ABSTRACT

The CaribData project, funded by the Inter-American Development Bank and implemented by The University of the West Indies, aims to enhance data-handling, -sharing and reuse capabilities in the Caribbean. The project focuses on four main objectives: developing an online data-handling platform, creating a sustainable training and mentoring program, launching a data communication initiative and conducting data availability audits.

To evaluate its progress, CaribData integrates two implementation science frameworks, RE-AIM (for Reach, Effectiveness, Adoption, Implementation, Maintenance) and the Consolidated Framework for Implementation Research. The evaluation will use quantitative and qualitative methods, including monitoring usage metrics, and surveys, interviews and thematic content analysis. Informed consent will be obtained for all evaluation activities. Positive outcomes would include enhanced regional data-sharing capabilities, improved data-handling skills among participants, increased production and dissemination of impactful data stories, and the identification of data gaps and priorities. The online platform is anticipated to streamline the processes of data collection and sharing, while the training program is expected to bolster regional expertise in data analytics and management. If successful, CaribData will bolster the Caribbean’s data-sharing infrastructure, promoting regional data sovereignty and enhancing the utility of data for evidence-based decision-making. The project’s technology, educational and communication strategies will lay a foundation for sustained impact. However, sustainability will depend on ongoing stakeholder engagement, ongoing funding from multiple sources and adapting to evolving data governance frameworks. Ensuring a robust sustainability plan and monitoring its implementation will be critical for maintaining the project’s benefits beyond the initial funding period (2023–2025).

Keywords
Information dissemination; data management; training

RESUMEN

El proyecto CaribData, financiado por el Banco Interamericano de Desarrollo y llevado a cabo por la Universidad de las Indias Occidentales, pretende mejorar las capacidades de gestión, difusión y reutilización de datos en el Caribe. El proyecto se centra en cuatro objetivos principales: la elaboración de una plataforma de gestión de los datos en línea, la creación de un programa sostenible de capacitación y tutoría, la puesta en marcha de una iniciativa de presentación de los datos, y la realización de auditorías de disponibilidad de los datos.

Para evaluar su progreso, CaribData incorpora dos marcos de la ciencia de la implementación: el RE-AIM (sigla en inglés de alcance, efectividad, adopción, implementación y mantenimiento) y el marco consolidado para la investigación de la implementación. Para la evaluación se utilizarán métodos cuantitativos y cualitativos como el seguimiento de los parámetros de medición del uso, encuestas, entrevistas y análisis de contenidos temáticos. Para todas las actividades de evaluación se obtendrá el consentimiento informado. Entre los resultados favorables cabe citar la mejora de las capacidades regionales de intercambio de datos, la mejora de las competencias de los participantes en la gestión de los datos, el aumento de la producción y difusión de presentaciones de gran impacto generadas a partir de los datos y la determinación de las deficiencias y prioridades en materia de datos. Se espera que la plataforma en línea agilice los procesos de recopilación e intercambio de datos y que el programa de capacitación contribuya a fortalecer los conocimientos especializados a nivel regional en materia de análisis y gestión de datos. Si tiene éxito, CaribData impulsará la infraestructura de intercambio de datos del Caribe, con el consiguiente fortalecimiento de la soberanía en materia de datos regionales y la mejora de su utilidad para la toma de decisiones basada en la evidencia. Las estrategias tecnológicas, formativas y de comunicación del proyecto sentarán las bases para lograr un impacto sostenible. Sin embargo, la sostenibilidad dependerá del compromiso permanente de las partes interesadas, la continuidad del financiamiento por parte de diversas fuentes y la adaptación a la evolución de los marcos de gobernanza de datos. Garantizar un plan de sostenibilidad sólido y realizar un seguimiento de su aplicación será un factor crucial para lograr que los beneficios del proyecto se extiendan más allá del periodo de financiamiento inicial (2023-2025).

