***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Clinical Queries filters were developed to improve the retrieval of high- quality studies in search es on clinical matters . The study objective was to determine the yield of relevant citations and physician satisfaction while search ing for diagnostic and treatment studies using the Clinical Queries page of PubMed compared with search ing PubMed without these filters . MATERIAL S AND METHODS Forty practicing physicians , presented with st and ardized treatment and diagnosis questions and one question of their choosing , entered search terms which were processed in a r and om , blinded fashion through PubMed alone and PubMed Clinical Queries . Participants rated search retrievals for applicability to the question at h and and satisfaction . RESULTS For treatment , the primary outcome of retrieval of relevant articles was not significantly different between the groups , but a higher proportion of articles from the Clinical Queries search es met method ologic criteria ( p=0.049 ) , and more articles were published in core internal medicine journals ( p=0.056 ) . For diagnosis , the filtered results returned more relevant articles ( p=0.031 ) and fewer irrelevant articles ( overall retrieval less , p=0.023 ) ; participants needed to screen fewer articles before arriving at the first relevant citation ( p<0.05 ) . Relevance was also influenced by content terms used by participants in search ing . Participants varied greatly in their search performance . DISCUSSION Clinical Queries filtered search es returned more high- quality studies , though the retrieval of relevant articles was only statistically different between the groups for diagnosis questions . CONCLUSION Retrieving clinical ly important research studies from Medline is a challenging task for physicians . Method ological search filters can improve search retrieval Physicians often fail to provide nationally recommended preventive services for their patients . Addressing this , we have review ed selected literature on changing physician behavior using the organizational construct of the " readiness for change " transtheoretical model . This model suggests that behavior evolves through stages from precontemplation , to contemplation , to preparation , to initiation , and to maintenance of change . Traditional continuing medical education may affect knowledge and beliefs , but rarely results in behavior change . However , motivational strategies such as practice feedback reports and influential peers can foster stage change . Successful interventions aim ed at physicians preparing for change frequently use an office-system approach that targets not only physicians , but office staff and patients as well . Illustrating how the readiness to change model can guide the design and implementation of interventions , we describe strategies being used in a statewide r and omized controlled trial to improve cancer prevention counseling and early detection by primary care physicians . The multistage interventions of Partners for Prevention include support from a medical liability carrier , a motivational videotape , a task-delineated office manual , chart flowsheets , patient activation forms , practice feedback reports , a design ated prevention coordinator within each practice and regular telephone calls and office visits by project staff Background Although for more than a decade healthcare systems have attempted to provide evidence -based mental health treatments , the availability and use of psychotherapies remains low . A significant need exists to identify simple but effective implementation strategies to adopt complex practice s within complex systems of care . Emerging evidence suggests that facilitation may be an effective integrative implementation strategy for adoption of complex practice s. The current pilot examined the use of external facilitation for adoption of cognitive behavioral therapy ( CBT ) in 20 Department of Veteran Affairs ( VA ) clinics . Methods The 20 clinics were paired on facility characteristics , and 23 clinicians from these were trained in CBT .  A clinic in each pair was r and omly selected to receive external facilitation . Quantitative methods were used to examine the extent of CBT implementation in 10 clinics that received external facilitation compared with 10 clinics that did not , and to better underst and the relationship between individual providers ' characteristics and attitudes and their CBT use . Costs of external facilitation were assessed by tracking the time spent by the facilitator and therapists in activities related to implementing CBT . Qualitative methods were used to explore context ual and other factors thought to influence implementation . Results Examination of change scores showed that facilitated therapists averaged an increase of 19 % [ 95 % CI : ( 2 , 36 ) ] in self-reported CBT use from baseline , while control therapists averaged a 4 % [ 95 % CI : ( -14 , 21 ) ] increase . Therapists in the facilitated condition who were not providing CBT at baseline showed the greatest increase ( 35 % ) compared to a control therapist who was not providing CBT at baseline ( 10 % ) or to therapists in either condition who were providing CBT at baseline ( average 3 % ) . Increased CBT use was unrelated to prior CBT training . Barriers to CBT implementation were therapists ' lack of control over their clinic schedule and poor communication with clinical leaders . Conclusions These findings suggest that facilitation may help clinicians make complex practice changes such as implementing an evidence -based psychotherapy . Furthermore , the substantial increase in  CBT usage among the facilitation group was achieved at a modest cost Background Despite the burgeoning number of well-vali date d interventions that have been shown in r and omized trials to produce superior outcomes compared to usual services , it is estimated that only 10 % of public systems deliver evidence -based mental health services . In California , for example , more than 15,000 children are placed in group homes or residential centers with some evidence of iatrogenic effects . The present study evaluates the willingness among county leaders of child public service systems to adopt a new evidence -based model , Multidimensional Treatment Foster Care , ( MTFC ) , as a way to decrease the prevalence of out-of-home placements . Specifically , the study examines how county-level socio-demographic factors and child public service system leaders ' perceptions of their county 's organizational climate influence their decision of whether or not to consider adopting MTFC . Methods Two levels were examined in this study : Stable and historical factors from 40 California counties gathered from public records including population size , number of entries into out-of-home care , financing of mental health services , and percent minority population ; and system leaders ' perceptions of their county 's organizational climate and readiness for change measured via a web-based survey . The number of days-to-consent was the primary outcome variable defined as the duration of time between being notified of the opportunity to implement MTFC and the actual signing of a consent form indicating interest