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Original Paper
Online Health Information–Seeking Behaviors Among the
Chongqing Population: Cross-Sectional QuestionnaireStudy
Honghui Rong1*, MSc; Lu Lu2*, MSc; Miao He2, MSc; Tian Guo2, MSc; Xian Li2, MSc; Qingliu Tao2, MSc; Yixin
Li2, MSc; Chuanfen Zheng2, MSc; Ling Zhang1, MSc; Fengju Li2, MSc; Dali Yi1, MSc; Enyu Lei1, BS; Ting Luo2,
MSc; Qinghua Yang2, MSc; Ji-an Chen1, PhD
1Department of Health Education, School of Military Preventive Medicine, Army Medical University (Third Military Medical University),
Chongqing, China
2Chongqing Health Education Institute, Chongqing, China
*these authors contributed equally
Corresponding Author:
Ji-an Chen, PhD
Department of Health Education, School of Military Preventive Medicine
Army Medical University (Third Military Medical University)
Gaotanyan Street No 30, Shapingba District
Chongqing, 400038
China
Phone: 86 02368771579
Email: cjatmmu@hotmail.com
Abstract
Background: With the rapid development of the internet and its widespread use, online health information–seeking (OHIS)
has become a popular and important research topic. Various benefits of OHIS are well recognized. However, OHIS seems to
be a mixed blessing. Research on OHIS has been reported in Western countries and in high-income regions in eastern China.
Studies on the population in the western region of China, such as Chongqing, are still limited.
Objective: The aim of the study was to identify the prevalence, common topics, and common methods of health informa-
tion–seeking and the factors influencing these behaviors among the Chongqing population.
Methods: This cross-sectional questionnaire study was conducted from September to October 2021. A web-based question-
naire was sent to users aged 15 years and older in Chongqing using a Chinese web-based survey hosting site (N=14,466). Data
on demographics, web-based health information resources, and health topics were collected. Factors that may influence health
literacy were assessed using the chi-square test and multivariate logistic regression models.
Results: A total of 67.1% (9704/14,466) of the participants displayed OHIS behaviors. Participants who were younger, had
a higher educational level, and worked as medical staff or teachers were more likely to engage in OHIS, while those living
in rural areas, ethnic minorities, and farmers were less likely to seek health information on the web (P<.01). Among the
Chongqing population, the most common topic searched on the internet was health behavior and literacy (87.4%, 8483/9704),
and the most popular method of seeking health information on the web was through WeChat (77.0%, 7468/9704).
Conclusions: OHIS is prevalent in Chongqing. Further research could be performed based on the influencing factors
identified herein and high-priority, effective ways of improving the OHIS behaviors of the Chongqing population.
JMIR Form Res 2025;9:e56028; doi: 10.2196/56028
Keywords: online health information seeking; health behavior; Chongqing; China; Internet
Introduction
With rapid development, the internet has become a major
source of health information worldwide. According to
Internet World Stats [1], there are 5 billion internet users,
accounting for more than 60% of the world population.
China also has a large population of internet users. In
2020, approximately 9.89 million Chinese people (70.4%
of the Chinese population) had access to the internet [2].
The internet hosts a tremendous amount and variety of
health-related information that can be accessed at conven-
iently, anonymously, and at relatively low cost [3,4]. Among
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all health information sources, the internet has the high-
est usage rate [5-7]. Although certain groups still rely on
traditional sources such as books and printed journals for
health information [8], web-based sources of health informa-
tion are increasingly growing in popularity.
Various benefits of online health information–seeking
(OHIS) are well recognized. Patients turning to the internet
before seeking medical consultations or diagnosis may help
improve patient-doctor relationships, and patients are more
inclined to trust their physicians’ advice when they are able
to discuss the information they found on the web with their
doctors [9-12]. As individuals aim to change their lifestyle
or health behavior, the frequency of the use of the internet
to retrieve health information is likely to increase [13]. For
people with chronic diseases, OHIS may help them manage
their health condition [14,15]. However, OHIS seems to be a
mixed blessing. Studies have reported that the overall quality
of web-based health information is relatively low [16-18].