Palabras clave
Difusión de la información; manejo de datos; tutoría

RESUMO

O projeto CaribData, financiado pelo Banco Interamericano de Desenvolvimento e implementado pela Universidade das Índias Ocidentais, visa melhorar as capacidades de processamento, compartilhamento e reutilização de dados no Caribe. O projeto se concentra em quatro objetivos principais: desenvolver uma plataforma on-line de processamento de dados; criar um programa sustentável de capacitação e mentoria; lançar uma iniciativa de comunicação de dados; e realizar auditorias sobre a disponibilidade de dados.

Para avaliar seu progresso, o CaribData integra duas estruturas da ciência da implementação: RE-AIM (sigla em inglês para Alcance, Efetividade, Adoção, Implementação e Manutenção) e CFIR (sigla em inglês para Quadro Consolidado para Pesquisa de Implementação). A avaliação vai utilizar métodos quantitativos e qualitativos, como indicadores de monitoramento do uso da plataforma e inquéritos, entrevistas e análise temática do conteúdo. Em todas as atividades de avaliação será obtido o consentimento livre e esclarecido dos participantes. Resultados positivos incluiriam uma melhor capacidade regional de compartilhamento de dados, melhores habilidades de processamento de dados entre os participantes, maior produção e difusão de narrativas impactantes (storytelling) com dados e a identificação de lacunas e prioridades. Espera-se que a plataforma on-line simplifique os processos de coleta e compartilhamento de dados e que o programa de capacitação fortaleça o conhecimento técnico regional em análise e gestão de dados. Caso seja bem-sucedido, o CaribData reforçará a infraestrutura de compartilhamento de dados do Caribe, promovendo a soberania regional sobre os dados e aumentando sua utilidade para a tomada de decisões baseadas em evidências. As estratégias do projeto no âmbito da tecnologia, educação e comunicação estabelecerão as bases para um impacto sustentado. No entanto, a sustentabilidade dependerá do envolvimento contínuo das partes interessadas, de financiamento ininterrupto de fontes variadas e da adaptação a estruturas de governança dos dados em constante evolução. Para que os benefícios do projeto se mantenham além do período de financiamento inicial (2023–2025), será fundamental contar com um plano de sustentabilidade robusto e monitorar sua implementação.

Palavras-chave
Disseminação de informação; gerenciamento de dados; tutoria

The endpoint of many health-related research projects remains the dissemination of findings through peer-reviewed publications or in-person presentations. Nevertheless, there is an increasing recognition that additional steps are needed to facilitate the uptake of knowledge into practice (¹1. Wilson PM, Petticrew M, Calnan MW, Nazareth I. Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks. Implement Sci. 2010;5(1):91., ²2. Connell LA, McMahon NE, Watkins CL, Eng JJ. Therapists’ use of the Graded Repetitive Arm Supplementary Program (GRASP) intervention: a practice implementation survey study. Phys Ther. 2014;94(5):632–43.). Efforts to implement evidence-based innovations frequently falter, despite detailed plans for their execution (³3. Rafferty AE, Jimmieson NL, Armenakis AA. Change readiness: a multilevel review. J Manag. 2013;39(1):110–35.–⁵5. Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.); the complexity of this transition from theory to practice is often overlooked. In response, funding agencies have developed holistic guidance, integrating strategies that consider at inception the research context, the range of project stakeholders and the potential impacts of the project (⁶6. Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ. 2021;374;n2061.). More generally, implementation science focuses on the “scientific study of methods to promote the effective uptake of research findings”, offering valuable insights into this challenge (⁷7. Walker AE, Grimshaw J, Johnston M, Pitts N, Steen N, Eccles M. PRIME – PRocess modelling in ImpleMEntation research: selecting a theoretical basis for interventions to change clinical practice. BMC Health Serv Res. 2003;3(1):22.). Implementation science recognizes that the application of research outcomes is influenced by environmental contexts that facilitate or hinder the implementation process (⁵5. Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.), and frameworks exist to help researchers consider implementation and dissemination at every stage of their research project. These frameworks can guide the initial planning and execution of research and ensure that findings are actionable and effectively integrated into practice.

In this article, we present our protocol for implementing a project to enable and encourage data-sharing in the Caribbean region. The project is called CaribData, and the protocol is based on the integration of two implementation science frameworks for the development and continual assessment of the project’s success, focusing particularly on its impact and sustainability.

