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Systems-based Approach and Systems Thinking in School Health Promotion

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Systems-based Approach and Systems Thinking in School Health Promotion
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Health Promoting

Continuous Learning Sustainable

Education System



Colleen M. Stanton

Ph.D. Candidate, OISE, University of Toronto

R.N., B.Sc.N., B.Ed., M.E.S., M.B.A.



Bob Harper

B.A., M.Ed.



November 22, 2011

Overview of the Presentation



1. Introductions

2. An Ecological Approach to Health

3. Building on Questions and Findings from

Previous International Research

4. Doctoral Research in Health Promoting

Continuous Learning Sustainable Systems

5. What Can We Learn from this Research?

6. Conclusion

Colleen Stanton has 30 years of extensive experience as a:

• registered nurse; community health nurse in public health;

• teacher (children, youth, graduate students);

• health promotion consultant;

• researcher, evaluator, planner;

• teacher in graduate programs – (Masters in Nursing & Health Studies);

• senior health promotion manager in public health;

• initial management committee of the Ontario Healthy Communities

Coalition;

• member of the Ontario Healthy Schools Steering Committee.



Focus: Leadership towards healthy sustainable families, schools, workplaces,

communities, cities and regions.





3

Bob Harper has 39 years of extensive experience as:

• Coordinating Superintendent of Education for a large school board

in Ontario for ten years

• Member of the Senior Management Team for 15 years

• Worked in various roles in the education system for 39 years as a

teacher, principal, superintendent, coordinating superintendent

• Most recent portfolio was as Coordinating Superintendent of

Workplaces and Learning Environments

• Focus on healthy schools, eco-schools, plant services, international

education, continuing education, transportation, etc.

• Expertise in secondary education

• Member of the Ontario Healthy Schools Steering Committee



Focus: Leadership Towards Healthy Sustainable Workplaces & Education

Systems



4

An ecological approach to health…..



• A key step would lie in understanding

health as a pattern of relations rather than as

a quantitative outcome.



• A pattern though is not a fixed matter but

‘primarily’ a dance of interacting parts…..



• This opens the possibility of understanding

health as a process.

(Kickbusch, 1989).



5

A shift from a deficit model of disease to

an asset model of health potentials

inherent in social and institutional settings

of everyday life (Kickbusch, 1996)









6

Is dynamic, interconnected, and

characterized by interrelationships,

interdependencies, and synergies.



(Capra, 1982; 1996)







7

Health promotion is the process

of enabling individuals and

communities to increase control

over the determinants of health

and thereby improve their health

(WHO, 1986).









8

Moving Towards

Open Design and Emergence

How can we begin to describe and

understand health as a process, as a

pattern of dynamic interrelationships, as

potential, as synergy? As a open living

system? As a pattern of open design and

emergence?





9

Building on Previous Research

• Completed an international research study

entitled a Systems Approach to Health

Promoting Schools, 2004;

• Summary published in the IUHPE Promotion

and Education, Volume XII, No. 3-4, 2005;

• Interviewed 35 key informants – system leaders

working to promote healthy schools around the

world;





10

Open Living Systems

Evolve & Grow



• The previous research identified six core

elements and a framework for a systems

approach to health promoting schools;

• Identified key challenges and

opportunities of creating a systems change

process towards health promoting

schools.



11

Core Elements of a Systems Approach to

Health Promoting Schools, 2004

Knowledge and Appreciation of

Continuous Learning and

Sustainability







Shared Vision



Collaborative Culture

Interconnectedness Interconnectedness

with with

Internal/External Referent Structure Internal/External

Environments Environments



Overarching Strategy



Personal/Professional

Development/Learning



Evaluation and Monitoring







Knowledge and Appreciation of Knowledge and Appreciation of

Health & Health Promoting Systems Change

Systems (Holistic, Integrated Approaches)

Holistic, Ecological, Systems Approach)

12

Key Questions

• How and where is health created?

• What creates health in large organizations, workplaces, and

systems?

• How can a health promoting system support the core business of an

organization (in this case a school board)?

• How can we link health promoting systems with learning systems?

• How can we work with others to build a common and shared vision

and strategy that meets the needs of all stakeholders?

