7",$0+(+#),#-,B-CK=#"5,"c=+KC"'#S<,,&*,*=B73,#7"*",
(+C+#$#+-'*,C=*#,0",B-'*+2"5"2,a7"',2"*+E'+'E,a"0%0$*"2,+'#"59"'#+-'*,.-5,#7"*",E5-=K*<,
47+*,*#=2),$(*-,.-='2,#7$#,a"0%0$*"2,#$+(-5"2,+'#"59"'#+-'*,B-'2=B#"2,+',H<A<,
*"##+'E*,#"'2"2,#-,0",C-5",*=BB"**.=(,B-CK$5"2,#-,#7-*",($='B7"2,"(*"a7"5"<,1"(+".*,$0-=#,
7"$(#73,2+*"$*",$'2,#5"$#C"'#,7$9",0""',.-='2,#-,2+9"5E",$B5-**,5$B+$(,$'2,"#7'+B,C+'-5+#),
E5-=K*,PD7"'E,"#,$(<3,@MIMf,]5-"'"9"(23,A-''$23,:""3,&*B73,F,A7"$3,@MMNf,W"$'%>+"55","#,$(<3,
@MIMf,V-"(3,@MIMf,A7+5"3,@MM@S<,`"*"$5B7,7$*,*7-a',#7$#,+'2+9+2=$(+*C%B-(("B#+9+*C3,+',
$22+#+-',#-,-#7"5,B=(#=5$(%5"($#"2,B-'*#5=B#*,P+<"<3,7"$(#7,(-B=*,-.,B-'#5-(,-5,0"(+".,+',a7-,
=(#+C$#"(),7$*,5"*K-'*+0+(+#),.-5,-'"p*,7"$(#7S3,K($),$',+CK-5#$'#,5-(",+',$',+'2+9+2=$(p*,
7"$(#7,2"B+*+-'%C$\+'E,$'2,7"$(#7,0"7$9+-5*,$'2,7$*,0""',.-='2,#-,"^K($+',*-C",$C-='#,
-.,9$5+$'B",+',K5"."5"'B"*,.-5,7"$(#7,C"**$E+'E,P?=##$3,@MMTS<,,,
47"5",+*,$(*-,(+C+#"2,"9+2"'B",5"E$52+'E,7-a,B=(#=5$(,2+.."5"'B"*,C+E7#,+'.(="'B",
#7",&2253*&'25,-.,#$+(-5"2,$KK5-$B7"*<,?$9+*,P@MMQS,B-CK$5"2,#7",5"$B#+-'*,-.,&C"5+B$',
P5"K5"*"'#+'E,+'2+9+2=$(+*#+B,B=(#=5"*S,$'2,W$K$'"*",P5"K5"*"'#+'E,B-(("B#+9+*#+B,B=(#=5"*S,
+'2+9+2=$(*,#-,B=(#=5$(()%#$+(-5"2,C"**$E"*<,47",*#=2),.-='2,*+E'+.+B$'#,2+.."5"'B"*,
0"#a""',B=(#=5$(,-5+"'#$#+-'*,+',#"5C*,-.,5"K-5#"2,"'E$E"C"'#3,K"5B"+9"2,$##5$B#+9"'"**,
$'2,'-9"(#),-.,#7",+'.-5C$#+-',K5"*"'#"2,+',#7",#$+(-5"2,B-'2+#+-'<,/7+(",W$K$'"*",
K$5#+B+K$'#*,a"5",C-5",(+\"(),#-,5"%5"$2,#7",#$+(-5"2,+'.-5C$#+-'3,#7"),a"5",05$$,(+\"(),#-,
.+'2,+#,=*".=(,#-,B7$'E",#7"+5,2+"#$5),0"7$9+-5*,B-CK$5"2,#-,#7-*",a7-,a"5",*7-a',#7",
E"'"5+B,C"**$E"*<,,
4=5'+'E,#-,-=#B-C",B5+#"5+$3,#7",5"*=(#*,+'2+B$#"2,#7$#,#$+(-5"2,a"0%0$*"2,
+'#"59"'#+-'*,#$5E"#+'E,$,*+'E(",7"$(#7,0"7$9+-5,a"5",'-#,*+E'+.+B$'#(),C-5","..+B$B+-=*,
#7$',#7-*",#$5E"#+'E,C=(#+K(",7"$(#7,0"7$9+-5*<,8#,+*,+CK-5#$'#,#-,'-#",#7$#,".."B#,*+;"*,-.,
+'#"59"'#+-'*,#$5E"#+'E,C=(#+K(",7"$(#7,0"7$9+-5*,a"5",B$(B=($#"2,0),$9"5$E+'E,$((,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
19
0"7$9+-5$(,-=#B-C"*,0"B$=*","$B7,*#=2),B-=(2,-'(),B-'#5+0=#",-'",".."B#,*+;",#-,#7",C"#$%
$'$()*+*<,47",($B\,-.,*+E'+.+B$'#,2+.."5"'B"*,*=EE"*#*,#7$#,#7",".."B#*,-.,a"0%0$*"2,
+'#"59"'#+-'*,C$),'-#,$##"'=$#",$B5-**,C=(#+K(",7"$(#7,0"7$9+-5,"'2K-+'#*<,47"*",.+'2+'E*,
$5",($5E"(),B-'*+*#"'#,a+#7,5"B"'#,5"*"$5B7,PZ5"0*3,"#,$(<3,@MIMf,>5-B7$*\$3,@MMQS<,,
`"E$52+'E,$'$()*"*,-.,#$+(-5+'E,*#5$#"E+"*3,.+'2+'E*,*7-a,#7$#,#7",.5"c="'B),-.,
#$+(-5+'E,$**"**C"'#*,2+2,'-#,*+E'+.+B$'#(),$.."B#,+'#"59"'#+-',"..+B$B)<,&,5"B"'#,C"#$%
$'$()*+*,"^$C+'+'E,(-'E%#"5C,".."B#*,-.,#$+(-5"2,+'#"59"'#+-'*,.-='2,#7$#,2)'$C+B,#$+(-5+'E,
+*,C-5","..+B$B+-=*,#7$',*#$#+B,#$+(-5+'E,.-5,$((,+'#"59"'#+-'*,"CK(-)+'E,"+#7"5,*+'E(",-5,
C=(#+K(",2"(+9"5),C-2"*,PZ5"0*3,"#,$(<3,@MIMS<,,/",.-='2,#7$#,*#=2+"*,"CK(-)+'E,$,*+'E(",
$**"**C"'#,a"5",*(+E7#(),C-5",".."B#+9",#7$',#7-*","CK(-)+'E,C=(#+K(",$**"**C"'#*,-9"5,
#+C"3,#7-=E7,'-#,*+E'+.+B$'#(),*-<,,,
HK-',B(-*"5,"^$C+'$#+-'3,C-*#,*#=2+"*,=*+'E,$,*+'E(",#$+(-5+'E,$**"**C"'#,a"5",
05+".3,#$5E"#"2,0"7$9+-5*3,*=B7,$*,("9"(*,-.,K7)*+B$(,$B#+9+#)3,.5=+#,$'2,9"E"#$0(",+'#$\"3,
*$#=5$#"2,.$#,+'#$\",$'2,$0*#+'"'B",.5-C,*C-\+'E,$'2,$(B-7-(,B-'*=CK#+-'3,$'2,a"5",
"9$(=$#"2,a+#7+',*7-5#"5,.-((-a%=K,K"5+-2*<,A#=2+"*,"CK(-)+'E,C=(#+K(",$'2,+#"5$#+9",
#$+(-5+'E,$**"**C"'#,a"5",#)K+B$((),(-'E"5,#"5C3,.-B=*"2,-',C-5",B-CK("^,B-'2+#+-'*,P+<"<3,
C$'$E"C"'#,-.,B75-'+B,2+*"$*"*,*=B7,$*,$*#7C$,$'2,$5#75+#+*S3,$'2,#)K+B$((),#$5E"#"2,"+#7"5,
K$#+"'#,-5,7+E7,5+*\,K-K=($#+-',E5-=K*,P"<E<3,"*#$0(+*7"2,*C-\"5*3,-0"*",$2=(#*3,2+$0"#+B*S<,
47+*,B-'.(="'B",-.,.$B#-5*,C$),7$9",C$2",+#,C-5",2+..+B=(#,#-,$B7+"9",+'#"59"'#+-',E-$(*,
$'2,#7=*3,+'$29"5#"'#(),$##"'=$#"2,#7",K-#"'#+$(,0"'".+#*,-.,C=(#+K(",#$+(-5+'E,$**"**C"'#*<,,
!-5"-9"53,+#,a$*,='B("$5,.5-C,C-*#,5"K-5#*,7-a,C=(#+K("3,+#"5$#+9",$**"**C"'#*,
a"5",$B#=$((),$2C+'+*#"5"2,$'2,7-a,#7"*",+'.-5C"2,#7",2"9"(-KC"'#,-.,#$+(-5"2,7"$(#7,
C"**$E"*<,4+C+'E,-.,l5"%$**"**C"'#m,C$),0",+CK-5#$'#,"*K"B+$((),+',B$*"*,a7"5",7"$(#7,
C"**$E"*,$5",#$+(-5"2,$BB-52+'E,#-,5"$2+'"**,#-,B7$'E"<,8',#7+*,B$*"3,#7",$**=CK#+-',+*,#7$#,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
20
#7",K$5#+B+K$'#,a+((,7$9",='2"5E-'",C"$'+'E.=(,B7$'E"*,0".-5",#7"),B$',0",5"%$**"**"2,
$'2,C-#+9$#"2,#-,C-9",-',#-,#7",'"^#,*#$E",-.,B7$'E"<,,
V"^#3,'-,*+E'+.+B$'#,2+.."5"'B"*,a"5",-0#$+'"2,a7"',B-CK$5+'E,".."B#,*+;"*,-.,*"(.%
E=+2"2,$'2,"^K"5#%E=+2"23,a"0%0$*"2,#$+(-5"2,+'#"59"'#+-'*<,A"(.%E=+2"2,+'#"59"'#+-'*,
5"c=+5",C-5",$B#+9","'E$E"C"'#,.5-C,K$5#+B+K$'#*,$'2,5"(),7"$9+(),-',#7",K$#+"'#,#-,
l25+9"m,#7"+5,K5-E5"**,#75-=E7,#7",7"$(#7,K5-E5$C<,j^K"5#%E=+2"2,+'#"59"'#+-'*3,-',#7",
-#7"5,7$'23,5"c=+5",E5"$#"5,+'9-(9"C"'#,.5-C,7"$(#7B$5",K5$B#+#+-'"5*,#-,2+5"B#,K$#+"'#*,
#75-=E7,#7",K5-E5$C,$'2,K5-9+2",C-5",+CC"2+$#",.""20$B\<,`"*=(#*,+'2+B$#"2,#7$#,a7+(",
$22+#+-'$(,.""20$B\,.5-C,"^K"5#*,B$',+CK5-9","..+B$B)3,+'#"59"'#+-'*,a+#7,("**,"^K"5#,+'K=#,
B$',0",Y=*#,$*,".."B#+9"<,47=*3,a"0%0$*"2,#$+(-5"2,$KK5-$B7"*,.-5,*"(.%C$'$E"C"'#,B$',0",
=*".=(,"9"',a7"',*=KK-5#,.5-C,7"$(#7B$5","^K"5#*,C$),'-#,0",5"$2+(),$9$+($0("<,
47",C-*#,B-CK"((+'E,.+'2+'E,7"5",+*,#7$#,#$+(-5"2,a"0*+#"*,a"5",*+E'+.+B$'#(),C-5",
".."B#+9",#7$','-'%#$+(-5"2,a"0*+#"*,+',$B7+"9+'E,0"7$9+-5$(,-=#B-C"*,P7%d,<IQQS<,47+*,
*=KK-5#*,"$5(+"5,C"#$%$'$()*"*,,#7$#,7$9",.-='2,#7$#,#$+(-5+'E,B$',0",$',".."B#+9",*#5$#"E),
.-5,7"$(#7,0"7$9+-5,B7$'E",PZ5"0*3,"#,$(<3,@MIMf,V-$53,"#,$(<3,@MMTf,>-5#'-)3,"#,$(<3,@MMQf,A-7(,
F,!-)"53,@MMTS<,47+*,+*,not%#-,*$),#7$#,$((,#$+(-5"2,a"0*+#"*,a+((,0",*+C+($5(),"..+B$B+-=*<,
47"5",+*,E5"$#,9$5+$0+(+#),+',7-a,#$+(-5+'E,a$*,B$55+"2,-=#<,47"5",a$*,*+E'+.+B$'#,
7"#"5-E"'"+#),$C-'E,#7+*,*"#,-.,*#=2+"*,0"B$=*",#7",a"0,$((-a*,.-5,$,9$5+"#),-.,."$#=5"*3,
$'2,.-5C$#*3,$'2,("9"(*,-.,+'#"5$B#+9+#)<,47+*,C$),7"(K,"^K($+',a7),*#=2+"*,B-CK$5+'E,
#$+(-5"2,a"0*+#"*,#-,'-,#5"$#C"'#,B-'#5-(,B-'2+#+-'*,"^7+0+#"2,*+E'+.+B$'#(),*C$(("5,
a"+E7#"2,C"$',".."B#,*+;"*,P7,d,<MTIS,#7$',#7-*",B-CK$5+'E,#$+(-5"2,#-,'-'%#$+(-5"2,
a"0*+#"*,P7,d,<IQQS<,47+*,+*,B-='#"5%+'#=+#+9"3,$*,-'",a-=(2,"^K"B#,#7",0&,/5$*%".."B#,#-,0",
"^7+0+#"2,a7"',$,#5+$(,B-CK$5"*,$',+'#"59"'#+-',#-,l'-#7+'Em,P+<"<3,'-,#5"$#C"'#,B-'#5-(S<,,
47+*,+*,(+\"(),#-,0",$,C"#7-2-(-E+B$(,$5#+.$B#,-.,#7"*",*#=2+"*<,,8#,+*,K-**+0(",#7$#,+',-52"5,#-,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
21
.$B+(+#$#",C-5",5+E-5-=*,#"*#+'E3,C-5",".."B#+9",C"**$E"*,a"5",E"'"5$#"2,+',*#=2+"*,
B-CK$5+'E,#$+(-5"2,$'2,'-'%#$+(-5"2,a"0*+#"*,#7$',#7-*",*#=2+"*,a+#7,-'(),'-,#5"$#C"'#,
B-'#5-(,E5-=K*<,h'",("**-',7"5",+*,#7$#,5"*"$5B7"5*,*7-=(2,'-#,#7+'\,-.,#$+(-5+'E,$*,$,lC$E+B,
0=(("#m,$'2,*7-=(2,.-((-a,$,B$5".=(,K5-B"**,-.,2"9"(-KC"'#,P"<E<3,Z5"=#"5,"#,$(<3,@MMMS,0$*"2,
-',B-CK5"7"'*+9",.-5C$#+9",a-5\<,
]#9#*&*#+'$%
h'",(+C+#$#+-',-.,#7",*#=2)3,a7+B7,+*,B-CC-',a7"',$**"**+'E,C-2"5$#-5*,+',C"#$%
$'$()*"*3,+*,#7$#,9$5+$0("*,C$),*-C"#+C"*,0",B-'.-='2"2,a+#7,-#7"5,9$5+$0("*,$'2,#7+*3,+',
#=5'3,C$),5"*=(#,+',B-='#"5%+'#=+#+9",.+'2+'E*,P:+K*")3,@MMLS<,V"9"5#7"("**3,+#,+*,B5+#+B$(,#7$#,
#$+(-5+'E,5"*"$5B7"5*,B-'#+'=",#-,"^$C+'",='2"5,a7$#,B+5B=C*#$'B"*,$'2,.-5,a7$#,
B-'2+#+-'*,a"0%0$*"2,#$+(-5"2,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-'*,B$',0",C-*#,".."B#+9"<,
47+*,B$',0",$B7+"9"2,#75-=E7,'"a,K5+C$5),*#=2+"*,$*,a"((,$*,C"#$%$'$()*"*<,47",E5-a+'E,
a"0%#$+(-5+'E,(+#"5$#=5",K5-9+2"*,$',-KK-5#='+#),#-,B-'2=B#,C"#$%5"E5"**+-',$'$()*+*3,
a7+B7,C$),0"##"5,B-'#5-(,.-5,l$5#+.$B#m,9$5+$0("*,$'2,7"(K,$29$'B",-=5,='2"5*#$'2+'E,-.,
C"B7$'+*C*,+',#$+(-5+'E<,,,
R930#2&*#+'$%&'7%I)*),5%U#,52*#+'$%
8',*=C3,#7+*,*#=2),K5-9+2"*,"9+2"'B",.-5,#7",-9"5$((,"..+B$B),-.,a"0%0$*"2,#$+(-5"2,
$KK5-$B7"*,.-5,0-#7,*7-5#,$'2,(-'E"5%#"5C,0"7$9+-5,B7$'E",+'#"59"'#+-'*,<,
/"0%0$*"2,#$+(-5"2,+'#"59"'#+-'*,#$5E"#+'E,E"'"5$(,K-K=($#+-',E5-=K*,a"5",
*+E'+.+B$'#(),C-5",".."B#+9",#7$',#7-*",#$5E"#+'E,*K"B+.+B,K$#+"'#,E5-=K*,-5,C+'-5*<,/"0%
0$*"2,#$+(-5"2,+'#"59"'#+-'*,+',#7",H<A<,a"5",.-='2,#-,7$9",*+E'+.+B$'#(),E5"$#"5,".."B#,*+;"*,
#7$',#7-*",B-'2=B#"2,"(*"a7"5"<,,8'#"5"*#+'E()3,#7+*,$'$()*+*,.-='2,'-,*+E'+.+B$'#,2+.."5"'B",
+',".."B#,*+;"*,.-5,*#=2+"*,#$5E"#+'E,*+'E(",9*<,C=(#+K(",7"$(#7,0"7$9+-5*<,A+'B",a",$9"5$E"2,
".."B#,*+;"*,$B5-**,9$5+-=*,0"7$9+-5*,+',C=(#+K("%0"7$9+-5,#$+(-5"2,+'#"59"'#+-'*3,#7+*,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
22
*=EE"*#*,#7$#,#7",($##"5,C$),0","c=$((),".."B#+9",$*,+'#"59"'#+-'*,#$5E"#+'E,-'(),$,*+'E(",
0"7$9+-5<,,
D-='#"5,#-,K5"9+-=*,C"#$%$'$()*"*3,a",.-='2,#7$#,5$'2-C+;"2,B-'#5-(("2,#5+$(*,
B-CK$5+'E,$,a"0%0$*"2,#$+(-5"2,+'#"59"'#+-',a+#7,$,C"$'+'E.=(,B-CK$5+*-',E5-=K,P"<E<3,$,