CaribData: DATA-DRIVEN RESILIENCE

The Inter-American Development Bank (IDB) has provided funding to develop a regional infrastructure and associated training to support data-sharing and storytelling. The project is implemented and supported in kind by The University of the West Indies (Cave Hill campus, Barbados; UWI), and initial beneficiaries will be national statistical offices in the Caribbean region (⁸8. Inter-American Development Bank (IDB). CaribData: Caribbean data-driven resilience [Internet]. Washington (DC): Inter-American Development Bank; 2024 [cited 2024 Feb 19]. Available from: https://www.iadb.org/en/whats-our-impact/RG-T4186
https://www.iadb.org/en/whats-our-impact... ).

Aim and objectives

Ultimately, the CaribData initiative has a vision to sustainably increase the region’s capacity for data-handling, data-sharing and data reuse, offering centralized expertise to resource-limited institutions. The aim of this first funding round (January 2023 to December 2025) is to design and implement a virtual center of expertise for supporting and encouraging Caribbean data-sharing and data reuse. This aim translates to four objectives, operationalized as CaribData subprojects.

Subproject 1: build and operate an online data-handling platform. CaribData will develop and implement an online platform for data collection and data-sharing. The goal of the platform is to offer a regional solution to data producers that meets international data security standards, and along with training (subproject 2), provides Caribbean data producers with a simplified process for sharing their data resources. Many data producers operate their own platforms – for example the World Bank (https://data.worldbank.org/), the United Nations (https://data.un.org/) and the Food and Agriculture Organization of the United Nations (https://www.fao.org/faostat/en/) – and the CaribData platform aims to be ready to federate – not compete – with existing data platforms (⁹9. Hallock H, Marshall SE, ’t Hoen PAC, Nygård JF, Hoorne B, Fox C, et al. Federated networks for distributed analysis of health data. Front Public Health. 2021;9:712569.).

Subproject 2: develop and test a model for a sustainable training and mentoring program. CaribData will co-develop a training program in data-handling in collaboration with the project’s beneficiaries, focusing on data analytics, curation, sharing and reuse, and using delivery modes to meet the competing work demands of early career data scientists. CaribData will also develop an internship program, providing longer-term, practical on-the-job support for data-handling. As an early example of this initiative, CaribData will be a training partner with the Intra-Caribbean Academic Mobility Programme (¹⁰10. The University of the West Indies. Scholarship opportunities that enhance your future [Internet]. Saint Augustine: Intra-Caribbean Academic Mobility Programme; 2024 [cited 2024 Jun 23]. Available from: https://icampcaribbean.org/
https://icampcaribbean.org/... ).

Subproject 3: develop and test a model for a sustainable data communication program. The most visible CaribData subproject aims to develop a data communication program focusing on data stories for non-academic audiences. These stories will use regional data to highlight positive examples of data-sharing. One aspect of this subproject will involve working closely with the UWI and staff at national statistical offices to showcase the wider societal impact of their activities. The program will develop a website to host stories, and it will employ multiple social media channels in its communication strategy. With the Pan American Health Organization, CaribData has produced an early example of open data reuse, publishing a report on the leading causes of death and disease in the World Health Organization’s Region of the Americas (¹¹11. Pan American Health Organization (PAHO). Leading causes of death and disease burden in the Americas: noncommunicable diseases and external causes. Washington (DC): PAHO; 2024. Available from: https://iris.paho.org/handle/10665.2/59568
https://iris.paho.org/handle/10665.2/595... ).

Subproject 4: develop and test methods for auditing data availability. Limited data availability has long been acknowledged as a persistent challenge among Caribbean small island developing states, but efforts to quantify this issue have been scarce (¹²12. United Nations Department of Economic and Social Affairs, United Nations Office for Disaster Risk Reduction. Gaps, challenges and constraints in means of implementing the Sendai Framework for Disaster Risk Reduction in small island developing states. New York: UN Department of Economic and Social Affairs, UN Offfice for Disaster Risk Reduction; 2022. Available from: https://www.undrr.org/publication/small-island-developing-states-sids-gaps-challenges-and-constraints-means-implementing
https://www.undrr.org/publication/small-... ). CaribData will develop protocols for understanding data availability. This work can be likened to systematic evidence reviews for data. Gap-maps of key regional data needs will be developed (¹³13. Saran A, White H. Evidence and gap maps: a comparison of different approaches. Campbell Syst Rev. 2018;14(1):1–38.). The ability to share data across the region is influenced by the governance frameworks in place to protect personal information and privacy. CaribData will summarize and compare national legislation across the region, providing a legislative backdrop for future data-sharing endeavors.