Information seekers are at risk of making hasty or dangerous
health decisions based on questionable web-based informa-
tion [19]. In contrast to the information available in Western
countries, low-quality web-based health information seems to
be particularly prevalent in Asian countries [20].
With the rapid development of the internet and its
widespread use, OHIS has become a popular and impor-
tant research topic. Research on OHIS has been reported
in Western countries [8,14,21] as well as low- and mid-
dle-income countries [22-24]. Various factors, such as age,
gender, education, and internet usage, have been shown to
affect the prevalence and extent of OHIS in previous studies
[13,22,25]. In addition, researchers have been interested in the
topic of OHIS. A previous study also reported that various
health topics are searched by web-based health information
seekers. The most common topics searched on the internet
are likely to fall under 2 categories: health behavior, such
as nutrition or diet, exercise, and body maintenance; and
medical concerns, including information related to disease,
medications, and treatments [11,14,22,26]. In recent years,
several academic studies on OHIS have collected evidence
from high-income regions in eastern China, such as Zhejiang,
Guangdong, and Hong Kong [26-30]. Western China, as
a transitional region—home to 27% of the national popu-
lation with distinct socioeconomic and health care system
characteristics—remains critically underresearched [31]. This
knowledge gap limits our understanding of the situation of
OHIS thoroughly in this vast country with uneven devel-
opment. Chongqing, as the largest municipality in western
China, embodies the region’s characteristic “urban-rural dual
structure” with more than a 60% urbanization rate and
significant health resource disparities between metropolitan
and rural areas [32]. This metropolis is an ideal context for
understanding situation of OHIS in western China.
The study objectives were to (1) determine the prevalence,
common topics, and methods of OHIS in the Chongqing
population and (2) identify the factors that influence the
OHIS behaviors of this population. This research may help
improve ways of promoting efficient and appropriate OHIS
for users and harnessing the benefits of the internet as a
source of health information.
Methods
Study Design
From September to October 2021, Chongqing Health
Education Institution and the Army Medical University
carried out a web-based study to assess residents’ health
care needs in Chongqing municipality. The target participants
were Chongqing residents. A survey QR code was dissemi-
nated on popular Chinese social media applications such as
WeChat for voluntary participation in our web-based survey,
which was hosted on the Chinese Sojump site. The first
page of the survey was a web-based consent form includ-
ing study information. After reading the consent forms and
indicating consent to participate in the survey, respondents
were allowed to proceed. To avoid multiple submissions,
only one submission per IP address was allowed. Ultimately,
14,466 participants were included in this study.
Measures
This questionnaire included 2 parts: demographic charac-
teristics and OHIS behaviors. Demographic characteristics
included age, gender, education, occupation, ethnicity, and
area of residence, gender, education, and ethnicity. Age was
measured by asking participants to indicate their numeric
age, and other variables were measured with multiple-choice
questions. The part on OHIS behaviors were included three
questions. The first one dealt addressed having experi-
ence with OHIS, wherein participants’ OHIS behavior was
measured with a single question, “Which sources are your
main sources for seeking health information?” The response
options included books and journals, broadcasts, televi-
sion, PCs (desktops and laptops), mobile phones, lectures,
professional staff, and advertisements. Participants who chose
PCs and/or mobile phones as their main sources for seek-
ing health information were considered to have experience
with OHIS. The second one addressed major health topics
in OHIS: health topics that the participants searched on the
internet were captured by a multiple-choice question with
response options including health behavior and literacy (such
as diet, fitness, exercise, and drug usage), infectious diseases,
chronic disease, first aid, and health policies (such as medical
insurance). Participants could select one or more answers
as their major health topics when searching on the internet.
The third one addressed the main method of OHIS: the
main method of seeking health information on the web was
measured with a single item with response options including
WeChat, Weibo, search engines (such as Baidu and Google),
websites, short-video apps (such as TikTok), and others.
Participants could select one or more answers as their main
method of seeking health information on the web.
Ethical Considerations
The study was carried out in accordance with ethical
principals and was approved by the ethics review board
of the Army Medical University (2023-5-02). Participants
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provided informed consent. All participants’ information
was anonymized. There was no financial compensation for
patients or researchers nor any source of funding that could
lead to a conflict of interest for the study.