'-'%#$+(-5"2,-5,a$+#(+*#,B-'#5-(,B-'2+#+-'S,a"5",*+E'+.+B$'#(),C-5",".."B#+9",#7$',c=$*+%
"^K"5+C"'#$(,*#=2+"*,a+#7,'-,#5"$#C"'#,B-'#5-(,E5-=K*<,
h9"5$((3,#7+*,*#=2),5$+*"*,$,'=C0"5,-.,+CK-5#$'#,c="*#+-'*,#7$#,'""2,.=5#7"5,
"^K(-5$#+-',#-,"'$0(",=*,#-,-K#+C+;",#7",=*",-.,a"0%0$*"2,#$+(-5+'E,+',0"7$9+-5,B7$'E",
+'#"59"'#+-'*<,`"*"$5B7"5*,*7-=(2,0","'B-=5$E"2,#-,K5-9+2",0"##"5,2"*B5+K#+-'*,-.,#7"+5,
#$+(-5+'E,B5+#"5+$,$'2,#$B#+B*,=*"2,.-5,C"**$E",2"*+E'3,C-2"*,-.,2"(+9"5),$'2,B-CK-'"'#*,-.,
#7",+'#"59"'#+-'3,+'B(=2+'E,'=C0"5,$'2,+'#"'*+#),-.,+'#"59"'#+-',B-'#$B#*,K"5,#$+(-5"2,
B-CK-'"'#,P*"",6$55+'E#-',F,V-$53,@MI@S<,A=B7,2"*B5+K#+-'*,a+((,.$B+(+#$#",C-5",$BB=5$#",
B-2+'E,$'2,#"*#+'E,-.,K-**+0(",C-2"5$#-5*,-.,"..+B$B),$'2,a+((,7"(K,B($5+.),*-C",-.,#7",
+**="*,5$+*"2,7"5"<,,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
23
REFERENCES
&'3,:<,D<3,Z($##3,D<3,>"55)3,D<,:<3,:"+'3,j<,1<3,6"''5+\=*3,?<,W<3,>$((-'"'3,H<,j<3,<,<,<,j7(+'E"53,j<,><,
P@MMQS<,47",`"$(H,-'(+'",B"**$#+-',+'#"59"'#+-',.-5,B-(("E",*C-\"5*O,&,5$'2-C+;"2,
B-'#5-(("2,#5+$(<,K,585'*#85%157#2#'5:%^_P@S3,IXJ%IXX<,2-+O,
IM<IMINbY<)KC"2<@MMQ<MJ<MII,
1$'2=5$3,&<,PIXXQS<,6"$(#7,K5-C-#+-',.5-C,#7",K"5*K"B#+9",-.,*-B+$(,B-E'+#+9",#7"-5)<,
K$G2"+0+/G%&'7%?5&0*":%DEPJS3,N@L%NJX<,2-+O,IM<IMQMbMQQTMJJXQMQJMTJ@@,
15=E3,W<3,h"'"C$3,&<3,F,D$CK0"((3,!<,P@MMLS<,>$*#3,K5"*"'#3,$'2,.=#=5",-.,B-CK=#"5%#$+(-5"2,
'=#5+#+-',"2=B$#+-'<,(95,#2&'%>+),'&0%+4%@0#'#2&0%O)*,#*#+':%__PJ,A=KK(S3,IM@QA%
IMLJA<,,
1=(("53,?<,1<3,1-5($'23,`<3,/--2$((3,/<,]<3,6$((3,W<,`<3,6+'"*3,W<,!<3,1=55+*%/--2$((3,><3,<,<,<,A$0$3,:<,
P@MMQS<,`$'2-C+;"2,#5+$(*,-',D-'*+2"5,47+*3,$,#$+(-5"23,8'#"5'"#%2"(+9"5"2,*C-\+'E,
K5"9"'#+-',K5-E5$C,.-5,$2-("*B"'#*<,?5&0*"%X7)2&*#+'%H%`5"&8#+,:%EaP@S3,@NM%@QI<,
2-+O,IM<IITTbIMXMIXQIMN@QQXQ@,
D$+$#$,g=.."5")3,!<3,F,AB7=(;3,><,W<,P@MMXS<,A"(.%C$'$E"C"'#,-.,B75-'+B,(-a,0$B\,K$+'O,&',
"^K(-5$#+-',-.,#7",+CK$B#,-.,$,K$#+"'#%B"'#"5"2,a"0*+#"<,K&*#5'*%X7)2&*#+'%&'7%
@+)'$50#'/:%__PIS3,@T%L@<,2-+O,IM<IMINbY<K"B<@MMX<MI<MIN,
D$5(*-'3,Z<,?<3,F,AB7C+2#3,G<,:<,PIXXXS<,8CK$B#,-.,"^K"5+C"'#$(,2"*+E',-',".."B#,*+;"O,
G+'2+'E*,.5-C,#7",5"*"$5B7,(+#"5$#=5",-',#5$+'+'E<,>+),'&0%+4%(330#57%K$G2"+0+/G:%
N^PNS3,QRI%QN@<,2-+O,IM<IMLTbMM@I%XMIM<QJ<N<QRI,
D7"'E3,D<,j<3,85a+'3,1<3,!$=5+"((-3,?<3,6"CC+'E"53,:<3,>$KK"5#3,&<3,F,Z+C0$((3,&<,1<,P@MIMS<,
6"$(#7,2+*K$5+#+"*,$C-'E,2+.."5"'#,"#7'+B,$'2,5$B+$(,C+22(",$'2,7+E7,*B7--(,*#=2"'#*,
+',*=',"^K-*=5",0"(+".*,$'2,\'-a("2E"<,>+),'&0%+4%(7+05$25'*%?5&0*":%^_PIS3,IMN%IMX<,
2-+O,IM<IMINbY<Y$2-7"$(#7<@MMX<I@<M@Q,
D7+$=;;+3,j<3,]5""'3,4<,D<3,:-523,A<3,47=C3,D<3,F,]-(2*#"+'3,!<,P@MMRS<,&,7+E7%5+*\,25+'\+'E,
K5"9"'#+-',a"0,*+#",.-5,B-(("E",*#=2"'#*<,>+),'&0%+4%(95,#2&'%@+005/5%?5&0*":%aEPNS3,
@NL%@TJ<,2-+O,IM<L@MMbW&D6<RL<N<@NL%@TJ,
?$9+*3,A<,P@MMQS<,47",+'.(="'B",-.,B-(("B#+9+*#+B,$'2,+'2+9+2=$(+*#+B,9$(=",-5+"'#$#+-'*,-',#7",
$BB"K#$'B",-.,+'2+9+2=$(()%#$+(-5"2,+'#"5'"#,B-CC='+B$#+-'*<,R'*5,4&25M%!"5%>+),'&0%
4+,%X7)2&*#+':%@+99)'#*G:%&'7%;&0)5$:%NPIS<,`"#5+"9"2,.5-C,
http://bcis.pacificu.edu/journal/article.php?id=160,
?+Y\*#5$3,&<,P@MMRS<,/-5\+'E,C"B7$'+*C*,-.,B-CK=#"5%#$+(-5"2,7"$(#7,"2=B$#+-'O,j9+2"'B",
.5-C,*C-\+'E,B"**$#+-'<,?5&0*"%X7)2&*#+'%<5$5&,2":%BCPRS3,R@T%RLX<,2-+O,
IM<IMXLb7"5bB)7MIJ,
?='#-'3,]<,G<3,F,`-0"5#*-'3,4<,><,P@MMQS<,&,#$+(-5"2,+'#"5'"#%K(=*%"C$+(,+'#"59"'#+-',.-5,
+'B5"$*+'E,K7)*+B$(,$B#+9+#),$C-'E,"#7'+B$(()%2+9"5*",a-C"'<,K,585'*#85%157#2#'5:%
^_PNS3,NMR%NII<,2-+O,IM<IMINbY<)KC"2<@MMQ<IM<MMJ,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
24
?=##$3,!<,W<,P@MMTS<,D-CC='+B$#+'E,$0-=#,B=(#=5",$'2,7"$(#7O,47"-5+;+'E,B=(#=5"%B"'#"5"2,
$'2,B=(#=5$(,*"'*+#+9+#),$KK5-$B7"*<,@+99)'#2&*#+'%!"5+,G:%D_PLS3,LMJ%L@Q<,2-+O,
IM<IIIIbY<IJNQ%@QQR<@MMT<MM@XT<^,
?=9$(3,A<3,F,4a""2+"3,`<,P@MMMS<,45+C,$'2,.+((O,&,*+CK(",.=''"(%K(-#t0$*"2,C"#7-2,-.,#"*#+'E,
$'2,$2Y=*#+'E,.-5,K=0(+B$#+-',0+$*,+',C"#$%$'$()*+*<,`#+95*,#2$:%abP@S3,JRR%JNL<,2-+O,
IM<IIIIbY<MMMN%LJIu<@MMM<MMJRR<^,
G+*70"+'3,!<3,F,D$KK"(($3,W<,V<,P@MMNS<,47",5-(",-.,#7"-5),+',2"9"(-K+'E,".."B#+9",7"$(#7,
B-CC='+B$#+-'*<,>+),'&0%+4%@+99)'#2&*#+':%abP*IS3,AI%AIT<,2-+O,IM<IIIIbY<IJNM%
@JNN<@MMN<MM@QM<^,
G5"''3,!<3,!$(+'3,A<3,15-a'3,`<,:<3,]5""53,_<3,G-^3,W<3,]5""53,W<3,F,AC)B;"\3,A<,P@MMRS<,D7$'E+'E,
#7",#+2"O,$',8'#"5'"#b9+2"-,"^"5B+*",$'2,(-a%.$#,2+"#,+'#"59"'#+-',a+#7,C+22("%
*B7--(,*#=2"'#*<,(330#57%O),$#'/%<5$5&,2":%DNPIS3,IL%@I<,2-+O,
IM<IMINbY<$K'5<@MMJ<MJ<MML,
]$'*3,Z<,!<3,`+*+B$3,><,!<3,A#5-(($3,:<,h<3,G-=5'+"53,:<3,Z+5#$'+$3,H<3,HK"E=+3,?<3,<,<,<,&B7$5))$3,A<,
P@MMXS<,j.."B#+9"'"**,-.,2+.."5"'#,C"#7-2*,.-5,2"(+9"5+'E,#$+(-5"2,'=#5+#+-',
"2=B$#+-',#-,(-a,+'B-C"3,"#7'+B$((),2+9"5*",$2=(#*<,R'*5,'&*#+'&0%>+),'&0%+4%
`5"&8#+,&0%O)*,#*#+'%&'7%K"G$#2&0%(2*#8#*G:%b3,@J<,2-+O,IM<IIQNbIJTX%RQNQ%N%@J,
]5-"'"9"(23,><,/<3,A-''$23,A<,A<3,:""3,&<,Z<3,&*B73,?<,&<3,F,A7"$3,W<,j<,P@MMNS<,`$B+$(,2+.."5"'B"*,
+',$##+#=2"*,#-a$52,+''-9$#+9",C"2+B$(,#"B7'-(-E)<,>+),'&0%+4%c5'5,&0%R'*5,'&0%
157#2#'5:%BDPNS3,RRX%RNL<,2-+O,IM<IIIIbY<IR@R%IJXT<@MMN<MMJRL<^,
6$E"C$'3,><,&<3,/$(\"53,A<,V<3,F,>=(("'3,D<,6<,P@MMRS<,4$+(-5"2,9"5*=*,*#$'2$52,8'#"5'"#%
2"(+9"5"2,+'#"59"'#+-'*,#-,K5-C-#",K7)*+B$(,$B#+9+#),+',-(2"5,a-C"'<,>+),'&0%+4%
c5,#&*,#2%K"G$#2&0%!"5,&3G:%BNPIS3,@Q%LL<,,
6$55+'E#-'3,V<,]<3,F,V-$53,A<,!<,P@MI@S<,`"K-5#+'E,*#$'2$52*,.-5,*#=2+"*,-.,#$+(-5"2,
+'#"59"'#+-'*<,?5&0*"%X7)2&*#+'%<5$5&,2":%B_P@S3,LLI%LJ@<,2-+O,IM<IMXLb7"5bB)5IMQ,
6$a\+'*3,`<,><3,Z5"=#"53,!<3,`"*'+B-a3,Z<3,G+*70"+'3,!<3,F,?+Y\*#5$3,&<,P@MMQS<,H'2"5*#$'2+'E,
#$+(-5+'E,+',B-CC='+B$#+'E,$0-=#,7"$(#7<,?5&0*"%X7)2&*#+'%<5$5&,2":%BEPLS3,JRJ%JNN<,
2-+O,IM<IMXLb7"5bB)'MMJ,
6$)"*3,&<,G<3,F,Z5+KK"'2-5..3,Z<,P@MMTS<,&'*a"5+'E,#7",B$((,.-5,$,*#$'2$52,5"(+$0+(+#),
C"$*=5",.-5,B-2+'E,2$#$<,@+99)'#2&*#+'%15*"+7$%&'7%15&$),5$:%DPIS3,TT%QX<,2-+O,
IM<IMQMbIXLI@JRMTMXLLNNNJ,
6"2E"*3,:<,[<3,F,h(\+'3,8<,PIXQRS<,V*&*#$*#2&0%95*"+7$%4+,%95*&S&'&0G$#$<,h5($'2-O,&B$2"C+B,
>5"**<,
6=$'E3,&<3,1$5;+3,G<3,6=^(")3,`<3,?"')"53,]<3,`-75($B73,1<3,W$)'"3,Z<3,F,V"$(3,1<,P@MMNS<,47",
".."B#*,-',*$#=5$#"2,.$#,K=5B7$*"*,-.,K5-9+2+'E,8'#"5'"#,*7-KK"5*,a+#7,K=5B7$*"%
*K"B+.+B,2+"#$5),$29+B"O,&,5$'2-C+;"2,#5+$(<,K]+V%@0#'#2&0%!,#&0$:%DPRS3,"@@<,2-+O,
IM<ILTIbY-=5'$(<KB#5<MMIMM@@,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
25
6=5(+'E3,`<3,D$##3,!<3,?",1-'+3,!<3,G$+5(")3,1<,/<3,6=5*#3,4<3,!=55$)3,><3,<,<,<,1$5\7==*3,:<,P@MMTS<,
H*+'E,8'#"5'"#,$'2,C-0+(",K7-'",#"B7'-(-E),#-,2"(+9"5,$',$=#-C$#"2,K7)*+B$(,
$B#+9+#),K5-E5$CO,`$'2-C+;"2,B-'#5-(("2,#5+$(<,>+),'&0%+4%157#2&0%R'*5,'5*%<5$5&,2":%
\P@S3,"T<,2-+O,IM<@IXNbYC+5<X<@<"T,
W"$'%>+"55"3,><3,G+*B"(($3,Z<3,]5+EE*3,W<3,W-*"K73,W<,[<3,!-55-a3,]<3,D$55-((3,W<3,<,<,<,Z+5*7'"53,W<,W<,
P@MIMS<,`$B"b"#7'+B+#)%0$*"2,B-'B"5'*,-9"5,='2"5*#$'2+'E,B$'B"5,2+$E'-*+*,$'2,
#5"$#C"'#,K($'<,>+),'&0%+4%*"5%O&*#+'&0%157#2&0%($$+2#&*#+':%DCBPLS3,IQJ%IQX<,,
W-*"K73,D<,:<,!<3,>"#"5*-'3,j<3,6$9*#$23,A<3,W-7'*-'3,D<,D<3,6-"5$=.3,A<3,A#5+'E"53,A<3,<,<,<,A#5"B7"53,
[<,P@MMTS<,&,a"0%0$*"23,#$+(-5"2,$*#7C$,C$'$E"C"'#,K5-E5$C,.-5,=50$',&.5+B$'%
&C"5+B$',7+E7,*B7--(,*#=2"'#*<,(95,#2&'%>+),'&0%+4%<5$3#,&*+,G%&'7%@,#*#2&0%@&,5%
157#2#'5:%D_aPXS3,QQQ%QXR<,2-+O,IM<IINJb5BBC<@MMNMQ%I@JJhD,
Z5"0*3,><3,>5-B7$*\$3,W<,h<3,F,`-**+3,W<,A<,P@MIMS<,&,C"#$%$'$()*+*,-.,B-CK=#"5%#$+(-5"2,
+'#"59"'#+-'*,.-5,7"$(#7,0"7$9+-5,B7$'E"<,K,585'*#85%157#2#'5:%aDPL%JS3,@IJ%@@I<,
2-+O,IM<IMINbY<)KC"2<@MIM<MN<MMJ,
Z5"=#"53,!<,/<3,D$0=5'$)3,D<,&<3,D7"'3,W<,W<3,F,?-'(+'3,!<,W<,P@MMJS<,j.."B#+9"'"**,-.,
+'2+9+2=$(()%#$+(-5"2,B$("'2$5*,+',K5-C-#+'E,B7+(27--2,+CC='+;$#+-',+',=50$',
K=0(+B,7"$(#7,B"'#"5*<,(95,#2&'%>+),'&0%+4%K)=0#2%?5&0*":%\^PIS3,I@@%I@T<,,
Z5"=#"53,!<,/<3,G$55"((3,?<3,h("9+#B73,:<3,F,15"''$'3,:<,P@MMMS<,!&#0+,#'/%"5&0*"%95$$&/5$M%
@)$*+9#Y#'/%2+99)'#2&*#+'%6#*"%2+93)*5,%*52"'+0+/G%!$7a$73,V<W<O,:$a5"'B",
j5(0$=C,&**-B+$#"*<,
Z5"=#"53,!<,/<3,A#5"B7"53,[<,W<3,F,]($**C$'3,1<,PIXXXS<,h'",*+;",2-"*,'-#,.+#,$((O,#7",B$*",.-5,
#$+(-5+'E,K5+'#,C$#"5+$(*<,(''&0$%+4%`5"&8#+,&0%157#2#'5:%BDPJS3,@TN%@QL<,2-+O,
IM<IMMTb1GM@QXRXRQ,
Z5"=#"53,!<,/<3,F,/5$)3,`<,W<,P@MMLS<,4$+(-5"2,$'2,#$5E"#"2,7"$(#7,B-CC='+B$#+-'O,
*#5$#"E+"*,.-5,"'7$'B+'E,+'.-5C$#+-',5"("9$'B"<,(95,#2&'%>+),'&0%+4%?5&0*"%`5"&8#+,:%
B_%V)330%E3,A@@T%@L@<,,
Z5+KK"'2-5..3,Z<,P@MMJS<,@+'*5'*%('&0G$#$M%('%R'*,+7)2*#+'%*+%R*$%15*"+7+0+/G<,h$\*3,D&O,
A$E",>=0(+B$#+-'*<,
Z5-";"3,/<3,/"5\C$'3,&<3,F,15=E3,W<,P@MMNS<,&,*)*#"C$#+B,5"9+"a,-.,5$'2-C+;"2,#5+$(*,-',#7",
".."B#+9"'"**,-.,B-CK=#"5%#$+(-5"2,"2=B$#+-',-',K7)*+B$(,$B#+9+#),$'2,2+"#$5),
0"7$9+-5*<,(''&0$%+4%`5"&8#+,&0%157#2#'5:%EDPLS3,@MR%@@L<,2-+O,
IM<I@MTb*IRL@JTXN$0CLIMLv@,