Implementation: conceptual framework

The CaribData initiative has adopted the concept of the implementation and dissemination bridge proposed by Becker et al. (¹⁴14. Becker SJ, DiClemente-Bosco K, Scott K, Helseth SA, Patel-Syed Z, Li DH. The “D&I Bridge”: introducing a teaching tool to define the D, the I, and the why. Implement Sci Commun. 2024;5(1):18.). Developed for public health, this framework aligns with the objectives of CaribData. For implementation, the project looks to bridge the gap between the as-is state of regional data-sharing and the possible future reality in which the adoption of best-practice sharing is encouraged. Best practice might include, for example, the FAIR guiding principles for data stewardship (referring to digital assets that are findable, accessible, interoperable and reusable) and open-science standards (¹⁵15. Wilkinson MD, Dumontier M, Aalbersberg IJ, Appleton G, Axton M, Baak A, et al. The FAIR Guiding Principles for scientific data management and stewardship. Sci Data. 2016;3(1):160018., ¹⁶16. United Nations Educational, Scientific and Cultural Organization (UNESCO). UNESCO recommendation on open science. Paris: UNESCO; 2021. Available from: https://unesdoc.unesco.org/ark:/48223/pf0000379949
https://unesdoc.unesco.org/ark:/48223/pf... ). For dissemination, the project seeks to bridge the gap between those who need support to enable data-sharing and those who are receiving support. This support might, for example, include information about the practicalities of data-sharing or how to develop a data-sharing framework.

Governance and sustainability

The operational details of the CaribData project, along with all staff terms of reference, are posted on a dedicated IDB web page (⁸8. Inter-American Development Bank (IDB). CaribData: Caribbean data-driven resilience [Internet]. Washington (DC): Inter-American Development Bank; 2024 [cited 2024 Feb 19]. Available from: https://www.iadb.org/en/whats-our-impact/RG-T4186
https://www.iadb.org/en/whats-our-impact... ). This online resource maintains a detailed record of the project’s progress. The project is led by a single member of UWI staff (IRH) who has formal training in data-handling and statistics. A steering committee for the project meets quarterly, with each beneficiary national statistical office represented (Belize, Guyana, Jamaica, Trinidad and Tobago); monthly progress meetings are held with the project’s sponsor, IDB; and weekly team meetings facilitate close monitoring of CaribData progress. Informal and formal lines of communication between the project team and its beneficiaries will be established and maintained via meetings and by co-production of training and data collection resources. CaribData has two team members who act as dedicated focal points for stakeholders.

Ensuring the sustainability of CaribData beyond the first funding round is a key component of the project’s implementation. The creation and testing of a formal sustainability plan will be undertaken by team members with business development expertise. Ongoing sustainability will be monitored and will focus on the supply of CaribData resources, the demand for those resources and the ability to sustainably fund the initiative.

The regional context

The United Nations identifies 58 small island developing states, including 29 in the Caribbean (¹⁷17. United Nations Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States. List of small island developing states [Internet]. New York: UNOHRLLS; 2024 [cited 2024 Feb 16]. Available from: https://www.un.org/ohrlls/content/list-sids
https://www.un.org/ohrlls/content/list-s... ). Their small populations, remoteness and vulnerability to environmental and economic shocks commonly translate to narrow, import-dependent economies with limited human resources and limited financing, characteristics that lead to challenges for development and global integration (¹⁸18. Government of Canada. Improving development impact in small island developing states: implementing effectiveness principles [Internet]. Ottawa: Global Affairs Canada; 2022 [cited 2024 May 10]. Available from: https://www.international.gc.ca/world-monde/issues_development-enjeux_developpement/priorities-priorites/sids-peid.aspx?lang=eng
https://www.international.gc.ca/world-mo... ).