• What should we call this “entity”?

• A health promoting sustainable school? A Living School? An

Effective School? A Learning School?

• What are the essential aspects of the system design and how can it

remain open and flexible enough to grow and evolve?

13

Key Questions

• How do we ensue the word “health” does not get in the

way of developing a common and shared vision?

• What type of leadership would enable this large open

systems change process?

• What type of ongoing evaluation, monitoring and

scanning would be helpful but not limit our thinking,

our learning and our ability to allow emergence?









14

Key Questions

• How can we share our experiences locally,

provincially, nationally and internationally?

• Is there a role for technology and international

learning forums?

• How can we involve and engage people across

the world in learning and sharing?









15

Quotes from Key Informants

“Working to create health promoting

schools involves a paradigm shift. We

need to recognize that this is an integral

process. It is a challenge to see the world

differently. Change is messy. We have to

embrace it and reorganize at a higher

level. It takes “big brains” to make this

happen.”



“16

Quote from Key Informant

“It is not possible or desirable to create the

model of a health promoting school. Every

model is a result of dialogue and

consensus among its “constructors” and

has meaning within a certain value-

framework in a particular context. The

health promoting school is more of a

process of contextual interpretation than

an outcome of the implementation of

global principles.” 17

Quotes from Key Informants

HPS requires that people:

• can see the big picture; value a child and youth

centred society;

• be comfortable with ambiguity and change and

believe that by working together we can make a

bigger difference – build synergy exponentially;

• believe that by working collaboratively we can

get a greater return on our investment;

• appreciate that systems change requires ongoing

dialogue and developing shared meanings.

18

Key Findings

The development of health promoting continuous

learning sustainable systems require that we focus on

developing the capacity to:

• authentically share power, distribute leadership and responsibility

through empowering self-organizing processes;

• build authentic, open, honest relationships through collaborative

partnerships, networks and communities

• increase our capacity to take risks, be creative and be comfortable

with deep dialogue and diversity;

• learn to be comfortable with turbulence, non linearity and the

messiness of change;

• move from top down, designed, approaches of management and

control to more guided and emergent, creative approaches to

learning and change.

19

Key Findings



While the content and curriculum of a healthy

sustainable school system is important, it is

really about an ongoing systems change process

of relationship building, collaboration, ongoing

feedback looping, paying attention to

disturbances, distributing and sharing

leadership and power, appreciating diversity

and facilitating open environments that promote

deep learning and emergence.



20

Research Questions



1. What are the top three system environments that have

the most influence or enable the emergence of health,

wellbeing, continuous learning and sustainability for

individuals and for the organization as a whole?



2. What are the interrelationships, patterns and synergies

between these top three (3) system environments?



3. Are there one or two system environments that might

be considered the key synergy point(s) for this systems

change process?





21

System Environments That Promote Optimal Health,

Wellbeing, Continuous Learning & Sustainability

Knowledge and Appreciation of

Living Systems,

Change & Sustainability Lens

(Holistic, Systems Approach)







System Environments*



1. Leadership (Shared and Distributed)



2. Culture of Continuous Learning

(Intellectual Environment)

Interconnectedness Interconnectedness

with 3. Interrelatedness of Work & Life with

Internal/External Internal/External

Environments 4. Meaning/Purpose/Connectedness Environments



5. Collaborative Culture



6. Health Promoting Physical Environments



7. Health Promoting Social/Emotional

Environments



8. Work Organization/Design/Emergence



Knowledge and Appreciation of Knowledge and Appreciation of

Health & Health Promotion Lens Continuous Learning Lens

(Holistic, Ecological, Systems Approach) (Holistic, Systems Approach)