Statistical Analysis
All data were input into an Epidata database (version 3.1)
after checking and correcting errors. SPSS (version 22.0; IBM
Corp) was used for analyses. A descriptive analysis (frequen-
cies, percentages, and means with SDs) of the participant
characteristics was performed. The chi-square test was used
to compare OHIS behaviors among groups. Multiple logistic
regression models were used to assess the influencing factors
associated with OHIS. Statistical significance was set to a P
value of <.05 (2-sided).
Results
Sociodemographic Characteristics of the
Study Sample
The demographic characteristics of the study sample are
listed in Table 1. In total, 67.1% (9704/14,466) of the
participants had OHIS experience. The average age was
46.2 (SD 18.0) years, while approximately half (51.8%,
7495/14,466) of the participants were younger than 45 years.
More than half (52.0%, 7520/14,466) of the participants
were female. Most participants (95.3%, 13,793/14,466) were
of Han Chinese ethnicity. The percentage of participants
residing in urban areas was 69.7% (10,090/14,466). Overall,
47.1% (6813/14,466) of participants were college graduates
or had a higher level of education. The participants spanned
all occupation groups.
As indicated in Table 1, OHIS experience significantly
differed by age, ethnicity, area of residence, education and
occupation (P<.05) but not by gender.
Table 1. Differences in the OHISa characteristics of the respondents and their sociodemographic characteristics (N=14,466).
Characteristics Participants, n (%)
Respondents without OHIS
experience, n (%)
Respondents with OHIS
experience, n (%) P value
Age (years)
15‐45 7495 (51.8) 1208 (25.4) 6287 (64.8) <.001
46‐60 3036 (21.0) 790 (16.6) 2246 (23.1)
61 or older 3935 (27.2) 2764 (58.0) 1171 (12.1)
Gender
Male 6946 (48.0) 2308 (48.5) 4638 (47.8) .46
Female 7520 (52.0) 2454 (51.5) 5066 (52.2)
Ethnicity
Han Chinese 13,793 (95.3) 4513 (94.8) 9280 (95.6) .02
Ethnic minority 673 (4.7) 249 (5.2) 424 (4.4)
Area of residence
Urban 10,090 (69.7) 2587 (54.3) 7503 (77.3) <.001
Rural 4376 (30.3) 2175 (45.7) 2201 (22.7)
Education level
Primary school or less 2998 (20.7) 2301 (48.3) 697 (7.2) <.001
Junior high school 2467 (17.1) 1020 (21.4) 1447 (14.9)
Senior high school 2188 (15.1) 514 (10.8) 1674 (17.3)
College graduate 6289 (43.5) 855 (18.0) 5434 (56.0)
Postgraduate 524 (3.6) 72 (1.5) 452 (4.7)
Occupation
Civil servants 1669 (11.5) 253 (5.3) 1416 (14.6) <.001
Teachers 1208 (8.4) 150 (3.1) 1058 (10.9)
Medical staff 1603 (11.1) 223 (4.7) 1380 (14.2)
Staff in public institutions 969 (6.7) 175 (3.7) 794 (8.2)
Students 887 (6.1) 171 (3.6) 716 (7.4)
Farmers 3317 (22.9) 2266 (47.6) 1051 (10.8)
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Characteristics Participants, n (%)
Respondents without OHIS
experience, n (%)
Respondents with OHIS
experience, n (%) P value
Workers 1180 (8.2) 407 (8.5) 773 (8.0)
Enterprise personnel 1250 (8.6) 238 (5.0) 1012 (10.4)
Others 2383 (16.5) 879 (18.5) 1504 (15.5)
aOHIS: online health information–seeking.