Z)K5+3,Z<3,:$'E(")3,W<,?<3,A$='2"5*3,W<,1<3,D$*7"((%AC+#73,!<,:<3,F,6"50+*-'3,><,P@MMQS<,
`$'2-C+;"2,B-'#5-(("2,#5+$(,-.,a"0%0$*"2,$(B-7-(,*B5""'+'E,$'2,05+".,+'#"59"'#+-',
+',K5+C$5),B$5"<,(,2"#85$%+4%R'*5,'&0%157#2#'5:%DbNPRS3,RLM%RLN<,2-+O,
IM<IMMIb$5B7+'#"5'C"2<@MMT<IMX,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
26
Z)K5+3,Z<3,F,!B&'$(()3,6<,!<,P@MMRS<,`$'2-C+;"2,B-'#5-(("2,#5+$(,-.,$,a"0%0$*"2,K5+C$5),
B$5",+'#"59"'#+-',.-5,C=(#+K(",7"$(#7,5+*\,0"7$9+-5*<,K,585'*#85%157#2#'5:%^DPL%JS3,
TNI%TNN<,2-+O,IM<IMINbY<)KC"2<@MMR<MT<MIM,
Z)K5+3,Z<3,A$='2"5*3,W<,1<3,/+((+$C*3,A<,!<3,!B]""3,`<,h<3,:$'E(")3,W<,?<3,D$*7"((%AC+#73,!<,:<3,F,
]$(($E7"53,A<,W<,P@MMJS<,/"0%0$*"2,*B5""'+'E,$'2,05+".,+'#"59"'#+-',.-5,7$;$52-=*,
25+'\+'EO,&,2-=0("%0(+'2,5$'2-C+;"2,B-'#5-(("2,#5+$(<,(77#2*#+':%\\PIIS3,IJIM%IJIT<,
2-+O,IM<IIIIbY<ILNM%MJJL<@MMJ<MMQJT<^,
:$C0"5#3,A<,?<3,:-+*"(("3,D<,]<3,F,!$B2-'$(23,!<,j<,P@MMXS<,&',+'%2"K#7,"^K(-5$#+-',-.,
+'.-5C$#+-'%*""\+'E,0"7$9+-5,$C-'E,+'2+9+2=$(*,a+#7,B$'B"5O,>$5#,I,%,
H'2"5*#$'2+'E,2+.."5"'#+$(,K$##"5'*,-.,$B#+9",+'.-5C$#+-',*""\+'E<,@&'25,%O),$#'/:%
EBPIS3,II%@L<,2-+O,IM<IMXTbMI<VDD<MMMMLJLLT@<@JRIT<02,
:+K*")3,!<,/<,P@MMLS<,47-*",B-'.-='2"2,C-2"5$#-5*,+',C"#$%$'$()*+*O,]--23,0$23,$'2,=E()<,
(''&0$%+4%*"5%(95,#2&'%(2&759G%+4%K+0#*#2&0%&'7%V+2#&0%V2#5'25:%aN_PIS3,NX%QI<,2-+O,
IM<IITTbMMM@TIN@M@@RMTXI,
:+K*")3,!<,/<3,F,/+(*-'3,?<,1<,P@MMIS<,K,&2*#2&0%95*&S&'&0G$#$%d(330#57%$+2#&0%,5$5&,2"%
95*"+7$e%47-=*$'2,h$\*3,D&O,A&]j,>=0(+B$#+-'*,,
:-5+E3,Z<,`<3,`+##"53,><,:<3,:$=5"'#3,?<,?<3,F,>($'#3,Z<,P@MMQS<,47",+'#"5'"#%0$*"2,$5#75+#+*,*"(.%
C$'$E"C"'#,K5-E5$CO,&,-'"%)"$5,5$'2-C+;"2,#5+$(,.-5,K$#+"'#*,a+#7,$5#75+#+*,-5,
.+05-C)$(E+$<,(,*",#*#$%@&,5%&'7%<5$5&,2":%a\PTS3,IMMX%IMIT<,2-+O,IM<IMM@b$5#<@LQIT,
:=*#5+$3,!<,:<,&<3,D-5#"*"3,W<3,V-$53,A<,!<3,F,](="B\$=.3,`<,:<,P@MMXS<,D-CK=#"5%#$+(-5"2,7"$(#7,
+'#"59"'#+-'*,2"(+9"5"2,-9"5,#7",a"0O,`"9+"a,$'2,$'$()*+*,-.,\"),B-CK-'"'#*<,
K&*#5'*%X7)2&*#+'%&'7%@+)'$50#'/:%_^P@S3,IRN%ITL<,2-+O,IM<IMINbY<K"B<@MMQ<MQ<M@L,,
!$'E='\=*=C-3,`<,4<3,15=E3,W<3,2",Z-'+'E3,6<,W<3,9$',2"5,:"+3,W<3,F,`$$#3,6<,P@MMTS<,AB7--(%
0$*"2,8'#"5'"#%#$+(-5"2,.5=+#,$'2,9"E"#$0(","2=B$#+-',B-C0+'"2,a+#7,05+".,
B-='*"((+'E,+'B5"$*"*,B7+(25"'i*,$a$5"'"**,-.,+'#$\",("9"(*<,K)=0#2%?5&0*"%O)*,#*#+':%
DCPMLS3,@TL%@TX<,2-+O,IM<IMITbAILNQXQMMMT@JNNTI,
!$5B=*3,&<,D<3,!$*-'3,!<3,/-(."3,><3,`+C"53,1<,Z<3,:+K\=*3,8<3,A#5"B7"53,[<,W<3,<,<,<,15+E7#3,!<,&<,
P@MMRS<,47","..+B$B),-.,#$+(-5"2,K5+'#,C$#"5+$(*,+',K5-C-#+'E,B-(-5"B#$(,B$'B"5,
*B5""'+'EO,5"*=(#*,.5-C,$,5$'2-C+;"2,#5+$(,+'9-(9+'E,B$(("5*,#-,#7",V$#+-'$(,D$'B"5,
8'*#+#=#"i*,D$'B"5,8'.-5C$#+-',A"59+B"<,>+),'&0%+4%?5&0*"%@+99)'#2&*#+':%DCPA=KK(,
IS3,QL%IMJ<,2-+O,IM<IMQMbIMQIMTLMRMM@RTTRJ,
!$5B=*3,1<,6<3,:"a+*3,1<,&<3,/+((+$C*3,?<,!<3,?='*+E"53,A<3,W$\+B+B3,W<,!<3,/7+#"(")3,W<,&<3,<,<,<,>$5+*+3,
&<,G<,P@MMTS<,&,B-CK$5+*-',-.,8'#"5'"#,$'2,K5+'#%0$*"2,K7)*+B$(,$B#+9+#),
+'#"59"'#+-'*<,(,2"#85$%+4%R'*5,'&0%157#2#'5:%Db_PXS3,XJJ%XJX<,2-+O,
IM<IMMIb$5B7+'#"<INT<X<XJJ,
!BZ$)3,6<,]<3,Z+'E3,?<3,j$\+'3,j<,]<3,A""(")3,W<,`<3,F,]($*E-a3,`<,j<,P@MMIS<,47",?+$0"#"*,
V"#a-5\,8'#"5'"#%0$*"2,K7)*+B$(,$B#+9+#),+'#"59"'#+-'O,&,5$'2-C+;"2,K+(-#,*#=2)<,
U#&=5*5$%@&,5:%B^PQS3,IL@Q%ILLJ<,2-+O,IM<@LLTb2+$B$5"<@J<Q<IL@Q,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
27
V$K-(+#$'-3,!<,&<3,G-#7"5+'E7$C3,!<3,4$#"3,?<3,AB+$C$''$3,D<3,:"*(+"3,j<3,ha"'3,V<3,<,<,<,!$5B=*3,
1<,P@MMLS<,j9$(=$#+-',-.,$',8'#"5'"#%0$*"2,K7)*+B$(,$B#+9+#),+'#"59"'#+-'O,&,
K5"(+C+'$5),+'9"*#+E$#+-'<,(''&0$%+4%`5"&8#+,&0%157#2#'5:%BaP@S3,X@%XX<,2-+O,
IM<I@MTb*IRL@JTXN$0C@RM@vMJ,
V"9+(("3,:<,!<3,!+($#3,&<,W<3,F,hi6$5$3,1<,P@MMXS<,D-CK=#"5%#$+(-5"2,a"+E7#,5"2=B#+-',
+'#"59"'#+-'*,#$5E"#+'E,$2=(#*O,$,'$55$#+9",*)*#"C$#+B,5"9+"a<,?5&0*"%K,+9+*#+'%
>+),'&0%+4%()$*,&0#&%BCPIS3,JQ%RT<,,
V"9+(("3,:<,!<3,hi6$5$3,1<3,F,!+($#3,&<,W<,P@MMX$S<,D-CK=#"5%#$+(-5"2,2+"#$5),0"7$9+-=5,B7$'E",
+'#"59"'#+-'*O,$,*)*#"C$#+B,5"9+"a<,?5&0*"%X7)2&*#+'%<5$5&,2":%B^PJS3,NXX%T@M<,2-+O,
IM<IMXLb7"5bB)KMMN,
V"9+(("3,:<,!<3,hi6$5$3,1<3,F,!+($#3,&<,W<,P@MMX0S<,D-CK=#"5%#$+(-5"2,K7)*+B$(,$B#+9+#),0"7$9+-5,
B7$'E",+'#"59"'#+-'*,#$5E"#+'E,$2=(#*O,$,*)*#"C$#+B,5"9+"a<,R'*5,'&*#+'&0%>+),'&0%+4%
`5"&8#+,&0%O)*,#*#+'%&'7%K"G$#2&0%(2*#8#*G:%b3,LM<,2-+O,IM<IIQNbIJTX%RQNQ%N%LM,
V-$53,A<,!<3,1"'$B3,D<,V<3,F,6$55+*3,!<,A<,P@MMTS<,?-"*,#$+(-5+'E,C$##"5k,!"#$%$'$()#+B,5"9+"a,
-.,#$+(-5"2,K5+'#,7"$(#7,0"7$9+-5,B7$'E",+'#"59"'#+-'*<,K$G2"+0+/#2&0%`)005*#':%
DEEPJS3,NTL%NXL<,2-+O,IM<IMLTbMMLL%@XMX<ILL<J<NTL,
V-$53,A<,!<3,6$55+'E#-'3,V<,]<3,F,&(25+B73,`<,A<,P@MMXS<,47",5-(",-.,C"**$E",#$+(-5+'E,+',#7",
2"9"(-KC"'#,-.,K"5*=$*+9",7"$(#7,B-CC='+B$#+-',C"**$E"*<,8',D<,A<,1"B\,Pj2<S3,
@+99)'#2&*#+'%f5&,=++Q%EE,PKK<,TL%ILLS<,V"a,_-5\O,:$a5"'B",j5(0$=C&**-B+$#"*3,
8'B<,
V-"(3,:<,4<,P@MIMS<,&',"#7'+Bb5$B+$(,B-CK$5+*-',-.,B$=*$(,0"(+".*,$'2,#5"$#C"'#,K5"."5"'B"*,
.-5,#7",*)CK#-C*,-.,2"K5"**+-',$C-'E,K$#+"'#*,a+#7,2+$0"#"*<,U#&=5*5$%X7)2&*+,:%
EbPRS3,QIN%Q@T<,2-+O,IM<IITTbMIJRT@ITIMLQMIJR,
V-5C$'3,D<,?<3,!$(")3,h<3,:+3,u<3,F,A\+''"53,6<,&<,P@MMQS<,H*+'E,#7",8'#"5'"#,#-,$**+*#,*C-\+'E,
K5"9"'#+-',$'2,B"**$#+-',+',*B7--(*O,&,5$'2-C+;"23,B-'#5-(("2,#5+$(<,?5&0*"%
K$G2"+0+/G:%B_PNS3,TXX%QIM<,2-+O,IM<IMLTb$MMILIMR,
h"'"C$3,&<3,15=E3,W<3,?+Y\*#5$3,&<3,/""52#3,8<3,F,[5+"*3,6<,P@MMQS<,j..+B$B),$'2,=*",-.,$',
8'#"5'"#%2"(+9"5"2,B-CK=#"5%#$+(-5"2,(+."*#)(",+'#"59"'#+-'3,#$5E"#+'E,*$#=5$#"2,.$#,
+'#$\"3,K7)*+B$(,$B#+9+#),$'2,*C-\+'E,B"**$#+-'O,&,5$'2-C+;"2,B-'#5-(("2,#5+$(<,
(''&0$%+4%`5"&8#+,&0%157#2#'5:%EaP@S3,I@R%ILR<,2-+O,IM<IMMTb*I@INM%MMQ%XM@L%I,
h"'"C$3,&<3,4$'3,G<3,F,15=E3,W<,P@MMRS<,A7-5#%#"5C,"..+B$B),-.,$,a"0%0$*"2,B-CK=#"5%#$+(-5"2,
'=#5+#+-',+'#"59"'#+-'O,!$+',".."B#*,$'2,C"2+$#-5*<,(''&0$%+4%`5"&8#+,&0%157#2#'5:%
B\PIS3,RJ%NL<,2-+O,IM<I@MTb*IRL@JTXN$0C@XMIvQ,
h5a+'3,`<,]<,PIXQLS<,&,.$+(%*$.",V,.-5,".."B#,*+;",+',C"#$%$'$()*+*<,>+),'&0%+4%X7)2&*#+'&0%&'7%
`=5"&8#+,&0%V*&*#$*#2$:%NP@S3,IRT%IRX<,2-+O,IM<LIM@bIMTNXXQNMMQMM@IRT,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
28
>$(C"53,A<3,]5$7$C3,]<3,F,j((+-##3,j<,P@MMRS<,j.."B#*,-.,$,a"0%0$*"2,7"$(#7,K5-E5$C,-',.+.#7,
E5$2",B7+(25"'p*,K7)*+B$(,$B#+9+#)3,\'-a("2E"3,$##+#=2"*,$'2,0"7$9+-5<,(95,#2&'%
>+),'&0%+4%?5&0*"%X7)2&*#+':%EbP@S3,QN%XL<,2-+O,IM<IMQMbIXL@RMLT<@MMR<IMNMQINJ,
>"##)3,`<,j<3,F,D$B+-KK-3,W<,4<,PIXTXS<,8**=",+'9-(9"C"'#,B$',+'B5"$*",-5,2"B5"$*",K"5*=$*+-',
0),"'7$'B+'E,C"**$E"%5"("9$'#,B-E'+#+9",5"*K-'*"*<,>+),'&0%+4%K5,$+'&0#*G%&'7%
V+2#&0%K$G2"+0+/GJ:%E_PIMS3,IXIR%IX@N<,,
>-5#'-)3,?<,1<3,AB-##%A7"(2-'3,:<,&<,W<3,W-7'*-'3,1<,4<3,F,D$5")3,!<,><,P@MMQS<,D-CK=#"5%
2"(+9"5"2,+'#"59"'#+-'*,.-5,7"$(#7,K5-C-#+-',$'2,0"7$9+-5$(,5+*\,5"2=B#+-'O,&,C"#$%
$'$()*+*,-.,TR,5$'2-C+;"2,B-'#5-(("2,#5+$(*3,IXQQ%@MMT<,K,585'*#85%157#2#'5:%^_PIS3,
L%IN<,2-+O,IM<IMINbY<)KC"2<@MMQ<M@<MIJ,
>5-B7$*\$3,W<,h<,P@MMQS<,!=(#+K(",7"$(#7,0"7$9+-5,5"*"$5B7,5"K5"*"'#*,#7",.=#=5",-.,
K5"9"'#+9",C"2+B+'"<,K,585'*#85%157#2#'5:%^bPLS3,@QI%@QR<,2-+O,
IM<IMINbY<)KC"2<@MMQ<MI<MIR,
>5-B7$*\$3,W<,h<3,F,?+D("C"'#"3,D<,D<,PIXQJS<,!"5%*,&'$*"5+,5*#2&0%&33,+&2"%M%@,+$$#'/%
*,&7#*#+'&0%=+)'7&,#5$%+4%*"5,&3G<,6-C"a--23,8((O,?-a,W-'"*%85a+'<,
`"9"5"3,?<3,F,?='0$53,><,W<,P@MMIS<,`"9+"a,-.,B-CK=#"5%E"'"5$#"2,-=#K$#+"'#,7"$(#7,
0"7$9+-5,+'#"59"'#+-'*O,B(+'+B$(,"'B-='#"5*,w+',$0*"'#+$w<,>+),'&0%+4%*"5%(95,#2&'%
157#2&0%R'4+,9&*#2$%($$+2#&*#+':%NPIS3,N@%TX<,2-+O,IM<IILNbY$C+$<@MMI<MMQMMN@,
`+B7$52*3,Z<,D<3,j'2"5(+'3,D<,&<3,1"B\3,D<3,!BAa""'")3,W<,D<3,W-'"*3,4<,D<3,F,`-0"5*-'3,><,Z<,
P@MMTS<,4$+(-5"2,0+-0"7$9+-5$(,+'#"59"'#+-'*O,&,(+#"5$#=5",5"9+"a,$'2,*)'#7"*+*<,
<5$5&,2"%&'7%!"5+,G%4+,%O),$#'/%K,&2*#25:%BDPJS3,@TI%@QR<,2-+O,
IM<IQXIbMQQXTIQMTTQ@J@QM@X,
`+C"53,1<,Z<3,F,]($**C$'3,1<,PIXXQS<,4$+(-5+'E,B-CC='+B$#+-'*,.-5,K5+C$5),B$5",*"##+'E*<,
15*"+7$%+4%R'4+,9&*#+'%#'%157#2#'5:%E_P@S3,ITI%ITT<,,
`+C"53,1<,Z<3,F,Z5"=#"53,!<,/<,P@MMNS<,&29$'B+'E,#$+(-5"2,7"$(#7,B-CC='+B$#+-'O,&,
K"5*=$*+-',$'2,C"**$E",".."B#*,K"5*K"B#+9"<,>+),'&0%+4%@+99)'#2&*#+':%abP*IS3,
AIQJ%A@MI<,2-+O,IM<IIIIbY<IJNM%@JNN<@MMN<MM@QX<^,
`+##"50$'23,:<,!<3,D-^3,?<,W<3,/$(\"53,:<,A<3,Z-9$#B7"93,1<3,!BZ'+E7#3,:<3,>$#"(3,Z<3,<,<,<,A=#K7"'3,W<,
P@MMLS<,&',8'#"5'"#,+'#"59"'#+-',$*,$2Y='B#+9",#7"5$K),.-5,K"2+$#5+B,"'B-K5"*+*<,
>+),'&0%+4%@+'$)0*#'/%&'7%@0#'#2&0%K$G2"+0+/G:%_DPRS3,XIM%XIT<,2-+O,IM<IMLTbMM@@%
MMN^<TI<R<XIM,
`-*"'#7$(3,`<,PIXXIS<,15*&S&'&0G*#2%3,+257),5$%4+,%$+2#&0%,5$5&,2",P5"9+*"2,"2<S<,V"a0=5),
>$5\3,D&O,A$E"<,
`-#7"5#3,Z<3,A#5"B7"53,[<,W<3,?-)("3,:<,&<3,D$K($'3,/<,!<3,W-)B"3,W<,A<3,W+C+*-'3,6<,1<3,<,<,<,`-#73,!<,&<,
P@MMNS<,/"0%0$*"2,a"+E7#,C$'$E"C"'#,K5-E5$C*,+',$',+'#"E5$#"2,7"$(#7,B$5",
*"##+'EO,$,5$'2-C+;"23,B-'#5-(("2,#5+$(<,.=5$#*G:%D^P@S3,@NN%@T@<,2-+O,