22

Different ways of

understanding and

appreciating systems

3 Major Lenses of a HPCLSS



Health Promoting Systems

Continuous Learning Systems

Living/Sustainable Systems







24

Health Promoting Systems

• Trevor Hancock, M.D., Ministry of Health, Public Health Consultant,

Victoria, British Columbia, Canada

• Irv Rootman, Ph.D., Professor, University of British Columbia, Canada

• Lawry St. Leger, Ph.D., Deakin University, School of Health and Social

Development, Australia

• Harvey Skinner, Ph.D., Dean, Faculty of Health, York University, Canada

• David Rivett, Previous Coordinator of ENHPS, World Health Organization

• Cameron Norman, Ph.D., University of Toronto, Canada

• Allan Best, Ph.D., University of British Columbia, Canada

• Michael Goodstadt, Ph.D., University of Toronto, Canada









25

Continuous Learning Systems

• Carol Rolheiser, Ph.D., Previous Associate Dean, OISE, University

of Toronto & Current Director, Centre for Teaching Excellence and

Innovation, University of Toronto

• Blair Mascall, Ph.D., OISE, University of Toronto, Canada

• Stephen Anderson, Ph.D. OISE, University of Toronto, Canada

• Ken Leithwood, Ph.D., OISE, University of Toronto, Canada

• Lyn Sharratt, Ph.D., OISE, University of Toronto, Canada

• Marilyn Laiken, Ph.D. , OISE, University of Toronto, Canada

• Michael Fullan, Ph.D., OISE, University of Toronto, Canada

• Andy Hargreaves, PhD., Lynch School of Education, Boston

College, MA

• Bryan Smith, Ph.D., President, Broad Reach Innovations, Markham,

Ontario, Canada





26

Continuous Learning Systems



• Cristina D’Arce, Ph.D., President, Society for Organizational

Learning, (SOL), Brazil

• Doug Reeves, Ph.D. & Elle Allison, Ph.D., Renewal Coaching for

Sustainable Change for Individuals and Organizations

• Jack Miller, Ph.D., Professor, OISE, University of Toronto, Holistic

Curriculum & Holistic Learning;

• Alma Harris, Ph.D., Professor, University of London, UK

• James Spillane, Ph.D., Professor, Northwestern University

• Mary Anne Archer, Ph.D., Professor, OISE, University of Toronto









27

Living Sustainable Systems

• Fritjof Capra, Ph.D., Berkley California, United States of

America

• Margaret Wheatley, Ph.D. , Berkana Institute, United

States of America

• Michael Fullan, Ph.D., Previous Dean, OISE, University

of Toronto

• Andy Hargreaves, Ph.D., Lynch School of Education,

Boston College, M.A.

• Gareth Morgan, Ph.D. , York University, Schulich School

of Business, Ontario, Canada

• Glenda Eoyang, Ph.D., President, Human System

Dynamics 28

Data Collection Methods and

Criteria for Sampling/Selection



• Preliminary Interviews (10)

• Semi-Structured Interviews (60)

– District Level (14)

– School Level (46)

• Review of Key System Patterns with Systems

Thinkers and Change Leaders (Internal/External)









29

Findings









30

System Environment #1:

Leadership (key enabler)

1. Appreciation of human qualities, relationships, respect for life;

2. Authentic sharing of power, control, empowering forms of

distributed/shared leadership;

3. Promotes meaningful and authentic input into decision-making;

4. Creates a culture of continuous learning, deep dialogue, risk taking

and innovation;

5. An appreciation of diversity - diverse opinions, ideas, cultures,

worldviews, mental models;

6. Creates a culture of collaboration, networking and community

building.







31

System Environment #2:

Culture of Continuous Learning

1. Capacity to adapt to change and generate/co-create

new knowledge, wisdom, and ways of knowing;

2. Capacity to take risks, be creative and learn from

mistakes;

3. Capacity to access and synergize resources to address

complex issues in personal and organizational lives;

4. Appreciation of diversity – diverse cultures, opinions,

worldviews, ideas, ways of learning etc.

5. Meaning, purpose, coherence and consciousness









32

System Environment #3:

Interrelatedness of Work & Life

Individual and Organizational Levels:

1. Increased awareness that we are interrelated and

interconnected to each other and to the whole;

2. Appreciation that we are open systems nested within

broader open systems (individuals, family,

organization, community, planet);

3. Increased awareness that we are all part of something

bigger than ourselves and working towards common

good, moral purpose, collective purpose

4. Capacity to address specific issues related to

interrelatedness of work and life (quality of life) – e.g.

generational issues, more flexible work hours, life

stages, opportunities to return to school, time off with

family, caregiver support, mentoring and support

during difficult and stressful times, etc.