Multivariate Logistic Regression Analysis
of Risk Factors Associated With the Rate
of Health Literacy Knowledge
The variables with statistical significance in the chi-square
test (Table 1) were analyzed using multivariate logistic
regression. As shown in Table 2, participants aged 46‐60
years (odds ratio [OR] 0.782, 95% CI 0.695-0.880) or more
than 61 years (OR 0.298, 95% CI 0.260-0.341) were less
likely to have OHIS experience than those younger than 20
years. Participants who belonged to ethnic minorities (OR
0.621, 95% CI 0.513-0.752) were less likely to have OHIS
experience than Han Chinese participants. Participants from
rural areas (OR 0.815, 95% CI 0.734-0.906) were less likely
to have OHIS experience than urban participants. Compared
to the respondents with primary school education and below,
those with junior high school education (OR 2.290, 95% CI
2.000-2.622), senior high school education (OR 3.274, 95%
CI 2.765-3.877), college graduate degrees (OR 5.012, 95%
CI 4.163-6.033), and postgraduate education (OR 4.809, 95%
CI 3.442-6.720) were more likely to have OHIS experience.
Based on the participants’ occupation, compared to civil
servants, teachers (OR 1.407, 95% CI 1.118-1.770) and
medical staff (OR 1.359, 95% CI 1.098-1.683) were more
likely to seek health information on the web, while farmers
(OR 0.656, 95% CI 0.525-0.820) were less likely to seek
health information on the internet.
Table 2. Multivariate logistic regression analysis of the factors associated with OHISa in participants.
Characteristics ORb95% CI P value
Age (years)
15‐45 1c —d —
46‐60 0.782 0.695‐0.880 <.001
61 or older 0.298 0.260‐0.341 <.001
Gender
Male 1 — —
Female 0.950 0.871‐1.036 .24
Ethnicity
Han Chinese 1 — —
Ethnic minority 0.621 0.513‐0.752 <.001
Area of residence
Urban 1 — —
Rural 0.815 0.734‐0.906 <.001
Education
Primary school or less 1 — —
Junior high school 2.290 2.000‐2.622 <.001
Senior high school 3.274 2.765‐3.877 <.001
College graduate 5.012 4.163‐6.033 <.001
Postgraduate 4.809 3.442‐6.720 <.001
Occupation
Civil servants 1 — —
Teachers 1.407 1.118‐1.770 .004
Medical staff 1.359 1.098‐1.683 .005
Staff in public institution 1.100 0.872‐1.837 .421
Students 1.279 0.979‐1.672 .072
Farmers 0.656 0.525‐0.820 <.001
Workers 0.905 0.721‐1.135 .385
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Characteristics ORb95% CI P value
Enterprise personnel 1.052 0.843‐1.313 .652
Others 1.035 0.843‐1.272 .740
aOHIS: online health information–seeking.
bOR: odds ratio.
cReference variable.
dNot applicable.
Health Topics Searched on the Internet
by Participants With OHIS Experience
Table 3 shows the health topics searched on the inter-
net by the study participants. Most of the participants
(8483/9704, 87.4%) indicated that they sought information
about health behavior and literacy. More than three-quarters
of the participants used the internet to find information about
infectious diseases (78.6%, 7628/9704), chronic diseases
(76.0%, 7375/9704), and first aid (75.0%, 7277/9704). More
than half (58.6%, 5688/9704) of the participants searched for
health policy information on the web.
Table 3. Common health topics searched on the internet by participants with OHISa experience (N=9704).
Topics Participants, n (%)
Health behavior and literacy 8483 (87.4)
Infectious diseases 7628 (78.6)
Chronic disease 7375 (76.0)
First aid 7277 (75.0)
Health policies 5688 (58.6)
aOHIS: online health information–seeking.
Sources of Web-Based Health
Information Among Participants With
OHIS Experience
Participants reported 1 or more different sources of health
information that they sought on the web. The majority
of participants (7468/9704, 77.0%) used WeChat. More
than half of the participants indicated that search engines
(5547/9704, 57.2%) and short-video apps (5359/9704, 55.2%)
were their main sources. A total of 4079 out of 9704
(42.0%) participants used Weibo. Websites and web-based
courses were used for seeking health information on the web
by 36.3% (3527/9704) and 31.3% (3034/9704) of partici-
pants, respectively. The prevalence of the source of web-
based health information among the participants with OHIS
experience is shown in Table 4.
Table 4. Source of online health information among the participants with OHIS experience (N=9704).
Sources Participants, n (%)
WeChat 7468 (77.0)
Weibo 4079 (42.0)
Search engines 5547 (57.2)
Websites 3527 (36.3)
Web-based courses 3034 (31.3)
Short-video apps 5359 (55.2)
Others 418 (4.3)
aOHIS: online health information–seeking.