IM<IMLQb-0)<@MMN<LJ,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
29
`-#7C$'3,&<,W<,P@MMMS<,4-a$52,$,#7"-5)%0$*"2,$'$()*+*,-.,0"7$9+-5$(,C$+'#"'$'B"<,?5&0*"%
K$G2"+0+/G:%D\PI,A=KK(S3,NJ%NX<,,
A"9"5*-'3,6<,6<3,]-52-'3,W<,A<3,?$'$7"53,1<,]<3,F,&\"5*3,:<,P@MMQS<,D7"aG5""<B-CO,j9$(=$#+-',
-.,$,a"0%0$*"2,B"**$#+-',K5-E5$C,.-5,*C-\"("**,#-0$BB-,=*"5*<,O#2+*#'5%H%!+=&22+%
<5$5&,2":%DCP@S3,LQI%LXI<,2-+O,IM<IMQMbIJN@@@MMTMIQ@JXQJ,
A7+5"3,V<,P@MM@S<,j.."B#*,-.,5$B"3,"#7'+B+#)3,E"'2"53,B=(#=5"3,(+#"5$B)3,$'2,*-B+$(,C$5\"#+'E,-',
K=0(+B,7"$(#7<,>+),'&0%+4%c5'75,SV352#4#2%157#2#'5:%aP@S3,JQ%RJ<,,
A(--#C$\"53,A<,!<3,D7+'$K$a3,!<,W<3,AB7=+#3,&<,W<3,A"+2"((3,W<,D<3,F,[$',!"B7"("'3,/<,P@MMXS<,
G"$*+0+(+#),$'2,".."B#+9"'"**,-.,-'(+'",K7)*+B$(,$B#+9+#),$29+B",0$*"2,-',$,K"5*-'$(,
$B#+9+#),C-'+#-5O,5$'2-C+;"2,B-'#5-(("2,#5+$(<,>+),'&0%+4%157#2&0%R'*5,'5*%<5$5&,2":%
DDPLS3,"@T<,2-+O,IM<@IXNbYC+5<IILX,
AC""#*3,4<3,15=E3,W<3,F,2",[5+"*3,6<,P@MMQS<,j.."B#*,-.,#$+(-5+'E,7"$(#7,C"**$E"*,-',K7)*+B$(,
$B#+9+#)<,?5&0*"%X7)2&*#+'%<5$5&,2":%BEPLS3,JM@%JIL<,2-+O,IM<IMXLb7"5bB)(IMI,
A-7(3,A<,W<3,F,!-)"53,&<,P@MMTS<,4$+(-5"2,+'#"59"'#+-'*,#-,K5-C-#",C$CC-E5$K7),*B5""'+'EO,
&,C"#$%$'$()#+B,5"9+"a<,K,585'*#85%157#2#'5:%^aPJS3,@R@%@NI<,2-+O,
IM<IMINbY<)KC"2<@MMT<MN<MMX,
AK+##$"(*3,6<3,?",1-=52"$=27=+Y3,8<3,15=E3,W<3,F,[$'2"($'-##"3,D<,P@MMTS<,j.."B#+9"'"**,-.,$',
-'(+'",B-CK=#"5%#$+(-5"2,K7)*+B$(,$B#+9+#),+'#"59"'#+-',+',$,5"$(%(+.",*"##+'E<,?5&0*"%
X7)2&*#+'%<5$5&,2":%BBPLS3,LQR%LXN<,2-+O,IM<IMXLb7"5bB)(MXN,
AK+##$"(*3,6<3,?",1-=52"$=27=+Y3,8<3,F,[$'2"($'-##"3,D<,P@MMTS<,j9$(=$#+-',-.,$,a"0*+#"%
2"(+9"5"2,B-CK=#"5%#$+(-5"2,+'#"59"'#+-',.-5,+'B5"$*+'E,K7)*+B$(,$B#+9+#),+',#7",
E"'"5$(,K-K=($#+-'<,K,585'*#85%157#2#'5:%^^PLS3,@MX%@IT<,2-+O,
IM<IMINbY<)KC"2<@MMN<II<MIM,
A#5"B7"53,[<,W<,PIXXXS<,D-CK=#"5%#$+(-5"2,*C-\+'E,B"**$#+-',C$#"5+$(*O,&,5"9+"a,$'2,
2+*B=**+-'<,K&*#5'*%X7)2&*#+'%&'7%@+)'$50#'/:%EbP@S3,IMT%IIT<,2-+O,IM<IMINbAMTLQ%
LXXIPXQSMMI@Q%I,
A#5"B7"53,[<,W<3,!BD(=5"3,W<,1<3,&("^$'2"53,]<,:<3,D7$\5$0-5#)3,1<3,V$+53,[<,V<3,Z-'\"(3,W<,!<3,<,<,<,
>-C"5("$=3,h<,G<,P@MMQS<,/"0%0$*"2,*C-\+'E%B"**$#+-',K5-E5$C*O,`"*=(#*,-.,$,
5$'2-C+;"2,#5+$(<,(95,#2&'%>+),'&0%+4%K,585'*#85%157#2#'5:%E^PRS3,LTL%LQI<,2-+O,
IM<IMINbY<$C"K5"<@MMT<I@<M@J,
A#5"B7"53,[<,W<3,A7+..C$'3,A<3,F,/"*#3,`<,P@MMRS<,`$'2-C+;"2,B-'#5-(("2,#5+$(,-.,$,a"0%0$*"2,
B-CK=#"5%#$+(-5"2,*C-\+'E,B"**$#+-',K5-E5$C,$*,$,*=KK("C"'#,#-,'+B-#+'",K$#B7,
#7"5$K)<,(77#2*#+':%DCCPRS3,NQ@%NQQ<,2-+O,IM<IIIIbY<ILNM%MJJL<@MMR<MIMXL<^,
A#5"B7"53,[<,W<3,/$'E3,D<3,?"55)3,6<3,/+(2"'7$=*3,Z<3,F,W-7'*-'3,D<,P@MM@S<,4$+(-5"2,
+'#"59"'#+-'*,.-5,C=(#+K(",5+*\,0"7$9+-5*<,?5&0*"%X7)2&*#+'%<5$5&,2":%D_PRS3,NIX%
N@N<,2-+O,IM<IMXLb7"5bIT<R<NIX,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
30
A=EE*3,:<,A<3,F,!B8'#)5"3,D<,P@MMXS<,&5",a",#7"5",)"#k,&',"^$C+'$#+-',-.,-'(+'",#$+(-5"2,
7"$(#7,B-CC='+B$#+-'<,?5&0*"%X7)2&*#+'%H%`5"&8#+,:%EbP@S3,@TQ%@QQ<,2-+O,
IM<IITTbIMXMIXQIMTLMLLMX,
A=##-'3,A<,!<3,1$(B73,]<,8<3,F,:"."095"3,`<,D<,PIXXRS<,A#5$#"E+B,c="*#+-'*,.-5,B-'*=C"5%0$*"2,
7"$(#7,B-CC='+B$#+-'*<,K)=0#2%?5&0*"%<53+,*$:%DDCPNS3,T@R%TLL<,,
Aa$5#;3,:<,6<,]<3,V-"((3,W<,/<3,AB75-"2"53,A<,/<3,F,&5)3,?<,[<,P@MMNS<,&,5$'2-C+*"2,B-'#5-(,
*#=2),-.,$,.=((),$=#-C$#"2,+'#"5'"#,0$*"2,*C-\+'E,B"**$#+-',K5-E5$CC"<,!+=&22+%
@+'*,+0:%DaPIS3,T%I@<,2-+O,IM<@LMTb@MTJTXMM,
4$#"3,?<,G<3,W$B\9-')3,j<,6<3,F,/+'E3,`<,`<,P@MMNS<,&,5$'2-C+;"2,#5+$(,B-CK$5+'E,7=C$',"%
C$+(,B-='*"(+'E3,B-CK=#"5%$=#-C$#"2,#$+(-5"2,B-='*"(+'E3,$'2,'-,B-='*"(+'E,+',$',
8'#"5'"#,a"+E7#,(-**,K5-E5$C<,(,2"#85$%+4%R'*5,'&0%157#2#'5:%DbbPIRS3,IN@M%IN@R<,
2-+O,IM<IMMIb$5B7+'#"<INN<IR<IN@M,
4",>-"(3,G<3,1-(C$'3,D<3,`"=0*$"#3,&<3,F,2",[5+"*3,6<,P@MMXS<,j..+B$B),-.,$,*+'E(",B-CK=#"5%
#$+(-5"2,"%C$+(,.-5,*C-\+'E,B"**$#+-'O,`"*=(#*,$.#"5,N,C-'#7*<,?5&0*"%X7)2&*#+'%
<5$5&,2":%B^PNS3,XLM%XJM<,2-+O,IM<IMXLb7"5bB)KMLN,
H<A<,?"K$5#C"'#,-.,6"$(#7,$'2,6=C$',A"59+B"*<,P@MII3,V-9<,IQS<,6"$(#7,D-CC='+B$#+-',
$'2,6"$(#7,8'.-5C$#+-',4"B7'-(-E),,`"#5+"9"2,hB#-0"5,T3,@MIM3,.5-C,
http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=18,
[$',?"',1"5E3,!<,6<3,`-'2$)3,6<,Z<3,>""#"5*3,&<,W<3,:",D"**+"3,A<3,[$',?"5,]+"*"'3,G<,W<3,
15""29"(23,G<,D<3,F,[(+"#,[(+"($'23,4<,><,!<,P@MMNS<,H*+'E,+'#"5'"#,#"B7'-(-E),#-,2"(+9"5,
$,7-C"%0$*"2,K7)*+B$(,$B#+9+#),+'#"59"'#+-',.-5,K$#+"'#*,a+#7,57"=C$#-+2,$5#75+#+*O,
&,5$'2-C+;"2,B-'#5-(("2,#5+$(<,(,*",#*#$%@&,5%&'7%<5$5&,2":%aaPNS3,XLR%XJR<,2-+O,
IM<IMM@b$5#<@@LLX,
9$',2"',1"5E3,!<,6<3,AB7--'"*3,W<,/<3,F,[(+"($'23,4<,><,!<,[<,P@MMTS<,8'#"5'"#%0$*"2,K7)*+B$(,
$B#+9+#),+'#"59"'#+-'*O,&,*)*#"C$#+B,5"9+"a,-.,#7",(+#"5$#=5"<,>+),'&0%+4%157#2&0%
R'*5,'5*%<5$5&,2":%\PLS3,TI%QN<,2-+O,IM<@IXNbYC+5<X<L<"@N,
["57"+Y2"'3,!<3,1$\^3,W<,D<3,&\\"5C$'*3,`<3,9$',2"',6--E"'3,6<3,]-2a+'3,V<,!<3,`-**"53,/<3,<,<,<,
9$',/""(3,D<,P@MMJS<,/"0%0$*"2,#$5E"#"2,'=#5+#+-',B-='*"((+'E,$'2,*-B+$(,*=KK-5#,
.-5,K$#+"'#*,$#,+'B5"$*"2,B$52+-9$*B=($5,5+*\,+',E"'"5$(,K5$B#+B"O,5$'2-C+;"2,
B-'#5-(("2,#5+$(<,>+),'&0%+4%157#2&0%R'*5,'5*%<5$5&,2":%bPJS3,"JJ<,2-+O,
IM<@IXNbYC+5<N<J<"JJ,
/$'E0"5E3,A<,D<,P@MMQS<,&',8'#"5'"#%0$*"2,2+$0"#"*,*"(.%B$5",+'#"59"'#+-',#$+(-5"2,#-,*"(.%
"..+B$B)<,?5&0*"%X7)2&*#+'%<5$5&,2":%BEPIS3,ITM%ITX<,2-+O,IM<IMXLb7"5bB)CMIJ,
/$''"53,!<3,!$5#+'%?+"'"53,j<3,15$='%G$75($'2"53,D<3,1$="53,]<3,F,!$5#+'3,1<,/<,P@MMXS<,
j.."B#+9"'"**,-.,$B#+9"%-'(+'"3,$',+'2+9+2=$((),#$+(-5"2,K7)*+B$(,$B#+9+#),+'#"59"'#+-'3,
+',$,5"$(%(+.",*"##+'EO,`$'2-C+;"2,B-'#5-(("2,#5+$(<,>+),'&0%+4%157#2&0%R'*5,'5*%
<5$5&,2":%DDPLS3,"@L<,2-+O,IM<@IXNbYC+5<IITX,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
31
/"003,:<,4<3,W-*"K73,W<3,_$52(")3,:<3,F,!+B7+"3,A<,P@MIMS<,H*+'E,#7",8'#"5'"#,#-,K5-C-#",7"$(#7,
0"7$9+-5,B7$'E"O,&,*)*#"C$#+B,5"9+"a,$'2,C"#$%$'$()*+*,-.,#7",+CK$B#,-.,#7"-5"#+B$(,
0$*+*3,=*",-.,0"7$9+-5,B7$'E",#"B7'+c="*3,$'2,C-2",-.,2"(+9"5),-',"..+B$B)<,>+),'&0%+4%
157#2&0%R'*5,'5*%<5$5&,2":%DBPIS3,"J<,2-+O,IM<@IXNbYC+5<ILTN,
/"+'*#"+'3,><,Z<,P@MMNS<,&,5"9+"a,-.,a"+E7#,(-**,K5-E5$C*,2"(+9"5"2,9+$,#7",8'#"5'"#<,
>+),'&0%+4%@&,7#+8&$2)0&,%O),$#'/:%BDPJS3,@RI%@RQ<,,
/+((+$C*%>+"7-#$3,><3,AB7'"+2"53,4<,`<3,>+;$55-3,W<3,!-a$23,:<3,F,A$(-9")3,><,P@MMLS<,!$#B7+'E,
7"$(#7,C"**$E"*,#-,+'.-5C$#+-'%K5-B"**+'E,*#)("*O,V""2,.-5,B-E'+#+-',$'2,
C$CC-E5$K7),=#+(+;$#+-'<,?5&0*"%@+99)'#2&*#+':%DaPJS3,LTR%LX@<,2-+O,
IM<I@MTbAIRL@TM@T6DIRMJvMI,
/+((+$C*-'3,?<,&<3,/$(2"'3,6<,!<3,/7+#"3,!<,&<3,_-5\%D5-a"3,j<3,V"a#-'3,`<,:<3,&(.-'*-3,&<3,<,<,<,
`)$'3,?<,P@MMNS<,4a-%)"$5,8'#"5'"#%0$*"2,5$'2-C+;"2,B-'#5-(("2,#5+$(,.-5,a"+E7#,
(-**,+',&.5+B$'%&C"5+B$',E+5(*<,.=5$#*G:%D^PTS3,I@LI%I@JL<,2-+O,
IM<IMLQb-0)<@MMN<IJM,
/+'"##3,`<,&<3,&'2"5*-'3,j<3,/-YB+\3,W<3,/+'"##3,A<3,F,1-a2"'3,4<,P@MMTS<,]=+2",#-,7"$(#7O,
V=#5+#+-',$'2,K7)*+B$(,$B#+9+#),-=#B-C"*,-.,$,E5-=K%5$'2-C+;"2,#5+$(,-.,$',+'#"5'"#%
0$*"2,+'#"59"'#+-',+',B7=5B7"*<,(''&0$%+4%`5"&8#+,&0%157#2#'5:%EEPLS3,@RI%@NI<,2-+O,
IM<IMMTb1GM@QTXXMT,
/+'"##3,`<,&<3,`--2C$'3,&<,&<3,/+'"##3,A<,]<3,1$Y;"\3,/<3,`-9'+$\3,:<,A<3,F,/7+#"(")3,W<,&<,PIXXXS<,
47",".."B#*,-.,j$#J:+.",8'#"5'"#%0$*"2,7"$(#7,0"7$9+-5,K5-E5$C,-',#7",'=#5+#+-',$'2,
$B#+9+#),-.,7+E7,*B7--(,E+5(*<,>+),'&0%+4%c5'75,:%@)0*),5%&'7%?5&0*":%^PLS3,@LX%@RJ<,2-+O,
IM<IM@Lb$OIM@L@LLJINQRX,
/-C0("3,:<,]<3,/$22"'3,4<,&<3,!B]=B\+'3,1<,]<3,A$5E"'#3,A<,:<3,`-#7C$'3,`<,&<3,F,Z5$=#7$C"5%
ja+'E3,j<,A<,P@MMJS<,&,5$'2-C+;"2,B-'#5-(("2,#5+$(,-.,$,B-CC"5B+$(,8'#"5'"#,a"+E7#,
(-**,K5-E5$C<,.=5$#*G%<5$5&,2":%DBPNS3,IMII%IMIQ<,2-+O,IM<IMLQb-0)<@MMJ<I@J,
/--(.3,A<,6<3,Z5+*#3,&<,6<3,W-7'*-'3,`<,j<3,/+(*-'3,?<,1<3,`-#7"C+B73,A<,G<3,V-5C$'3,]<,W<3,F,
?"9"5*3,Z<,W<,P@MMNS<,&,K5$B#+B"%*K-'*-5"2,/"0,*+#",#-,7"(K,K$#+"'#*,K=5*=",7"$(#7),
0"7$9+-5*O,&',&Dh`V,*#=2)<,(''&0$%+4%I&9#0G%157#2#'5:%^P@S3,IJQ%IR@<,2-+O,
IM<ILTMb$.C<R@@,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
32
Appendix!A:!Tables!
4$0(",I,
]#$*%+4%V*)7#5$%R'20)757%#'%15*&S('&0G$#$%
ELIGIBLE STUDIES INCLUDED IN META-ANALYSIS
1. An, L. C., Klatt, C., Perry, C. L., Lein, E. B., Hennrikus, D. J., Pallonen, U. E., . . .
Ehlinger, E. P. (2008). The RealU online cessation intervention for college
smokers: A randomized controlled trial. Preventive Medicine, 47(2), 194-199. doi:
10.1016/j.ypmed.2008.04.011
2. Buller, D. B., Borland, R., Woodall, W. G., Hall, J. R., Hines, J. M., Burris-
Woodall, P., . . . Saba, L. (2008). Randomized trials on Consider This, a tailored,
Internet-delivered smoking prevention program for adolescents. Health Education
& Behavior, 35(2), 260-281. doi: 10.1177/1090198106288982
3. Chiauzzi, E., Green, T. C., Lord, S., Thum, C., & Goldstein, M. (2005). A high-risk