33

System Environment #3

Interrelatedness of Work & Life

5. Increased awareness and appreciation of the need for

renewal, regeneration, and rejuvenation;

6. The capacity to deal with loss, change and growth;

letting go and moving on;

7. Increased emergent properties of compassion, caring,

empathy, forgiveness, global awareness, ecological

awareness.









34

Findings:

System Patterns



Leadership was identified as the major enabler of a

healthy sustainable learning system for individuals and

for the organization as a whole.



Guided and emergent forms of distributed leadership

(DL) were reported as promoting the highest levels of

optimal health, wellbeing, continuous learning and

sustainability for individuals and for the organization as

a whole.







35

Hargreaves’ Ladder of

Distributed Leadership

• Anarchy

• Emergent distribution

• Guided distribution

• Progressive delegation

• Traditional delegation

• Autocracy

(Hargreaves & Fink, 2006)





36

Schools with

Guided to Emergent

Patterns of Distributed Leadership

Exhibit characteristics and conditions of a HPCLSS such as:

• increased sense of empowerment;

• increased ownership and commitment;

• positive continuous learning environments;

• sense of meaning, purpose and connectedness;

• patterns of flow, appreciation of diversity;

• sharing of power and control; sense of “voice”;

• ability to cope; be resilient with increased workload and change;

• increased capacity to support each other socially, emotionally,

intellectually, physically, and spiritually;

• increased creativity, use of technology;

• increased capacity to integrate multiple initiatives and programs;

• Increased awareness of interrelatedness with emergent properties

of compassion, caring, empathy, forgiveness, global awareness and

environmental awareness.

37

Schools with Emergent Patterns of

Distributed Leadership



• There is an increased sense of aliveness, awareness and

consciousness…. capacity to grow and evolved …the

individual and collective systems are becoming more

complex;

• There is a growing appreciation of interrelatedness as

individuals, as organizations, communities and the

global environment/planet;









38

Findings:

Diverse Leadership Patterns

There are two very different leadership patterns across this

District.



• Leadership in one large area of the system is more open,

emergent and self-organizing;



• Leadership in another large area of the system is top

down, very directed, with pre-determined goals and

objectives;



• These can be termed “organized” & “self- organizing”

systems. (G. Eoyang; M. Wheatley; F. Capra);



39

Patterns of

Continuous Learning

• There is a strong culture of continuous learning in this

organization. The majority of the key informants

reported this to be health promoting for them as

individuals and for the organization as a whole.



• Staff (superintendents, principals and teachers) who are

nested under more closed top-down leadership

environments reported their learning environments

were not health promoting or sustainable because the

learning agenda was pre-determined, not personalized

and meaningful to them.



40

Patterns of Interrelatedness



• While health and wellbeing is being created in this

organization/school district through the leadership,

culture of collaboration and culture of continuous

learning, there is a need for greater appreciation of

individual health and wellbeing in key areas: increased

flexibility re personal needs; time off; more attention to

generational issues; more attention on ensuring balanced

work and family life; opportunities for rejuvenation and

renewal.





41

Patterns of Interrelatedness

• Key informants (teachers and principals in particular)

would like to see the continued expansion of

international networks, exchanges, volunteer work

opportunities, teacher training programs that promote

their continuous learning and growth.

• At the organizational level, there is a need to consider

how principal and vice principal leadership is

encouraged, developed and sustained on an ongoing

basis – paying more attention to various forms of

distributed leadership, the selection process, how and

when principals are recruited and transferred,

opportunities inside and outside the system for renewal,

rejuvenation, continuous learning. 42

Striking Patterns:

A Summary

• Throughout this system one of the striking patterns is

the creation of health, wellbeing and sustainability in the

areas of the system where the leadership is more open,

draws on guided to emergent leadership patterns and

facilitates emergence, creativity and innovation.

• In these school and system environments, individuals

report higher levels of health, wellbeing & sustainability.

• They describe feeling alive, a sense of wellbeing, support

from their colleagues and supervisor, openness to new

ideas and creative approaches, and a true sense of

respect for life, caring and appreciation of diversity.