Examples are emerging of meaningful data-sharing practices across the 29 Caribbean small island developing states, driven largely by international agencies and research-funded projects with mandates to share data (¹⁹19. World Wide Web Foundation. Open Data Barometer: 2016, fourth edition [Internet]. Washington (DC): World Wide Web Foundation; 2017 [cited 2024 Apr 28]. Available from: https://opendatabarometer.org/4thedition/?_year=2016&indicator=ODB
https://opendatabarometer.org/4thedition... ). At the same time, the environment for sharing is improving (²⁰20. World Bank. World Bank support for open data: 2012–2017. Washington (DC): World Bank; 2017. Available from: http://documents.worldbank.org/curated/en/760871509531665876/World-Bank-support-for-open-data-2012-2017
http://documents.worldbank.org/curated/e... ). Many Caribbean nations have recently enacted frameworks for data governance that have similarities to the European General Data Protection Regulation, and regional data producers are now adapting to these new regulatory environments (²¹21. Economic Commission for Latin America and the Caribbean (ECLAC), Subregional Headquarters for the Caribbean. Report of the expert group meeting on creating an enabling environment for e-government in the Caribbean: a review of data protection legislation for alignment with the General Data Protection Regulation. Port of Spain: ECLAC; 2020. Available from: https://hdl.handle.net/11362/46011
https://hdl.handle.net/11362/46011... ).

Despite these positive signs, data-sharing remains inconsistent between countries (²²22. Organisation for Economic Co-operation and Development. Enhancing access to and sharing of data: reconciling risks and benefits for data re-use across societies. Paris: OECD; 2019. Available from: https://doi.org/10.1787/276aaca8-en
https://doi.org/10.1787/276aaca8-en... –²⁴24. Organisation for Economic Co-operation and Development, World Bank. Health at a glance: Latin America and the Caribbean 2023. 2nd ed. Paris: OECD; 2023. Available from: https://doi.org/10.1787/532b0e2d-en
https://doi.org/10.1787/532b0e2d-en... ). There is no unified, regional data governance, complicating the effective cross-national collection, sharing and utilization of data. Shared data resources are particularly limited when there are data confidentiality considerations, for example in population health. Gaps in data-sharing are compounded by inadequate technological infrastructure and limited funding for data-handling initiatives. New skills related to data curation, warehousing and reuse are required but limited, contributing to the fragmented data-sharing environment (¹⁹19. World Wide Web Foundation. Open Data Barometer: 2016, fourth edition [Internet]. Washington (DC): World Wide Web Foundation; 2017 [cited 2024 Apr 28]. Available from: https://opendatabarometer.org/4thedition/?_year=2016&indicator=ODB
https://opendatabarometer.org/4thedition... ). Addressing these underlying issues is crucial for sustaining a data-sharing environment that can maximize the region’s limited resources for evidence-based decision-making.

Evaluation methods

Much of the evaluation process will use the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework (²⁵25. Glasgow RE, Harden SM, Gaglio B, Rabin B, Smith ML, Porter GC, et al. RE-AIM planning and evaluation framework: adapting to new science and practice with a 20-year review. Front Public Health. 2019;7:64.). The RE-AIM framework was developed more than two decades ago to support implementation research in public health and behavioral science. In the framework, reach assesses the extent to which a target population engages with the intervention; effectiveness measures the impact of the intervention on important outcomes; adoption examines the willingness of settings and staff to initiate the intervention; implementation evaluates the consistency and cost of delivering the intervention; and maintenance looks at the sustainability of the intervention’s effects over time, at both the individual and organizational levels. Although the RE-AIM framework includes an implementation domain, it assumes a project has already been proven elsewhere. Because CaribData is a newly designed initiative, the Implementation Process domain of the Consolidated Framework for Implementation Research (CFIR) (⁵5. Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.) was chosen instead, which is appropriate for new interventions and has been used to assess implementation success in a range of disciplines (²⁶26. Sorensen JL, Kosten T. Developing the tools of implementation science in substance use disorders treatment: applications of the Consolidated Framework for Implementation Research. Psychol Addict Behav. 2011;25(2):262–8., ²⁷27. Abbott PA, Foster J, Marin HDF, Dykes PC. Complexity and the science of implementation in health IT–knowledge gaps and future visions. Int J Med Inform. 2014;83(7):e12–22.). Table 1 presents details of the plan to assess three domains from the RE-AIM framework separately (reach, effectiveness and adoption) for each CaribData subproject. Table 2 presents details of plans to measure implementation success (from the CFIR framework) and project maintenance (from the RE-AIM framework) for the CaribData project as a whole. Figure 1 provides a high-level Gantt chart linking the implementation time frame for each subproject with evaluation time points.