Discussion
Principal Findings
In this study, more than 67% of participants sought health
information on the internet, which is similar to recent studies
reporting extensive internet use and highly prevalent OHIS
[22,24,26,33]. The internet has the highest usage rate among
health information sources [5-7]. The results from our study
suggested that among the Chongqing population, the internet
has become a major source for seeking health information,
which is consistent with other reports. How to provide more
high-quality health information on the web may be a key
objective for public health policies and practices in Chongq-
ing.
In this study, younger participants were more likely to
seek health information on the web than older participants.
Similar results were also reported in some previous studies
[22,30,33,34]. IT, including health IT, is usually accessible
for younger generations [35]. Therefore, younger populations
may more frequently seek health information on the internet.
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We also found evidence of disparities in OHIS by ethnicity
in Chongqing. This result was similar to those of previous
studies showing that racial or ethnic minorities were less
likely to use web-based resources to seek health informa-
tion [33,36,37]. A possible reason may be that differences
in cultural values, care preferences, and perceived benefits
of web-based health information likely contributed to these
differential rates of use [36-38]. Previous research has shown
that health communication in a multicultural society mainly
takes the dominant culture into account, often neglecting
those of nondominant groups [39-41]. In China, Han is the
dominant ethnicity. This is likely secondary in part to the
limited availability of web-based sources such as health-rela-
ted websites and patient-provider portals in ethnic minorities
other than the majority [42]. In Chongqing, the population
of ethnic minorities is more than 2 million [32]. Considering
the benefits of OHIS, providing web-based health information
that is suitable for racial or ethnic minorities may contribute
to health improvement in the multiethnic region.
Participants who lived in urban areas were more likely
to use the internet to seek health information. This result
corroborates previous findings that the urban population had
a higher rate of OHIS [33,34,43,44]. A possible reason may
be the digital divide between the urban and rural participants
in this study. Although there are more than 1 billion netizens
in China, people living in urban areas more easily access the
internet [45]. Goldner et al [44] reported that lower internet
access was associated with fewer web-based health behaviors.
Therefore, eliminating the digital divide may help the rural
population benefit from these resources.
In this study, a higher education level was associated with
the highest odds of OHIS among the Chongqing population.
This finding was in line with those of previous studies
[22,27,29,30,33,34,38]. Seeking health information on the
web requires not only access to technology but also the ability
to retrieve, understand, and use information [46]. In addition,
the vast majority of web-based patient resources contain
health information that is above the reading level of most
users [47,48]. Although a substantial proportion of lesser
educated individuals have significant health care needs, they
often encounter difficulties in finding acceptable information
on the web [49]. Continued efforts to ensure that web-based
health information is easy to read, understand, and retrieve
are needed.
We also found that occupation was associated with the
rate of OHIS behavior. In this study, participants who were
medical staff or teachers were more likely to use the internet
to seek health information. The reason may be that medical
staff and teachers more often have higher education levels,
higher socioeconomic status, and easier access to web-based
resources. In addition, due to their duties, medical staff and
teachers often conduct health education for patients and
students, and the internet has a tremendous amount and
variety of health-related information [3,4]. Therefore, they
may have a higher ability and willingness to seek health
information on the internet [50]. Farmers in our study were
less likely to use web-based sources for seeking health
information. This finding was similar to that of a previous
study in Zhejiang province [29]. Farmers always live in rural
areas. Due to the digital divide between urban and rural
areas, farmers may have more difficulty accessing the internet
[44,45].
In this study, participants reported seeking web-based
health information for a broad range of health topics,
including health behavior and literacy, infectious diseases,
chronic disease, first aid, and health policies. Health behavior
and literacy are the most common topics searched on the
internet. This finding is similar to those of previous stud-
ies in which health behavior, lifestyle, and health science
popularization were most commonly searched for types of
web-based health information among the Chinese general
or younger population [27,28]. In recent years, the Chinese
government has tended to use social media to improve public
health literacy and health status among Chinese citizens and
has encouraged the dissemination of health science populari-
zation information in various ways [51-53]. The increasing
popularity of social media and the ever-growing number of
official accounts of health science popularization might have
attracted many Chinese netizens to use such information to
improve their health behavior and literacy.