drinking prevention web site for college students. Journal of American College
Health, 53(6), 263-274. doi: 10.3200/JACH.53.6.263-274
4. Dunton, G. F., & Robertson, T. P. (2008). A tailored internet-plus-email
intervention for increasing physical activity among ethnically-diverse women.
Preventive Medicine, 47(6), 605-611. doi: 10.1016/j.ypmed.2008.10.004
5. Frenn, M., Malin, S., Brown, R. L., Greer, Y., Fox, J., Greer, J., & Smyczek, S.
(2005). Changing the tide: an Internet/video exercise and low-fat diet intervention
with middle-school students. Applied Nursing Research, 18(1), 13-21. doi:
10.1016/j.apnr.2004.04.003
6. Hageman, P. A., Walker, S. N., & Pullen, C. H. (2005). Tailored versus standard
Internet-delivered interventions to promote physical activity in older women.
Journal of Geriatric Physical Therapy, 28(1), 28-33.
7. Huang, A., Barzi, F., Huxley, R., Denyer, G., Rohrlach, B., Jayne, K., & Neal, B.
(2006). The effects on saturated fat purchases of providing Internet shoppers with
purchase-specific dietary advice: A randomized trial. PLoS Clinical Trials, 1(5),
e22. doi: 10.1371/journal.pctr.0010022
8. Hurling, R., Catt, M., De Boni, M., Fairley, B. W., Hurst, T., Murray, P., . . .
Barkhuus, L. (2007). Using Internet and mobile phone technology to deliver an
automated physical activity program: Randomized controlled trial. Journal of
Medical Internet Research, 9(2), e7. doi: 10.2196/jmir.9.2.e7
9. Joseph, C. L. M., Peterson, E., Havstad, S., Johnson, C. C., Hoerauf, S., Stringer,
S., . . . Strecher, V. (2007). A web-based, tailored asthma management program for
urban African-American high school students. American Journal of Respiratory
and Critical Care Medicine, 175(9), 888-895. doi: 10.1164/rccm.200608-1244OC

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
33
10. Kypri, K., Langley, J. D., Saunders, J. B., Cashell-Smith, M. L., & Herbison, P.
(2008). Randomized controlled trial of web-based alcohol screening and brief
intervention in primary care. Archives of Internal Medicine, 168(5), 530-536. doi:
10.1001/archinternmed.2007.109
11. Kypri, K., & McAnally, H. M. (2005). Randomized controlled trial of a web-based
primary care intervention for multiple health risk behaviors. Preventive Medicine,
41(3-4), 761-766. doi: 10.1016/j.ypmed.2005.07.010
12. Kypri, K., Saunders, J. B., Williams, S. M., McGee, R. O., Langley, J. D., Cashell-
Smith, M. L., & Gallagher, S. J. (2004). Web-based screening and brief intervention
for hazardous drinking: A double-blind randomized controlled trial. Addiction,
99(11), 1410-1417. doi: 10.1111/j.1360-0443.2004.00847.x
13. Lorig, K. R., Ritter, P. L., Laurent, D. D., & Plant, K. (2008). The internet-based
arthritis self-management program: A one-year randomized trial for patients with
arthritis or fibromyalgia. Arthritis Care and Research, 59(7), 1009-1017. doi:
10.1002/art.23817
14. Mangunkusumo, R. T., Brug, J., de Koning, H. J., van der Lei, J., & Raat, H.
(2007). School-based Internet-tailored fruit and vegetable education combined with
brief counselling increases children's awareness of intake levels. Public Health
Nutrition, 10(03), 273-279. doi: 10.1017/S1368980007246671
15. Marcus, A. C., Mason, M., Wolfe, P., Rimer, B. K., Lipkus, I., Strecher, V. J., . . .
Bright, M. A. (2005). The efficacy of tailored print materials in promoting
colorectal cancer screening: results from a randomized trial involving callers to the
National Cancer Institute's Cancer Information Service. Journal of Health
Communication, 10(Suppl 1), 83-104. doi: 10.1080/10810730500257754
16. McKay, H. G., King, D., Eakin, E. G., Seeley, J. R., & Glasgow, R. E. (2001). The
Diabetes Network Internet-based physical activity intervention: A randomized pilot
study. Diabetes Care, 24(8), 1328-1334. doi: 10.2337/diacare.24.8.1328
17. Napolitano, M. A., Fotheringham, M., Tate, D., Sciamanna, C., Leslie, E., Owen,
N., . . . Marcus, B. (2003). Evaluation of an Internet-based physical activity
intervention: A preliminary investigation. Annals of Behavioral Medicine, 25(2),
92-99. doi: 10.1207/s15324796abm2502_04
18. Norman, C. D., Maley, O., Li, X., & Skinner, H. A. (2008). Using the Internet to
assist smoking prevention and cessation in schools: A randomized, controlled trial.
Health Psychology, 27(6), 799-810. doi: 10.1037/a0013105
19. Oenema, A., Brug, J., Dijkstra, A., Weerdt, I., & Vries, H. (2008). Efficacy and use
of an Internet-delivered computer-tailored lifestyle intervention, targeting saturated
fat intake, physical activity and smoking cessation: A randomized controlled trial.
Annals of Behavioral Medicine, 35(2), 125-135. doi: 10.1007/s12160-008-9023-1
20. Oenema, A., Tan, F., & Brug, J. (2005). Short-term efficacy of a web-based
computer-tailored nutrition intervention: Main effects and mediators. Annals of
Behavioral Medicine, 29(1), 54-63. doi: 10.1207/s15324796abm2901_8

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
34
21. Palmer, S., Graham, G., & Elliott, E. (2005). Effects of a web-based health program
on fifth grade children’s physical activity, knowledge, attitudes and behavior.
American Journal of Health Education, 36(2), 86-93. doi:
10.1080/19325037.2005.10608164
22. Ritterband, L. M., Cox, D. J., Walker, L. S., Kovatchev, B., McKnight, L., Patel,
K., . . . Sutphen, J. (2003). An Internet intervention as adjunctive therapy for
pediatric encopresis. Journal of Consulting and Clinical Psychology, 71(5), 910-
917. doi: 10.1037/0022-006x.71.5.910
23. Rothert, K., Strecher, V. J., Doyle, L. A., Caplan, W. M., Joyce, J. S., Jimison, H.
B., . . . Roth, M. A. (2006). Web-based weight management programs in an
integrated health care setting: a randomized, controlled trial. Obesity, 14(2), 266-
272. doi: 10.1038/oby.2006.34
24. Severson, H. H., Gordon, J. S., Danaher, B. G., & Akers, L. (2008). ChewFree.com:
Evaluation of a web-based cessation program for smokeless tobacco users. Nicotine
& Tobacco Research, 10(2), 381-391. doi: 10.1080/14622200701824984
25. Slootmaker, S. M., Chinapaw, M. J., Schuit, A. J., Seidell, J. C., & Van Mechelen,
W. (2009). Feasibility and effectiveness of online physical activity advice based on
a personal activity monitor: randomized controlled trial. Journal of Medical
Internet Research, 11(3), e27. doi: 10.2196/jmir.1139
26. Spittaels, H., De Bourdeaudhuij, I., Brug, J., & Vandelanotte, C. (2007).
Effectiveness of an online computer-tailored physical activity intervention in a real-
life setting. Health Education Research, 22(3), 385-396. doi: 10.1093/her/cyl096
27. Spittaels, H., De Bourdeaudhuij, I., & Vandelanotte, C. (2007). Evaluation of a
website-delivered computer-tailored intervention for increasing physical activity in
the general population. Preventive Medicine, 44(3), 209-217. doi:
10.1016/j.ypmed.2006.11.010
28. Strecher, V. J., Shiffman, S., & West, R. (2005). Randomized controlled trial of a
web-based computer-tailored smoking cessation program as a supplement to
nicotine patch therapy. Addiction, 100(5), 682-688. doi: 10.1111/j.1360-
0443.2005.01093.x
29. Swartz, L. H. G., Noell, J. W., Schroeder, S. W., & Ary, D. V. (2006). A
randomised control study of a fully automated internet based smoking cessation
programme. Tobacco Control, 15(1), 7-12. doi: 10.2307/20747900
30. Tate, D. F., Jackvony, E. H., & Wing, R. R. (2006). A randomized trial comparing
human e-mail counseling, computer-automated tailored counseling, and no
counseling in an Internet weight loss program. Archives of Internal Medicine,
166(15), 1620-1625. doi: 10.1001/archinte.166.15.1620
31. Te Poel, F., Bolman, C., Reubsaet, A., & de Vries, H. (2009). Efficacy of a single
computer-tailored e-mail for smoking cessation: Results after 6 months. Health
Education Research, 24(6), 930-940. doi: 10.1093/her/cyp036

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
35
32. Van Den Berg, M. H., Ronday, H. K., Peeters, A. J., Le Cessie, S., Van Der Giesen,
F. J., Breedveld, F. C., & Vliet Vlieland, T. P. M. (2006). Using internet technology
to deliver a home-based physical activity intervention for patients with rheumatoid
arthritis: A randomized controlled trial. Arthritis Care and Research, 55(6), 935-
945. doi: 10.1002/art.22339
33. Verheijden, M., Bakx, J. C., Akkermans, R., van den Hoogen, H., Godwin, N. M.,
Rosser, W., . . . van Weel, C. (2004). Web-based targeted nutrition counselling and
social support for patients at increased cardiovascular risk in general practice:
randomized controlled trial. Journal of Medical Internet Research, 6(4), e44. doi:
10.2196/jmir.6.4.e44
34. Wanner, M., Martin-Diener, E., Braun-Fahrlander, C., Bauer, G., & Martin, B. W.
(2009). Effectiveness of active-online, an individually tailored physical activity
intervention, in a real-life setting: Randomized controlled trial. Journal of Medical
Internet Research, 11(3), e23. doi: 10.2196/jmir.1179
35. Williamson, D. A., Walden, H. M., White, M. A., York-Crowe, E., Newton, R. L.,
Alfonso, A., . . . Ryan, D. (2006). Two-year Internet-based randomized controlled
trial for weight loss in African-American girls. Obesity, 14(7), 1231-1243. doi:
10.1038/oby.2006.140
36. Winett, R. A., Anderson, E., Wojcik, J., Winett, S., & Bowden, T. (2007). Guide to
health: Nutrition and physical activity outcomes of a group-randomized trial of an
internet-based intervention in churches. Annals of Behavioral Medicine, 33(3), 251-
261. doi: 10.1007/BF02879907
37. Winett, R. A., Roodman, A. A., Winett, S. G., Bajzek, W., Rovniak, L. S., &
Whiteley, J. A. (1999). The effects of Eat4Life Internet-based health behavior
program on the nutrition and activity of high school girls. Journal of Gender,
Culture and Health, 4(3), 239-254. doi: 10.1023/a:1023233416859
38. Womble, L. G., Wadden, T. A., McGuckin, B. G., Sargent, S. L., Rothman, R. A.,
& Krauthamer-Ewing, E. S. (2004). A randomized controlled trial of a commercial
Internet weight loss program. Obesity Research, 12(6), 1011-1018. doi:
10.1038/oby.2004.124
39. Woolf, S. H., Krist, A. H., Johnson, R. E., Wilson, D. B., Rothemich, S. F.,
Norman, G. J., & Devers, K. J. (2006). A practice-sponsored Web site to help
patients pursue healthy behaviors: An ACORN study. Annals of Family Medicine,
4(2), 148-152. doi: 10.1370/afm.522
%

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
36
4$0(",:,
Summary'of'Web-Based'Tailored'Health'Behavior'Change'Interventions'
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;&',"#,$(<3,:==>?,
@A-B+'C,
DEF,G-(("C",*#H2"'#,
*A-B"5*I,A"$',$C"J:=I,
FKL,."A$("I,M@,*"##+'C,
K=%N""B,#$+(-5"2,*A-B+'C,G"**$#+-',+'#"59"'#+-',
5"OH+5+'C,:=,9+*+#*,#-,$,N"0*+#"I,$(*-,+'G(H2"2,
"A$+(,5"A+'2"5*3,N""B(),*"(.%A-'+#-5+'C3,
+'#"5$G#+9",#$+(-5"2,OH+PP"*,$'2,"A$+(,*HQQ-5#,
.5-A,Q""5,G-$G7"*I,#$5C"#"2,0"7$9+-5R,F%,$'2,K=%
2$),*A-B+'C,Q5"9$("'G"I,E==L,5"#"'#+-',5$#",
#$+(-5"2,-'(+'",A$C$P+'",
;'J:DF?,9*<,C"'"5$(,-'(+'",
5"*-H5G"*,;'J:S=?,
;1H(("5,"#,$(<3,:==>?,
@A-B+'C,
E:KT,$2-("*G"'#*I,A"$',
$C"JE:I,D:L,."A$("I,M@,
*"##+'C,
N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-',2"(+9"5"2,2H5+'C,S,G($**,A""#+'C*I,
"$G7,TD%S=,A+'H#",*"**+-',.-GH*"2,-',2+.."5"'#,
G-'#"'#,$'2,+'G(H2"2,*"(.%A-'+#-5+'C3,AH(#+%
A"2+$,G-'#"'#I,#$5C"#"2,0"7$9+-5R,K=%2$),
*A-B+'C,Q5"9$("'G"I,>EL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'JST=?,9*<,
*#$'2$52,7"$(#7,"2HG$#+-',
;'JKST?,
;1H(("53,"#,$(<3,
:==>?,
@A-B+'C,
:=FF,$2-("*G"'#*I,A"$',
$C"JE:I,TUL,."A$("I,'-'%
M@,*"##+'C,;&H*#5$(+$?,
N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-',2"(+9"5"2,2H5+'C,S,G($**,A""#+'C*I,
"$G7,TD%S=,A+'H#",*"**+-',.-GH*"2,-',2+.."5"'#,
G-'#"'#,$'2,+'G(H2"2,*"(.%A-'+#-5+'C3,AH(#+%
A"2+$,G-'#"'#I,#$5C"#"2,0"7$9+-5R,K=%2$),
*A-B+'C,Q5"9$("'G"I,FKL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'JFDT?,9*<,
*#$'2$52,7"$(#7,"2HG$#+-',
;'JFDS?,
;V7+$HPP+3,W5""'3,
X-523,47HA3,Y,
W-(2*#"+'3,:==D?,
&(G-7-(+*A,
:SD,G-(("C",*#H2"'#*,N7-,
N"5",7"$9),25+'B"5*I,
A"$',$C"J:=I,TSL,
."A$("I,M@,*"##+'C,
T%N""B,N"0%0$*"2,#$+(-5"2,+'#"59"'#+-',
2"*+C'"2,#-,5"2HG",7"$9),25+'B+'CI,"$G7,:=%
A+'H#",*"**+-',+'G(H2"2,#$+(-5"2,G-'#"'#3,
+'#"5$G#+9",$G#+9+#+"*3,Q""5,*#-5+"*3,$*B,$',"ZQ"5#3,
$'2,$,*-G+$(,'-5A,[G$(GH($#-5[I,#$5C"#"2,
0"7$9+-5*R,$(G-7-(,H*"I,0+'C",25+'B+'C3,$'2,
5"$2+'"**,#-,G7$'C"I,>=L,5"#"'#+-',5$#",
#$+(-5"2,N"0*+#",;'JEKE,9*<,
C"'"5+G,N"0*+#",;'JEKT?,
;\H'#-',Y,
]-0"5#*-'3,:==>?,
^7)*+G$(,
&G#+9+#),
EDS,$2H(#,N-A"'I,A"$',
$C"JTKI,E==L,."A$("I,M@,
*"##+'C,
E:%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,$(*-,+'G(H2"2,$G#+9+#),A-'+#-5,$'2,
N""B(),'"N*("##"5*,*"'#,9+$,"A$+(I,#$5C"#"2,
0"7$9+-5*R,("9"(,-.,Q7)*+G$(,$G#+9+#),$'2,
5"$2+'"**,#-,G7$'C"I,FTL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'J>D?,9*<,
N$+#(+*#,G-'#5-(,;'JFE?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
37
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;_5"'',"#,$(<3,:==D?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
EK:,A+22(",*G7--(,B+2*I,
A"$',$C"JEKI,D:L,
."A$("I,M@,*"##+'C,
N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),+'#"59"'#+-',
2"(+9"5"2,+',>3,T=%A+'H#",+'%G($**,*"**+-'*I,
+'G(H2"2,#$+(-5"2,G-'#"'#3,9+2"-*3,2+*GH**+-',
.-5HA*,$'2,#$+(-5"2,"A$+(,.""20$GBI,#$5C"#"2,
0"7$9+-5*R,("9"(,-.,Q7)*+G$(,$G#+9+#),Y,2+"#$5),.$#,
+'#$B"I,FFL,5"#"'#+-',
#$+(-5"2,"2HG$#+-'$(,*+#",9*<,
G-'#5-(,;*#$'2$52,G($**"*I,',
.-5,"$G7,G-'2+#+-','-#,G("$5(),
5"Q-5#"2?,
;6$C"A$'3,/$(B"53,
Y,^H(("'3,:==D?,
^7)*+G$(,
&G#+9+#),
KE,-(2"5,N-A"'I,A"$',
$C"JDSI,E==L,."A$("I,M@,
*"##+'C,
>%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-',2"(+9"5"2,9+$,K,#$+(-5"2,-'(+'",
'"N*("##"5*I,#$5C"#"2,0"7$9+-5*R,("9"(,-.,Q7)*+G$(,
$G#+9+#),$'2,*"(.%"..+G$G)I,UFL,5"#"'#+-',5$#",
#$+(-5"2,;'JED?,9*<,C"'"5+G,
;'JES?,-'(+'",'"N*("##"5*,
;6H$'C,"#,$(<3,
:==S?,
`H#5+#+-'a\+"#,
TUF,-'(+'",G-'*HA"5*I,
A"$',$C"JT=I,>F<DL,
."A$("I,'-'%M@,*"##+'C,
;@)2'")3,&H*#5$(+$?,
05+".,N"0%0$*"2,#$+(-5"2,+'#"59"'#+-',#-,5"2HG",
7+C7%.$#,QH5G7$*"*,-',$',-'(+'",*7-QQ+'C,
N"0*+#"I,0$*"2,-',G-'#"'#*,-.,*7-QQ+'C,G$5#3,
#$+(-5"2,$29+G",N$*,C+9"',#-,"'G-H5$C",*7-QQ"5*,
#-,0H),*+A+($5,Q5-2HG#*,(-N"5,+',*$#H5$#"2,.$#I,
#$5C"#"2,0"7$9+-5R,QH5G7$*",-.,Q5-2HG#*,7+C7,+',
*$#H5$#"2,.$#I,E==L,5"#"'#+-',5$#",,
#$+(-5"2,;'J:DE?,9*<,C"'"5$(,
;'J:TS?3,'-'%*Q"G+.+G,
*7-QQ+'C,$29+G",
;6H5(+'C,"#,$(<3,
:==F?,
^7)*+G$(,
&G#+9+#),
FF,-9"5N"+C7#a-0"*",
$2H(#*I,A"$',$C"JT=I,
STL,."A$("I,'-'%M@,
*"##+'C,;1"2.-52*7+5"3,
M'+#"2,b+'C2-A?,
U%N""B,N"0%0$*"2,Q7)*+G$(,$G#+9+#),+'#"59"'#+-'I,
+'9-(9"2,#$+(-5"2,*-(H#+-'*I,N""B(),"Z"5G+*",Q($'3,
*"(.%A-'+#-5+'C,-.,^&3,2+*GH**+-',.-5HA3,
5"A+'2"5*,*"'#,9+$,"A$+(,$'2,#"Z#,;@!@?I,
#$5C"#"2,0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,
E==L,5"#"'#+-',5$#",
#$+(-5"2,;'JTF?,9*<,C"'"5+G,
N"0*+#",;'JK=?,
;c-*"Q7,"#,$(<3,
:==F?,
&*#7A$,
KET,&&,7+C7,*G7--("5*I,
A"$',$C"JEFI,SKL,
."A$("I,M@,*"##+'C,
E:%A-'#7,N"0%0$*"2,$*#7A$,A$'$C"A"'#,
Q5-C5$AI,+'G(H2"2,#$+(-5"2,.""20$GB,$'2,
$'+A$#+-'I,#$5C"#"2,0"7$9+-5*R,G-'#5-(("5,
A"2+G$#+-',$27"5"'G"3,5"*GH",+'7$("5,
$9$+($0+(+#)3,$'2,*A-B+'C,G"**$#+-'a5"2HG#+-'I,
>SL,5"#"'#+-',
#$+(-5"2,;'JES:?,9*<,C"'"5+G,
;'JED:?,N"0*+#",

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
38
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;b)Q5+,Y,!G&'$(()3,
:==D?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#)I,
@A-B+'CI,
&(G-7-(+*A,
:E>,G-(("C",*#H2"'#*I,
A"$',$C"J:=I,TUL,
."A$("I,'-'%M@,*"##+'C,
;`"N,d"$($'2?,
05+".3,N"0%0$*"2,#$+(-5"2,+'#"59"'#+-',G-'2HG#"2,
$#,*#H2"'#,7"$(#7,*"59+G"*,#$5C"#+'C,AH(#+Q(",
7"$(#7,0"7$9+-5*I,+'9-(9"2,N"0%0$*"2,
$**"**A"'#,N+#7,+AA"2+$#",#$+(-5"2,.""20$GB,
$'2,,Q7-'",$'2,"A$+(,5"A+'2"5,#-,G-AQ("#",$,
.-((-N%HQ,*H59"),$#,S%N""B*I,#$5C"#"2,0"7$9+-5*R,
.5H+#,Y,9"C"#$0(",+'#$B"3,("9"(*,-.,Q7)*+G$(,
$G#+9+#)3,$(G-7-(,G-'*HAQ#+-'I,>DL,5"#"'#+-',,
E?,N"0%0$*"2,$**"**A"'#,$'2,
Q"5*-'$(+P"2,.""20$GB,
;'JF:?I,9*<,;:?,$**"**A"'#,
-'(),;'JFT?I,9*<,;K?,A+'+A$(,
G-'#$G#,;'JF:?,
;b)Q5+,"#,$(<3,:==T?,
&(G-7-(+*A,
E=T,G-(("C",*#H2"'#*,N7-,
N"5",7"$9),25+'B"5*I,
A"$',$C"J:=I,D=L,
."A$("I,'-'%M@,*"##+'C,
;`"N,d"$($'2?,
05+".3,N"0%0$*"2,#$+(-5"2,+'#"59"'#+-',#-,5"2HG",
7$P$52-H*,25+'B+'CI,+'9-(9"2,E=%ED,A+'H#",N"0%
0$*"2,$**"**A"'#,N+#7,+AA"2+$#",#$+(-5"2,
.""20$GB,$'2,Q7-'",$'2,"A$+(,5"A+'2"5,#-,
G-AQ("#",$,.-((-N%HQ,*H59"),$#,S%N""B*I,
#$5C"#"2,0"7$9+-5*R,$(G-7-(,G-'*HAQ#+-',$'2,
0+'C",25+'B+'CI,S:L,5"#"'#+-',,
N"0%0$*"2,$**"**A"'#,$'2,
#$+(-5"2,.""20$GB,;'JDE?,9*<,
C"'"5+G,Q5+'#,;'JDK?,
;b)Q5+3,X$'C(")3,
@$H'2"5*3,V$*7"((%
@A+#73,Y,6"50+*-'3,
:==>?,
&(G-7-(+*A,
DFS,G-(("C",*#H2"'#*,N7-,
N"5",7"$9),25+'B"5*I,
A"$',$C"J:=I,D:L,
."A$("I,'-'%M@,*"##+'C,
;`"N,d"$($'2?,
05+".,$'2,AH(#+Q("%2-*",N"0%0$*"2,#$+(-5"2,
A-#+9$#+-'$(,+'#"59"'#+-',#-,5"2HG",7$P$52-H*,
25+'B+'CI,+'9-(9"2,N"0%0$*"2,$**"**A"'#,N+#7,
#$+(-5"2,.""20$GB3,N+#7,-'",$5A,5"G"+9+'C,
AH(#+Q(",$**"**A"'#*,$'2,#$+(-5"2,.""20$GB,$#,E,
$'2,S,A-'#7*I,#$5C"#"2,0"7$9+-5*R,,$(G-7-(,
G-'*HAQ#+-',$'2,0+'C",25+'B+'CI,SKL,5"#"'#+-',,
;E?,*+'C(",2-*","9+2"'G"%
*HQQ-5#"2,*G5""'+'C,$'2,05+".,
+'#"59"'#+-',;"%@183,'JEK>?I,
;:?,AH(#+Q(",2-*","9+2"'G"%
*HQQ-5#"2,*G5""'+'CI,$'2,
05+".,+'#"59"'#+-'G-'#5-(,
;'JETD?I,;K?,C"'"5$(,
Q$AQ7("#,;'JETS?I,;T?,
$(#"5'$#",G-'#5-(,;'JETF?,
;X-5+C3,]+##"53,
X$H5"'#3,Y,^($'#3,
:==>?,
&5#75+#+*,
>DD,Q$#+"'#*,N+#7,
57"HA$#-+2,$5#75+#+*3,
-*#"-$5#75+#+*3,-5,
.+05-A)$(C+$I,A"$',
$C"JD:I,U=L,."A$("I,M@,
*"##+'C,
S%N""B,N"0%0$*"2,$5#75+#+*,*"(.%A$'$C"A"'#,
Q5-C5$AI,+'9-(9"2,+'#"5$G#+9"3,N"0%0$*"2,
+'*#5HG#+-'3,0H(("#+',0-$52,2+*GH**+-'3,"Z"5G+*",
(-C*3,A"2+G$#+-',2+$5+"*3,$'2,#$+(-5"2,"Z"5G+*",
Q5-C5$A*3,$'2,$',&5#75+#+*,6"(Q0--B,G-'#$+'+'C,
$((,-.,#7",Q5-C5$A,G-'#"'#I,#$5C"#"2,AH(#+Q(",
0"7$9+-5*R,+<"<3,$"5-0+G,"Z"5G+*"3,*#5"#G7+'C,$'2,
*#5"'C#7"'+'C,"Z"5G+*"3,Q5$G#+G",-.,*#5"**,
A$'$C"A"'#3,$'2,G-AAH'+G$#+-',N+#7,
Q7)*+G+$'*3,$'2,*"(.%"..+G$G)I,FDL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'JTKK?,9*<,
H*H$(,G$5",;'JT::?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
39
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;!$'CH'BH*HA-3,
15HC3,2",b-'+'C3,
9$',2"5,X"+3,Y,]$$#3,
:==F?,
`H#5+#+-'a\+"#,
TUD,$2-("*G"'#*I,A"$',
$C"JE=I,DKL,."A$("I,'-'%