The primary evaluation goals are (a) to determine the implementation success of the CaribData initiative (measured using the CFIR framework) and (b) to determine the extent to which the CaribData initiative improves regional data-sharing (measured using the RE-AIM Effectiveness domain). The secondary evaluation goals are (a) to assess the extent to which users interact with CaribData outputs (measured using the RE-AIM Reach domain), (b) to assess the awareness and acceptability of the CaribData infrastructure (measured using the RE-AIM Adoption domain), and (c) to explore individual and organizational barriers and facilitators affecting the creation and sharing of data stories.

Broadly, the project will use a range of methods to evaluate data collection, including monitoring usage metrics from the data-handling platform, monitoring activity on the website and social media to assess interest in the data communication initiatives, conducting post-training surveys and interviews to gather feedback on the training initiative and, generally, using qualitative interviewing and thematic analysis to summarize feedback from users about the perceived utility of the various initiatives, including their barriers and facilitators. Interviews will mostly use an online teleconferencing platform and will be recorded with consent, transcribed and transferred to a secure, encrypted online platform, after which the original recordings will be destroyed. Thematic content analysis will be used for the qualitative data, and emerging themes will be compared with descriptive findings from the quantitative surveys, specifically to examine where convergences and divergences of themes occur. Encouraging and sustaining data-sharing between countries in the Caribbean will be important longer-term goals, and the project will describe the data governance landscape in each country – collected as part of subproject 4 – as a potentially important influence on the ability to share data regionally.

Ethics and data-sharing

Approval will be sought to include new collections of data from national statistical offices and other beneficiaries of the project, with additional approval from the ethics committee of the UWI, as needed. Informed consent will be sought from individuals prior to collecting evaluation data from them. All data, in anonymized or aggregated formats, and associated collection forms will be made available via the project’s website.

Potential impact

By establishing the infrastructure for data collection and sharing, CaribData could encourage regional data sovereignty and ensure reliable access to regional data resources. A successful data communication program could ensure the active reuse of data and the dissemination of evidence to a general Caribbean audience, in turn promoting data transparency and highlighting the positive aspects of data-sharing. A successful training and mentoring program could contribute to enhancing the regional pool of data expertise, as the skills needed for best-practice data-handling continue to change rapidly. A successful systematic process for assessing data availability by country and subject matter could identify and prioritize attention to data gaps, and could also direct resources to where they are most needed.

Conclusions

CaribData, funded initially for 3 years by the IDB under the Regional Public Goods Initiative, aims to develop and pilot several programs to enhance the regional capacity and appetite for sharing data. An online platform for securely collecting and then sharing data will provide an enabling technical environment for regional data producers. A data communication program focusing on impactful data stories aimed at a general audience seeks to build interest in data-driven evidence and showcase positive reasons to share data. Programs for short-term and longer-term training tailored to the time demands of working data professionals will offer a practical pathway for continuing professional development. Data availability audits can help direct limited resources to key data collection needs among the small islands of the Caribbean. Sustainability will be critical to ensure there is longer-term championing of the benefits of widespread data-sharing and data reuse.

Disclaimer.

Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Revista Panamericana de Salud Pública/Pan American Journal of Public Health or the Pan American Health Organization.

Acknowledgements.

The authors thank the many colleagues who have contributed to insightful discussions around data availability, accessibility and sharing during the development of the CaribData project, funded by the Inter-American Development Bank (project number RG-T4186).

REFERENCES

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