• They describe many examples of emergence or co-

creation of new ideas, programs, structures, and ways of

seeing the world. 43

Striking Patterns

• Another striking pattern is the emergence of empathy,

caring, compassion, forgiveness, and increase global and

environmental awareness in schools exhibiting higher

forms of DL, deeper learning environments and

increased interrelatedness. This pattern was identified in

more open caring, emergent leadership environments.



• When emergent leaders (supervisory officers, principals

and teachers) are nested under more autocratic and top

down leadership they reported feelings of stress, ill

health, inability to grow and learn deeply, a lack voice,

choice and a lack of empowerment. They also reported

increased absences from work. 44

Blockages of Flow

in the System

There are a few major “blockages” of flow in this

system that are influencing health, wellbeing and

sustainability and that need to be addressed

related to:

• different leadership philosophies, values and forms

(sharing of power/control; empowerment);

• different attitudes related to control, flexibility,

empowerment in some key areas/departments;

• a need for more openness to deeper learning – allowing

deeper learning to take hold through dialogue, taking

risks, sharing of knowledge and control etc.

• lack of flexibility in relation to human resource policies,

job design, flexible work hours, elementary union

management and relations.

45

What are the underlying

principles of a HPCLSS?









46

12 Principles of HPCLSS

1. Holistic, ecological living systems *

(systems are nested within systems)



2. Interrelatedness *

(interdependence, ecological awareness, meaning/purpose)



3. Relationships

(trust, cooperation, reciprocity, honesty, authenticity)



4. Diversity *

(resilience, culture, conflict, gender differences, etc)



5. Sharing and distribution of power, control and leadership

(empowerment, trust, distributed, shared leadership)



6. Collaboration, Networks, Communities *

(social networks, collaboration, sharing of knowledge)

47

Principles of HPCLSS

7. Learning*

(double & triple loop learning, feedback loops, adaptability, generativity,

creativity, social support, innovation)





8. Growth, Loss & Change

(generativity, adaptability, openness, flexibility, willingness to be disturbed)





9. Balance/Equilibrium/Disequilibrium/Homeostasis *

(integrity, balance, awareness, consciousness)





10. Meaning/Purpose/Coherence/Consciousness

(interrelatedness, integrity, ability to think towards the future, ecological

awareness/sensitivity, aliveness)



48

Principles of a HPCLSS

11. Flow*

(energy, interrelationships, dynamics, synergy,

ideas, resources, generative learning, knowledge,

waste)



12. Emergence* & Design

(creativity, novelty, innovation, risk taking,

new and flexible structures)



Health, Wellbeing, & Sustainability

(health, wellbeing, continuous learning,

“aliveness”, “spirit”, future, energy,

ecological awareness)



* These are the principles of all living systems

49

Learning

•What can we learn from this

research? What further research

can be done in this area?

Open Design & Emergence

Health promoting continuous learning sustainable systems

are moving from:



• traditional planned systems to a growing understanding of

complex adaptive learning systems;

• organized, designed systems to self organizing, emergent,

creative systems.



This involves an ongoing process of growth and development

and increasing complexity.



51

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?



• Health is created in our everyday work and home lives.

• Educators are beginning to more fully understand and

appreciate how health is created and co-created in their

own work environments.

• A growing number of educators are developing an

increased appreciation of the interrelationships between

individual, organizational, community, and global

health, wellbeing and sustainability.

• Higher more evolved forms of distributed leadership

(DL) can be enablers of health, wellbeing, continuous

learning and sustainability; while less evolved forms can

be disablers of health, wellbeing and sustainability.

52

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?



• Cultures of collaboration, continuous learning and

distributed leadership are generally health promoting,

but in order to be sustainable they need to be supported

by sufficient flexible resources and attention to ensure

balance, renewal, regeneration and resilience of staff;

learning has to be personalized, relevant and meaningful

to each individual.

• People need to be supported socially and emotionally

through difficult change and life processes; and the

challenges of loss, change and growth – individually and

collectively.





53

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?



•In human/social systems, meaning, purpose, coherence

and consciousness are integral to health, wellbeing and

sustainability.



•Key informants reported that shared meaning, purpose

and coherence, and their awareness and consciousness of

this shared purpose was “ensuring the aliveness, health,

wellbeing and sustainability of their individual lives and

the life of the organization”.