M@,*"##+'C,;47",
`"#7"5($'2*?,
05+".,N"0%0$*"2,#$+(-5"2,'H#5+#+-',+'#"59"'#+-'I,
+'9-(9"2,N"0%0$*"2,$**"**A"'#,$'2,#$+(-5"2,
'H#5+#+-',$29+G"3,$#,$,($#"5,2$#",.-((-N"2,HQ,0),D%
A+'H#",2+"#$5),G-H'*"(+'C,+'9-(9+'C,Q$5"'#*I,
#$5C"#"2,0"7$9+-5R,.5H+#,Y,9"C"#$0(",+'#$B"I,U>L,
5"#"'#+-',
8'#"5'"#%#$+(-5"2,'H#5+#+-',
$29+G",.-5,*G7--(G7+(25"',$'2,
05+".,2+"#$5),G-H'*"(+'C,;N+#7,
G7+(2,$'2,Q$5"'#I,'J:SK?,9*<,
05+".,N"0%0$*"2,'H#5+#+-',
$29+G",;'J::K?,
;&<,V<,!$5GH*3,"#,$(<3,
:==D?,
^7)*+G$(,
&G#+9+#),
:TU,7"$(#7),0H#,*"2"'#$5),
$2H(#*I,A"$',$C"JTDI,
>KL,."A$("I,M@,*"##+'C,
N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'G(H2"2,#$+(-5"2,"9+2"'G"%0$*"2,
Q7)*+G$(,$G#+9+#),"2HG$#+-'$(,$'2,A-#+9$#+-'$(,
A$#"5+$(*3,A-'#7(),OH"*#+-''$+5"*,N+#7,#$+(-5"2,
+AA"2+$#",.""20$GB3,$,C-$(%*"##+'C3,$'2,(+'B*,#-,
-#7"5,*+#"*,$'2,"A$+(,5"A+'2"5*I,#$5C"#"2,
0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,>UL,
5"#"'#+-',
;E?,A-#+9$#+-'$((),#$+(-5"2,
8'#"5'"#,;'J>E?I,9*<,;:?,
A-#+9$#+-'$((),#$+(-5"2,Q5+'#,
;'J>S?I,9*<,;K?,S,*#$'2$52,
N"0*+#",;'J>:?,
;!Gb$)3,b+'C3,
e$B+'3,@""(")3,Y,
W($*C-N3,:==E?,
^7)*+G$(,
&G#+9+#),
F>,4)Q",:,2+$0"#+G*I,A"$',
$C"JD:I,DKL,."A$("I,M@,
*"##+'C,
>%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,#$+(-5"2,N"0*+#",+'G(H2"2,C-$(,
*"##+'C,$'2,Q"5*-'$(+P"2,.""20$GB3,-'(+'",$GG"**,
#-,Q"5*-'$(,G-$G7,$'2,Q""5,*HQQ-5#,C5-HQ*I,
#$5C"#"2,0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,>FL,
5"#"'#+-',
.H((),#$+(-5"2,N"0*+#",;'JK>?,
9*<,+'.-5A$#+-'%-'(),N"0*+#",
;'JT=?,
;`$Q-(+#$'-,"#,$(<3,
:==K?,
^7)*+G$(,
&G#+9+#),
SD,*"2"'#$5),$2H(#*I,
A"$',$C"JTKI,>SL,
."A$("I,M@,*"##+'C,
E:%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,#$+(-5"2,N"0*+#",N+#7,N""B(),"A$+(,
#+Q,*7""#*,$'2,$G#+9+#),OH+PP"*I,#$5C"#"2,
0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,>>L,
5"#"'#+-',
#$+(-5"2,N"0*+#",;'JK=?,9*<,
N$+#(+*#,G-'#5-(,;'JKD?,
;`-5A$'3,!$(")3,X+3,
Y,@B+''"53,:==>?,
@A-B+'C,
ET=:,$2-("*G"'#*I,A"$',
$C"JEKI,TSL,."A$("I,'-'%
M@,*"##+'C,;4-5-'#-3,
V$'$2$?,
S%A-'#7,N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-'I,+'9-(9"2,$,*+'C(",S=%A+'H#",
"ZQ(-5$#+-',-.,$',+'#"5$G#+9",#$+(-5"2,N"0*+#"3,
$'2,G-AQ("#+-',-.,Q$Q"5,f-H5'$(,$'2,*A$((%C5-HQ,
A-#+9$#+-'$(,+'#"59+"N3,$'2,*HQQ-5#"2,N+#7,
#$+(-5"2,.-((-N%HQ,"A$+(*,2"(+9"5"2,A-'#7(),-9"5,
#7",S%A-'#7,Q"5+-2I,#$5C"#"2,0"7$9+-5R,G+C$5"##",
H*"3,0"7$9+-5$(,+'#"'#+-'*,$'2,*"(.%"..+G$G),#-,
5"*+*#,*A-B+'CI,>KL,5"#"'#+-',
#$+(-5"2,N"0%0$*"2,
+'*#5HG#+-',;'J'-#,5"Q-5#"2?,
9*<,*#$'2$52,G($**,"Z"5G+*",
;'J'-#,5"Q-5#"2?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
40
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;g"'"A$3,15HC3,
\+fB*#5$3,/""52#3,Y,
h5+"*3,:==>?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#)I,
@A-B+'C,
:EDU,$2H(#*I,A"$',
$C"JTTI,DTL,."A$("I,'-'%
M@,*"##+'C,;47",
`"#7"5($'2*?,
T%N""B,N"0%0$*"2,#$+(-5"2,(+."*#)(",+'#"59"'#+-'I,
+'9-(9"2,#$+(-5"2,+'.-5A$#+-',A-2H("*,N+#7,
-'(+'",OH+PP"*3,C5$Q7+G*,$'2,C-$(,*"##+'C,
$G#+9+#+"*I,#$5C"#"2,0"7$9+-5*R,*$#H5$#"2,.$#,
+'#$B"3,("9"(,-.,Q7)*+G$(,$G#+9+#),$'2,*A-B+'C,
G"**$#+-'I,SKL,5"#"'#+-',
#$+(-5"2,N"0,+'#"59"'#+-',
;'JE=>=?,9*<,N$+#(+*#,G-'#5-(,
;'JE=FU?,
;g"'"A$3,4$'3,Y,
15HC3,:==D?,
`H#5+#+-'a\+"#,
F>:,$2H(#*I,A"$',$C"JT:I,
TKL,."A$("I,'-'%M@,
*"##+'C,;47",`"#7"5($'2*?,
K%N""B,N"0%0$*"2,#$+(-5"2,'H#5+#+-',
+'#"59"'#+-'I,+'9-(9"2,$,#$+(-5"2,N"0*+#",
+'G(H2+'C,+'.-5A$#+-',-',7-N,#-,A$B",
+AQ("A"'#$#+-',+'#"'#+-'*3,*"Z,$'2,$C"%#$+(-5"2,
5-(",A-2"(,*#-5+"*,$'2,(+*#,-.,7"$(#7),5"G+Q"*I,
#$5C"#"2,0"7$9+-5*R,*$#H5$#"2,.$#,+'#$B",$'2,.5H+#,
$'2,9"C"#$0(",+'#$B"I,FUL,5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',;'J:SE?,
9*<,C"'"5+G,+'.-5A$#+-',
G-'#5-(,;'J:S=?,9*<,'-%
+'.-5A$#+-',G-'#5-(,;'J:SE?,
;^$(A"53,W5$7$A3,
Y,e((+-##3,:==D?,
^7)*+G$(,
&G#+9+#),
:KK,.+.#7,C5$2"5*I,A"$',
$C",J,'5I,SSL,."A$("I,M@,
*"##+'C,
T%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,0+%N""B(),D=%A+'H#",
"ZQ(-5$#+-',-.,$,#$+(-5"2,N"0*+#",+'G(H2+'C,-'(+'",
OH+PP"*3,N5+#+'C,$G#+9+#+"*3,N""B(),$G#+9+#),
G7"GB(+*#3,C5$Q7+G*,$'2,$'+A$#+-'I,#$5C"#"2,
0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,E==L,
5"#"'#+-',
+'9-(9"2,Q5"%Q-*#,G5-**%-9"5,
2"*+C',
;]+##"50$'2,"#,$(<3,
:==K?,
e'G-Q5"*+*,
:T,G7+(25"',N+#7,
"'G-Q5"*+*I,:EL,."A$("I,
M@,*"##+'C,
K%N""B,N"0%0$*"2,#$+(-5"2,+'#"59"'#+-',2"$(+'C,
N+#7,"'G-Q5"*+*I,+'9-(9"2,#75"",N"0%0$*"2,G-5",
A-2H("*,#7$#,G-H(2,0",G-AQ("#"2,+',$,#-#$(,-.,S=%
U=,A+'H#"*,+',*+'C(",-5,AH(#+Q(",*"**+-'*3,#7+*,
N$*,.-((-N"2,HQ,N+#7,$**"**A"'#*,$'2,#$+(-5"2,
A-2H("*,$'2,Q"5*-'$(+P"2,+'*#5HG#+-',*7""#*,E,
$'2,:,N""B*,$.#"5,G-AQ("#+-',-.,#7",G-5",
A-2H("*3,Q5"*"'#$#+-',.-5A$#*,+'G(H2"2,
$'+A$#+-'3,-'(+'",OH+PP"*3,$H2+-,'$55$#+-'3,
-'(+'",C$A"*3,9+2"-3,#"("Q7-'",$'2,Q5+'#,
*HQQ-5#I,#$5C"#"2,0"7$9+-5R,#-+("#+'C,0"7$9+-5*I,
E==L,5"#"'#+-',
N"0%0$*"2,"'7$'G"2,#-+("#,
#5$+'+'C,+'#"59"'#+-',;'JE:?,
9*<,'-%N"0,+'#"59"'#+-',
+'9-(9+'C,H'*Q"G+.+"2,5-H#+'",
A"2+G$(,G$5",;'JE:?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
41
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;]-#7"5#,"#,$(<3,
:==S?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
:>S:,-9"5N"+C7#a-0"*",
$2H(#*I,A"$',$C"JTDI,
>KL,."A$("I,M@,*"##+'C,
S%N""B,N"0%0$*"2,#$+(-5"2,*"(.%7"(Q,N"+C7#,
A$'$C"A"'#,Q5-C5$AI,+'9-(9"2,2"9"(-QA"'#,-.,
+'2+9+2H$((),#$+(-5"2,N"+C7#,A$'$C"A"'#,Q($'*3,
"Z"5G+*",Q($'*3,[0H22)[,*HQQ-5#,9+$,"A$+(3,$'2,
.-((-N%HQ,#$+(-5"2,$G#+-',Q($'*I,#$5C"#"2,
0"7$9+-5R,N"+C7#,A$'$C"A"'#,0"7$9+-5*,
+'G(H2+'C,2+"#$5),$'2,Q7)*+G$(,$G#+9+#)I,E==L,
5"#"'#+-',
#$+(-5"2,N"0*+#",;'JETFD?,9*<,
+'.-5A$#+-',-'(),G-'#5-(,
;'JEK>F?,
;@"9"5*-'3,W-52-'3,
\$'$7"53,Y,&B"5*3,
:==>?,
@A-B+'C,
:D:K,$2H(#,*A-B"("**,
#-0$GG-,H*"5*I,A"$',
$C"JKFI,:<DL,."A$("I,M@,
*"##+'C,
S%A-'#7,N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-'I,#$+(-5"2,N"0*+#",+'G(H2",$',
[Q"5*-'$(,OH+##+'C,$**+*#$'#[,#-,G5"$#",
+'2+9+2H$(+P"2,OH+#,Q($'*3,*#5"$A+'C,9+2"-*,;N+#7,
OH+##+'C,+'.-5A$#+-',$'2,#"*#+A-'+$(*?3,Q5+'#$0(",
5"*-H5G"*3,$''-#$#"2,(+'B*,#-,-#7"5,N"0*+#"*3,
Q""5,$'2,"ZQ"5#,*HQQ-5#,9+$,2+*GH**+-',.-5HA*,
$'2,"A$+(,5"A+'2"5*I,#$5C"#"2,0"7$9+-5R,
*A-B"("**,#-0$GG-,H*"I,KTL,5"#"'#+-',,
+'#"5$G#+9"3,#$+(-5"2,N"0%
0$*"2,+'#"59"'#+-',;'JE:S=?,
9*<,(+'"$5,#"Z#%0$*"2,N"0*+#",
;'JE:SK?,
;@(--#A$B"53,
V7+'$Q$N3,@G7H+#3,
@"+2"((3,Y,h$',
!"G7"("'3,:==U?,
^7)*+G$(,
&G#+9+#),
E=:,$2H(#*I,A"$',$C"JK:I,
S=L,."A$("I,'-'%M@,
*"##+'C,;47",`"#7"5($'2*?,
K%A-'#7,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,H*",-.,Q7)*+G$(,$G#+9+#),
A-'+#-5,N+#7,$,^&!,V-$G7,N7+G7,2"9"(-Q"2,
+'2+9+2H$(+P"2,^&,$29+G",0$*"2,-',G-AQ("#+-',-.,
-'(+'",OH"*#+-''$+5"*3,$G#+9+#),(-C*3,C-$(,*"##+'C,
$G#+9+#+"*I,#$5C"#"2,0"7$9+-5R,("9"(*,-.,Q7)*+G$(,
$G#+9+#)I,US<KL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'JDE?,9*<,
C"'"5+G,Q5+'#,05-G7H5",
;'JDE?,
;@Q+##$"(*3,\",
1-H52"$H27H+f3,Y,
h$'2"($'-##"3,
:==F?,
^7)*+G$(,
&G#+9+#),
TKT,$2H(#*I,A"$',$C"JTEI,
SSL,."A$("I,'-'%M@,
*"##+'C,;1"(C+HA?,
S%A-'#7,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,#$+(-5"2,^&,$29+G",
C"'"5$#"2,9+$,H*"5,$**"**A"'#,$'2,+'G(H2"2,
(+'B*,#-,C-$(,*"##+'C,#--(*3,N""B(),Q($'*3,
.("Z+0+(+#),$'2,*#5"'C#7,"Z"5G+*"*3,2+*GH**+-',
.-5HA*,$'2,#$+(-5"2,"A$+(,.""20$GBI,#$5C"#"2,
0"7$9+-5R,("9"(*,-.,Q7)*+G$(,$G#+9+#)I,SSL,
5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',N+#7,
5"Q"$#"2,#$+(-5"2,.""20$GB,
;'JEFK?,9*<,#$+(-5"2,
+'#"59"'#+-',N+#7,*+'C(",
#$+(-5"2,.""20$GB,;'JE:U?,9*<,
N$+#(+*#,G-'#5-(,;'JEK:?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
42
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;@Q+##$"(*3,\",
1-H52"$H27H+f3,
15HC3,Y,
h$'2"($'-##"3,
:==F?,
^7)*+G$(,
&G#+9+#),
D:S,$2H(#*I,A"$',$C"JT=I,
KEL,."A$("I,'-'%M@,
*"##+'C,;1"(C+HA?,
>%N""B,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,#$+(-5"2,^&,$29+G",$'2,
+'2+9+2H$(+P"2,$G#+-',Q($'*,N+#7,D,*#$C"%0$*"2,
5"+'.-5G"A"'#,"A$+(*I,#$5C"#"2,0"7$9+-5*R,("9"(*,
-.,Q7)*+G$(,$G#+9+#),$'2,*"2"'#$5),0"7$9+-5*I,
F:L,5"#"'#+-',
;E?,-'(+'"%#$+(-5"2,Q7)*+G$(,
$G#+9+#),$29+G",i,*#$C"%0$*"2,
5"+'.-5G"A"'#,"A$+(*,
;'JEFT?,9*<,;:?,-'(+'"%
#$+(-5"2,Q7)*+G$(,$G#+9+#),
$29+G",-'(),;'JEFD?,9*<,;K?,
-'(+'",'-'%#$+(-5"2,*#$'2$52,
Q7)*+G$(,$G#+9+#),$29+G",
;'JEFF?,
;@#5"G7"53,
@7+..A$'3,Y,/"*#3,
:==D?,
@A-B+'C,
KUFE,-'(+'",G-'*HA"5*,-.,
'+G-#+'",Q$#G7I,A"$',
$C"JKFI,DFL,."A$("I,'-'%
M@,*"##+'C,;e'C($'2,Y,
85"($'2?,
E=%N""B,N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-'I,+'9-(9"2,$,#$+(-5"2,N"0%0$*"2,
G"**$#+-',CH+2"3,#75"",*"OH"'#+$(,#$+(-5"2,N"0%
0$*"2,'"N*("##"5*,$'2,0"7$9+-5$(,*HQQ-5#,
A"**$C"*,2"(+9"5"2,9+$,"%,A$+(,-9"5,$,E=%N""B,
Q"5+-2I,#$5C"#"2,0"7$9+-5R,$0*#+'"'G",.5-A,
*A-B+'CI,DKL,5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',
;'JEFDU?,9*<,C"'"5+G,
+'#"59"'#+-',;'JEFT:?,
;@N$5#P3,`-"((3,
@G75-"2"53,Y,&5)3,
:==S?,
@A-B+'C,
KDE,$2H(#*,N+((+'C,#-,
A$B",OH+#,$##"AQ#,+',K=,
2$)*I,A"$',$C"JT=I,T>L,
."A$("I,M@,*"##+'C,
N"0%0$*"2,#$+(-5"2,*A-B+'C,G"**$#+-',
+'#"59"'#+-'I,#7",#$+(-5"2,N"0*+#",G-H(2,0",
$GG"**"2,+',-'","Z#"'2"2,*"**+-',-5,AH(#+Q(",
#+A"*,-9"5,#7",U=%2$),+'#"59"'#+-',Q"5+-23,#7+*,
+'G(H2"2,#$+(-5"2,G-'#"'#3,+'2+9+2H$(+P"2,#+Q*,$'2,
OH+#,Q($',G$("'2$53,9+2"-,*"CA"'#*,$'2,"A$+(,
5"A+'2"5*I,#$5C"#"2,0"7$9+-5R,$0*#+'"'G",.5-A,
*A-B+'CI,DEL,5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',;'JEF=?,
9*<,N$+#(+*#,G-'#5-(,;'JE>=?,
;4$#"3,c$GB9-')3,Y,
/+'C3,:==S?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
EU:,-9"5N"+C7#a-0"*",
$2H(#*I,A"$',$C"JTUI,
>TL,."A$("I,M@,*"##+'C,
S%A-'#7,N"0%0$*"2,#$+(-5"2,N"+C7#,(-**,
Q5-C5$AI,#7",+'#"5$G#+9",N"0*+#",+'G(H2"2,