We found that WeChat was the most commonly used
source for OHIS on the internet. A previous study reported
that the number of WeChat customers has exceeded 900
million, with 150 million customers using the web for at least
2 hours every day [54]. A nationwide survey in China found
that one-third of participants regularly read health informa-
tion articles on WeChat, and more than 90% of the partici-
pants chose to use WeChat for health information seeking,
indicating that a WeChat account is the most popular platform
for acquiring health information in China [55]. However, due
to growing OHIS behaviors, increasing numbers of nonau-
thorized social media accounts share biased or inaccurate
health information; continued efforts are needed to improve
the quality of health information on social media [56-58].
Improving perceived eHealth literacy among netizens and
feedback-seeking behavior in digital environments would be
useful to increase OHIS, and may finally help to improve
public health among Chongqing Population [59,60].
Limitations
This study has several limitations. First, this study was
conducted in Chongqing, and the results may not be
generalizable to the general population in China. Second, due
to the nature of a cross-sectional survey, it is difficult to
draw causal conclusions. Third, as a hot topic of OHIS in
this study, failing to examine the effect of the COVID-19 on
OHIS was a significant study limitation.
Conclusion
In summary, OHIS is prevalent in Chongqing. We found
that participants who were younger, lived in an urban area,
had a higher educational level, and worked as medical staff
or teachers were more likely to engage in OHIS, while
ethnic minorities and farmers were less likely to seek health
information on the web. Among the Chongqing population,
the most common topics sought on the internet were health
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behavior and literacy, and the most popular method of
OHIS was through WeChat. According to the identified
influencing factors, future research could focus on bridging
the digital divide between urban and rural areas, providing
higher-quality web-based health information, and examining
cultural barriers to health information access among ethnic
minority groups. These efforts may help to enhance Chongq-
ing residents’ ability to obtain web-based health resources and
ultimately improve public health outcomes.
Acknowledgments
Ji-an Chen and Qinghua Yang are co-corresponding authors, the latter of which can be contacted using the following
information: phone number 86 02367168619 and email address 914543700@qq.com. We acknowledge all participants in the
study.
Data Availability
The datasets used and analyzed during this study are available from the corresponding author on reasonable request.
Authors’ Contributions
Conceptualization: HR, J-aC, and QY
Data collection: TG, XL, YL, and HR
Data curation: HR, LL, and DY
Formal analysis: LL, HR, and LZ
Investigation: TG, XL, YL, HR, and LL
Methodology: HR, J-aC, and LL
Software: EL, LZ, FL, and DY
Supervision: J-aC
Validation: TG, QT, and FL
Visualization: LL and HR
Writing—original draft: LL and HR
Writing—review and editing: LL, CZ, FL, and TL
Conflicts of Interest
None declared.
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Abbreviations
OHIS: online health information–seeking
OR: odds ratio
Edited by Amaryllis Mavragani; peer-reviewed by Patrick Cheong-Iao Pang, Xi Zhang; submitted 06.01.2024; final revised
version received 08.02.2025; accepted 20.02.2025; published 05.05.2025
Please cite as:
Rong H, Lu L, He M, Guo T, Li X, Tao Q, Li Y, Zheng C, Zhang L, Li F, Yi D, Lei E, Luo T, Yang Q, Chen JA
Online Health Information–Seeking Behaviors Among the Chongqing Population: Cross-Sectional Questionnaire Study
JMIR Form Res 2025;9:e56028
URL: https://formative.jmir.org/2025/1/e56028
doi: 10.2196/56028
© Honghui Rong, Lu Lu, Miao He, Tian Guo, Xian Li, Qingliu Tao, Yixin Li, Chuanfen Zheng, Ling Zhang, Fengju
Li, Dali Yi, Enyu Lei, Ting Luo, Qinghua Yang, Ji-an Chen. Originally published in JMIR Formative Research (https://
formative.jmir.org), 05.05.2025. This is an open-access article distributed under the terms of the Creative Commons Attri-
bution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction
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