•Meaning, purpose, coherence and consciousness is the

synergy point of this system.

54

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?



• It was important to create flexible, open, adaptive

structures to begin to dialogue and think about how to

fully integrate curriculum and portfolio areas across this

system.

• This began the process of building deep understanding

and ongoing commitment and ownership by all staff

throughout the system. Staff were beginning to come to

a deeper understanding of their own health, wellbeing

and sustainability and the interrelatedness to the whole.









55

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?

• Research that is currently underway in the education

system needs to be shared and understood.

• For example this particular research was built on the

research of key educational leaders in the areas of:

distributed leadership; organizational learning; learning

organizations; systems change; and collaborative

learning environments.

• This requires having researchers and professionals

working across a number of diverse fields including

education and health.







56

What can we learn from this research about integrating

health, wellbeing and sustainability into school districts?







As members of professional learning communities,

communities of inquiry and practice – teachers,

principals, superintendents, senior leaders,

parents, trustees, students have extensive

knowledge, skills and capacities to design and

work towards creating a vision of healthy

sustainable learning systems in collaboration with

community partners.

57

New Portfolio and

Open & Flexible Learning

Structure Created

• New Portfolio was created to address Healthy

Workplaces and Learning Environments;

• Linking and Integrating Healthy Schools, Eco-Schools,

Safe Schools, Outdoor Education, Positive Climates for

Learning;

• Wanted to give workplace wellbeing a key focus in the

organization;

• Wanted the process to be owned by the everyone;

• Wanted to increase overall understanding and

appreciation of leadership, learning and interrelatedness

in health, wellbeing & sustainability. 58

Towards Health Promoting, Continuous Learning Sustainable Systems

Ongoing growth patterns of increasing complexity, non linearity, openness,

health promoting relationships, empowered shared distributed leadership,

shared meaning & purpose, diversity, voice, choice, collaboration, coherence

and deeper adaptive and generative learning

Closed System Designed/Planned, Fairly More Open, Guided/Facilitative Emergent/Assertive

Autocratic, Top-Down, Closed, Aligned, Linear Approach Non-Linear Approach

Structured, Linear Approach

Approach Facilitates emergence, creativity,

People reported that the overall openness within the agreed upon Clear on shared purposes and

Structured, aligned, little framework, goals and outcomes framework and purpose. values, while promoting

choice, voice, input and are pre-determined and Becoming more complex and shared creativity, emergence,

ownership established by a few; They have non-linear; has developed their openness, innovation, risk

Work is delegated and little or minimal input into own structures for collaboration taking, increased flow, voice,

learning is organized at important decisions affecting and community building and empowerment, increased

the top; people are their work and life. This leads to does not stop emergence; still choice, involvement, increased

frustrated and reported frustration, dis-connect with fairly structured and people work growth, learning, double and

feeling stressed, lack of individual and organization collaboratively. People reported triple loop learning etc.

opportunities to grow and meaning and purpose; little feeling healthy, enjoying ongoing Very high levels of health,

learn, and be themselves input; feelings of collaboration and community wellbeing and sustainability

and contribute tot the disempowerment, lack of voice, building; learning with others; reported. Very high levels of

whole. Detailed planning lack of choice. There is very and there is flexibility in work life empowerment, self knowledge,

and analysis is used to superficial learning as the balance, and wellbeing. deep sense of contribution to

ensure predictability and outcomes and goals are already Data requirements are developed the whole; able to question

people feel they have no pre-determined and they have together by a team and they are authority and ask difficult

input, voice, or choice. limited input. Use of monitored and changed on an questions – deep dialogue etc.

They feel like “pawns” in quantitative data is very ongoing basis. Synergizes There is a strong sense of

the system. A few frustrating, lacks meaning and is existing resources and may access interrelatedness with

reported having to take time consuming and not helpful. some new resources. environmental and global

sleeping pills and taking Does not access or synergize There is a culture of honouring activities – locally and globally.

time off work. resources, talents, capacities. and respecting each individual’s Utilize both qualitative and

59

Feedback looping is used to strengths and the need for self quantitative data and involved

regulate and keep the “status determination, empowerment, in research

Thank You


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