N""B(),5"Q-5#*,$'2,C5$Q7*,*7-N+'C,N"+C7#,
G7$'C"*3,"A$+(,Q5-AQ#*3,"A$+("2,N"+C7#,(-**,#+Q*3,
5"G+Q"*,$'2,$GG"**,#-,$,N"+C7#%(-**,"%0H22),
'"#N-5B,*)*#"A,Q(H*,G-AQH#"5%$H#-A$#"2,
#$+(-5"2,.""20$GBI,#$5C"#"2,0"7$9+-5R,("9"(*,-.,
Q7)*+G$(,$G#+9+#),$'2,2+"#$5),0"7$9+-5*I,>EL,
5"#"'#+-',
;E?,#$+(-5"2,N"0*+#",-'(),
;'JSF?,9*<,,;:?,#$+(-5"2,
N"0*+#",N+#7,G-AQH#"5%
$H#-A$#"2,.""20$GB,;'JSE?,
9*<,;K?,#$+(-5"2,N"0*+#",N+#7,
7HA$',"A$+(,G-H'*"(+'C,
;'JST?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
43
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;4",^-"(3,"#,$(<3,
:==U?,
@A-B+'C,
SED,$2H(#*,*A-B"5*I,A"$',
$C"JTSI,DSL,."A$("I,'-'%
M@,*"##+'C,;47",
`"#7"5($'2*?,
05+".,N"0%0$*"2,*A-B+'C,G"**$#+-',+'#"59"'#+-'I,
+AA"2+$#"(),$.#"5,G-AQ("#+'C,$,05+".%N"0%0$*"2,
$**"**A"'#3,Q$5#+G+Q$'#*,N"5",*"'#,"A$+(*,N+#7,
#$+(-5"2,.""20$GBI,#$5C"#"2,0"7$9+-5R,$0*#+'"'G",
.5-A,*A-B+'CI,TKL,5"#"'#+-',5$#",
#$+(-5"2,+'#"59"'#+-',;'J::T?,
9*<,'-'%#$+(-5"2,+'#"59"'#+-',
;'J:KT?,
;!<,6<,h$',\"',
1"5C,"#,$(<3,:==S?,
^7)*+G$(,
&G#+9+#),
ES=,Q7)*+G$((),+'$G#+9",]&,
Q$#+"'#*I,A"$',$C"JD=I,
SEL,."A$("I,'-'%M@,
*"##+'C,;47",`"#7"5($'2*?,
E:%A-'#7,N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,$',+'2+9+2H$(+P"2,#5$+'+'C,
+'#"59"'#+-',5"OH+5+'C,N""B(),$G#+9+#),(-C*3,
Q"5*-'$(+P"2,Q5-C5$A,*G7"2H(",+'9-(9+'C,
2+.."5"'#,"Z"5G+*",$'2,Q7)*+G$(,$G#+9+#),
5"G-AA"'2$#+-',*HQQ-5#"2,0),N""B(),#$+(-5"2,
"A$+(*,.5-A,Q7)*+G$(,#7"5$Q+*#*3,$GG"**,#-,$,
2+*GH**+-',.-5HA,$'2,+'9+#$#+-'*,#-,$##"'2,.$G"%
#-%.$G",C5-HQ,A""#+'C*,"9"5),K,A-'#7*I,#$5C"#"2,
0"7$9+-5R,("9"(,-.,Q7)*+G$(,$G#+9+#)I,E==L,
5"#"'#+-',
N"0%0$*"2,+'2+9+2H$(+P"2,
#5$+'+'C,;'J>:?,9*<,;N"0%
0$*"2,C"'"5$(,#5$+'+'C,;'JF>?,
;h"57"+f2"',"#,$(<3,
:==T?,
`H#5+#+-'a\+"#,
ETS,Q$#+"'#*,N+#7,7+C7%
5+*B,.-5,Vh\I,A"$',
$C"JSKI,TDL,."A$("I,'-'%
M@,*"##+'C,;V$'$2$?,
>%A-'#7,N"0%0$*"2,#$+(-5"2,'H#5+#+-',
+'#"59"'#+-'I,#$+(-5"2,N"0*+#",+'G(H2"2,N""B(),
$**"**A"'#*,$'2,Q"5*-'$(+P"2,'H#5+#+-',
G-H'*"(+'C3,$GG"**,#-,Q""5,*HQQ-5#,9+$,$,
2+*GH**+-',.-5HA3,2+"#$5),.$#,+'#$B",(-C*3,$'2,
(+'B*,#-,-#7"5,5"*-H5G"*I,#$5C"#"2,0"7$9+-5R,
2+"#$5),.$#,5"2HG#+-'I,>SL,5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',;'JFK?,
9*<,H*H$(,G$5",;'JFK?,
;/$''"53,!$5#+'%
\+"'"53,15$H'%
_$75($'2"53,1$H"53,
Y,!$5#+'3,:==U?,
^7)*+G$(,
&G#+9+#),
EKSU,$2H(#*I,A"$',
$C"JTTI,FDL,."A$("I,'-'%
M@,*"##+'C,;W"'"9$3,
@N+#P"5($'2?,
N"0%0$*"2,#$+(-5"2,Q7)*+G$(,$G#+9+#),
+'#"59"'#+-'I,+'9-(9"2,#$+(-5"2,N"0*+#",N+#7,
+'2+9+2H$(,$**"**A"'#*,("$2+'C,#-,*#$C"%A$#G7"2,
G-'#"'#3,#$+(-5"2,.""20$GB,$'2,+'2+9+2H$(+P"2,
"A$+(*,%,$22+#+-'$(,*HQQ-5#,#--(*3,*HG7,$*,
*#5"'C#7,$'2,*#5"#G7+'C,"Z"5G+*",*7""#*3,$'2,
-5C$'+P$#+-'$(,$'2,A-#+9$#+-'$(,.-5A*,N"5",
$9$+($0(",.-5,2-N'(-$2I,#$5C"#"2,0"7$9+-5R,("9"(*,
-.,Q7)*+G$(,$G#+9+#)I,FU<:L,5"#"'#+-',5$#",
#$+(-5"2,N"0*+#",;'JS>E?,9*<,
'-'%#$+(-5"2,N"0*+#",;'JS>>?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
44
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;/+((+$A*-',"#,$(<3,
:==S?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
KF,-9"5N"+C7#,&&,."A$(",
$2-("*G"'#*I,N+#7,$#,("$*#,
E,-0"*",Q$5"'#,A"$',
$C"JEKI,E==L,."A$("I,M@,
*"##+'C,
:T%A-'#7,N"0%0$*"2,#$+(-5"2,N"+C7#,(-**,
Q5-C5$A,.-5,-9"5N"+C7#,&.5+G$'%&A"5+G$',
."A$(",$2-("*G"'#*I,+'9-(9"2,$,#$+(-5"2,0"7$9+-5,
#7"5$Q),N"0*+#",N+#7,*"(.%A-'+#-5+'C,#--(*3,C-$(%
*"##+'C,#--(*3,+'#"5$G#+9",$G#+9+#+"*,$'2,"A$+(,
*HQQ-5#I,#$5C"#"2,0"7$9+-5R,Q7)*+G$(,$G#+9+#),$'2,
2+"#$5),0"7$9+-5*I,F=L,5"#"'#+-',
#$+(-5"2,*+#",;'J'-#,5"Q-5#"2?,
9*<,C"'"5+G,*+#",;'J'-#,
5"Q-5#"2?,
;/+'"##,"#,$(<3,
EUUU?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
E>=,."A$(",7+C7,
*G7--("5*I,A"$',$C"JEDI,
E==L,."A$("I,M@,*"##+'C,
N"0%0$*"2,#$+(-5"2,'H#5+#+-',+'#"59"'#+-'I,
+'9-(9"2,D3,ED%:=,A+'H#",+'#"5$G#+9",#$+(-5"2,
A-2H("*,N+#7,-'(+'",$**"**A"'#*,$'2,
Q"5*-'$(+P"2,.""20$GB,Q5-9+2"2,+',#"Z#,$'2,
C5$Q7+G*,.-5A*I,#$5C"#"2,0"7$9+-5*R,2+"#$5),
0"7$9+-5*,$'2,("9"(,-.,Q7)*+G$(,$G#+9+#)I,E==L,
5"#"'#+-',
#$+(-5"2,+'#"59"'#+-',;'JE=K?,
9*<,'-%#5"$#A"'#,G-'#5-(,
;H*H$(,G($**"*?,;'JFF?,
;/+'"##3,&'2"5*-'3,
/-fG+B3,/+'"##3,Y,
1-N2"'3,:==F?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
E=FE,-9"5N"+C7#a-0"*",
$2H(#*I,A"$',$C"JDEI,
FFL,."A$("I,M@,*"##+'C,
E:%N""B,N"0%0$*"2,#$+(-5"2,'H#5+#+-',$'2,
Q7)*+G$(,$G#+9+#),+'#"59"'#+-'I,+'9-(9"2,$,E:%
A-2H(",#$+(-5"2,N"0*+#",%,"$G7,A-2H(",H*"2,ED,
#-,:=,*G5""'*,N+#7,*#5"$A+'C,$H2+-3,#--B,D,#-,
E=A+',#-,G-AQ("#"3,$'2,+'G(H2"2,Q5-C5$A,
+'#"5$G#+-'*,$'2,$,'$55$#-5,jjCH+2"kk3,$(*-,
+'G(H2"2,-'(+'",$**"**A"'#*3,9+2"-3,C-$(,$'2,*"(.%
A-'+#-5+'C,#--(*I,#$5C"#"2,0"7$9+-5R,2+"#$5),
0"7$9+-5*,$'2,Q7)*+G$(,$G#+9+#)I,>UL,5"#"'#+-',
#$+(-5"2,N"0*+#",;'JKST?,9*<,
#$+(-5"2,N"0*+#",Q(H*,Q""5,
*HQQ-5#,;'JKST?,9*<,N$+#(+*#,
G-'#5-(,;'JKTK?,
;/-A0(","#,$(<3,
:==T?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#),
TF,-9"5N"+C7#a-0"*",
N-A"'I,A"$',$C"JTTI,
E==L,."A$("I,M@,*"##+'C,
D:%N""B,G-AA"5G+$(3,N"0%0$*"2,#$+(-5"2,N"+C7#,
(-**,+'#"59"'#+-'I,+'9-(9"2,$GG"**,#-,$',-'(+'",
G-AA"5G+$(,N"+C7#,(-**,Q5-C5$A,#7$#,+'G(H2"2,
#$+(-5"2,2+"#,Q($'*3,GH*#-A+P"2,C5-G"5),(+*#*3,
$'+A$#"2,.+#'"**,+'*#5HG#-53,-'(+'",*-G+$(,
*HQQ-5#3,0+%N""B(),"A$+(,'"N*("##"5*,$'2,"A$+(,
5"A+'2"5*I,#$5C"#"2,0"7$9+-5*R,2+"#$5),0"7$9+-5*,
$'2,("9"(,-.,Q7)*+G$(,$G#+9+#)I,SSL,5"#"'#+-',
"\+"#*<G-A,;'J:K?,-5,
G-AA"5G+$(,#$+(-5"2,N"0*+#",
9*<,N"+C7#,(-**,A$'H$(,;'J:T?,

!"#$%&'$()*+*,-.,/"0%1$*"23,4$+(-5"2,6"$(#7,8'#"59"'#+-'*,
45
Study&
Focus&
Sample&Characteristics&
Intervention&Characteristics&
Conditions&
;/--(.,"#,$(<3,:==S?,
`H#5+#+-'a\+"#I,
^7)*+G$(,
&G#+9+#)I,
@A-B+'CI,
&(G-7-(+*A,
:FK,$2H(#*I,A"$',$C"J,
'-#,5"Q-5#"2I,L,."A$(",
'-#,5"Q-5#"2I,M@,*"##+'C,
U%A-'#7,N"0%0$*"2,#$+(-5"2,7"$(#7,0"7$9+-5,
+'#"59"'#+-'I,#7",N"0*+#",N$*,#$+(-5"2,0$*"2,-',
H*"5*l,7"$(#7,0"7$9+-5*,$'2,5"$2+'"**,#-,G7$'C",
$'2,+'G(H2"2,#$+(-5"2,7"$(#7,$29+G",$'2,
GH*#-A+P"2,(+'B*,#-,5"*-H5G"*I,#$5C"#"2,
0"7$9+-5*R,("9"(*,-.,,Q7)*+G$(,$G#+9+#)3,2+"#$5),
0"7$9+-5*3,#-0$GG-,H*"3,$(G-7-(,G-'*HAQ#+-'I,
:UL,5"#"'#+-',5$#",
Q5"%Q-*#,2"*+C',
,

Meta-Analysis
46
Table 3
Summary of Characteristics of the 40 Studies
Study Characteristic
k
%
Target Population
General population
26
65
Children
7
18
Patients (diagnosed with condition)
6
15
Students
1
2
Total
40
100
Gender
Female
5
12
Male
0
0
Both (mean proportion = 63% female)
35
88
Total
40
100
Behaviors
Single Behavior
29
73
Multiple Behaviors
11
27
Total
40
100
Behaviors
Physical Activity
23
42
Nutrition/Diet
14
25
Smoking/Tobacco
10
18
Drinking
5
9
Medication Adherence (Asthma management)
1
2
Stress Management
1
2
Fecal Soiling (Encopresis)
1
2
Total
55
100
Behavioral Theories
Stages of Change/Transtheoretical Model
11
50
Social Cognitive Theory
8
36
Health Belief Model
6
27
Theory of Reasoned Action/Planned Behavior
3
14
Precaution Adoption Process Model
2
9
Social Comparison Theory
2
9
Decisional Balance
2
9
I-Change Model
1
5
Problem Behavior Model
1
5
Elaboration Likelihood Model
1
5
Goal Theory
1
5

Meta-Analysis
47
Self-Determination Theory
1
5
Total
39
---
Note: k = number of studies. The behavioral theories sum to more than 100 because some
studies used more than 1 theory.

Meta-Analysis
48
Table 4
Sample Size-Weighted Effect Sizes by Participant/Descriptive Moderating Variables
Variable
k
d
95% CI
p
QB
Population Type
General population
26
.181
[.148, .214]
***
Children
7
-.007
[-.068, .054]
NS
Patients
6
.140
[.037, .244]
*
***
Country of Sample
United States
22
.182
[.141, .223]
***
Non-US
18
.101
[.063, .139]
***
**
Gender
Mixed samples
35
.140
[.111, .168]
***
Female Samples
5
.102
[-.088, .292]
NS
NS
Single Vs. Multiple Behavior
Single
30
.146
[.113, .180]
***
Multiple
10
.121
[.070, .172]
***
NS
Single Behavior Studies
Smoking/Tobacco
8
.152
[.110, .193]
***
Nutrition/Diet
4
.223
[.118, .328]
***
Physical Activity
12
.059
[-.020, .138]
NS
Drinking
3
.081
[-.088, .251]
NS
NS
Note: k = number of studies, d = sample size-weighted mean effect size,
CI = Confidence Interval, NS = non-significant.
*p<.05; **p<.01; ***p<.001

Meta-Analysis
49
Table 5
Sample Size-Weighted Effect Sizes by Tailoring Strategies
Variable
k
d
95% CI
p
QB
No. of Tailoring
Assessments1
Baseline
11
.194
[.136, .252]
***
Iterative
10
.140
[.098, .182]
***
NS
User Control
Expert led
8
.159
[.070, .247]
***
Self guided
32
.137
[.107, .166]
***
NS
Note: k = number of studies, d = sample size-weighted mean effect size,
CI = Confidence Interval, NS = non-significant. 1This variable was tested using the
follow-up data (N=21) to allow enough time for baseline vs. iterative assessment to have
an impact.
*p<.05; **p<.01; ***p<.001

Meta-Analysis
50
Table 6
Sample Size-Weighted Effect Sizes by Methodological Moderating Variables
Variable
k
d
95% CI
p
QB
Study Design
Randomized controlled trial
31
.159
[.127, .190]
***
Quasi-experimental
9
.066
[.006, .126]
*
**
Comparison Condition
No treatment control
18
.071
[.027, .115]
**
Non-tailored website
18
.188
[.152, .225]
***
Non-tailored print materials
4
.078
[-.107, .264]
NS
***
Note: k = number of studies, d = sample size-weighted mean effect size,
CI = Confidence Interval, NS = non-significant.
*p<.05; **p<.01; ***p<.001

Meta-Analysis
51
Appendix(B:(Figures(
Figure 1. Summary of the selection process used in the meta-analysis.

Meta-Analysis
52
Figure 2. Forest plot displaying effect sizes and 95% confidence intervals for all 40
studies (short term effects).
!

Meta-Analysis
53
Figure 3. Forest plot displaying effect sizes and 95% confidence intervals for the 21
studies reporting long term effects.
!
!