in considering implementation . Survival analysis methods were used to assess the predictors of this time-to-event measure . The present study is part of a larger r and omized trial comparing two methods of implementation where counties are r and omized to one of three time cohorts and two implementation conditions . Results The number of entries into care was the primary predictor of days-to-consent . This variable was significantly correlated to county size . System leader 's perceptions of positive climate and organizational readiness for change also contributed to but did not mediate or moderate the days-to-consent . Conclusions System leaders ' decision to consider implementing a new evidence -based model was influenced most by their objective need for the program and next by their perception of the county 's organizational climate and motivation to change . These findings highlight the importance of underst and ing the fit between the needs of the systems or agencies and the potential for addressing those needs with the proposed new program OBJECTIVE The objective of this study was to measure dietitians '  perceptions , attitudes , and knowledge of evidence -based practice ( PAK score ) , and to determine whether antecedent factors ( eg , sociodemographic characteristics , education and training , professional experiences , and employment setting ) predicted PAK score . DESIGN This cross-sectional , descriptive study used the Dietitian Research Involvement Survey following the Tailored Design Method . SUBJECTS/ SETTING This study surveyed 500 r and omly selected registered dietitians from seven dietetic practice groups of the American Dietetic Association . STATISTICAL ANALYSES PERFORMED Bivariate relationships were examined between antecedent factors and PAK score . Multiple linear regression analyses were conducted to test whether these factors predicted PAK score . RESULTS Higher PAK scores were associated with registered dietitians who completed more years of education ( r=0.28 , P<.0005 ) , had taken a research course ( r=0.28 , P<.0005 ) , frequently read research articles ( r=0.41 , P<.0005 ) , earned an advanced-level board certification ( r=0.18 , P=.004 ) , worked full-time ( r=0.26 , P<.0005 ) , or belonged to professional organizations ( r=0.18 , P=.003 ) . The strongest predictors for PAK score were " last time read research " ( beta=.33 , P<.0005 ) , work status ( beta=.20 , P<.0005 ) , level of education ( beta=.19 , P=.001 ) , and association memberships ( beta=.14 , P=.01 ) . CONCLUSIONS Results indicated that dietitians ' ability to incorporate an evidence -based approach is largely determined by their education and training , work experience , and professional association involvement . This study identified a need to integrate concepts and principles of evidence -based practice into dietetics curriculums so that practitioners are able to routinely apply research findings to clinical practice Background The Worksite Health Promotion Capacity Instrument ( WHPCI ) was developed to assess two key factors for effective worksite health promotion : collective willingness and the systematic implementation of health promotion activities in companies . This study evaluates the diagnostic qualities of the WHPCI based on its subscales Health Promotion Willingness and Health Promotion Management , which can be used to place companies into four different categories based on their level of health promotion capacity . Methods Psychometric evaluation was conducted using exploratory factor and reliability analyses with data taken from a r and om sample of managers from n = 522 German information and communication technology ( ICT ) companies . Receiver operating characteristic ( ROC ) analyses were conducted to determine further diagnostic qualities of the instrument and to establish the cut-off scores used to determine each company 's level of health promotion capacity . Results The instrument 's subscales , Health Promotion Willingness and Health Promotion Management , are based on one-dimensional constructs , each with very good reliability ( Cronbach 's alpha = 0.83/0.91 ) . ROC analyses demonstrated satisfactory diagnostic accuracy with an area under the curve ( AUC ) of 0.76 ( SE = 0.021 ; 95 % CI 0.72 - 0.80 ) for the Health Promotion Willingness scale and 0.81 ( SE = 0.021 ; 95 % CI 0.77 - 0.86 ) for the Health Promotion Management scale . A cut-off score with good sensitivity ( 71%/76 % ) and specificity ( 69%/75 % ) was determined for each scale . Both scales were found to have good predictive power and exhibited good efficiency . Conclusions Our findings indicate preliminary evidence for the validity and reliability of both subscales of the WHPCI . The goodness of each cut-off score suggests that the scales are appropriate for determining companies ' levels of health promotion capacity . Support in implementing ( systematic ) worksite health promotion can then be tailored to each company 's needs based on their current capacity level Background Psychological models are used to underst and and predict behaviour in a wide range of setting s , but have not been consistently applied to health professional behaviours , and the contribution of differing theories is not clear . This study explored the usefulness of a range of models to predict an evidence -based behaviour -- the placing of fissure sealants . Methods Measures were collected by postal question naire from a r and om sample of general dental practitioners ( GDPs ) in Scotl and . Outcomes were  behavioural simulation ( scenario decision-making )  , and behavioural intention .  Predictor variables were from the Theory of Planned Behaviour ( TPB ) , Social Cognitive Theory ( SCT ) , Common Sense Self-regulation Model ( CS-SRM ) , Operant Learning Theory ( OLT ) , Implementation Intention ( II ) , Stage Model , and knowledge ( a non-theoretical construct ) . Multiple regression analysis was used to examine the predictive value of each theoretical model individually . Significant constructs from all theories were then entered into a ' cross theory ' stepwise regression analysis to investigate their combined predictive value Results Behavioural simulation - theory level variance explained was : TPB 31 % ; SCT 29 % ; II 7 % ; OLT 30 % . Neither CS-SRM nor stage explained significant variance . In the cross theory analysis , habit ( OLT ) , timeline acute ( CS-SRM ) , and outcome expectancy ( SCT ) entered the equation , together explaining 38 % of the variance . Behavioural intention - theory level variance explained was : TPB 30 % ; SCT 24 % ; OLT 58 % , CS-SRM 27 % . GDPs in the action stage had significantly higher intention to place fissure sealants . In the cross theory analysis , habit ( OLT ) and attitude ( TPB ) entered the equation , together explaining 68 % of the variance in intention . Summary The study provides evidence that psychological models can be useful in underst and ing and predicting clinical behaviour . Taking a theory-based approach enables the creation of a replicable methodology for identifying factors that may predict clinical behaviour and so provide possible targets for knowledge translation interventions . Results suggest that more evidence -based behaviour may be achieved by influencing beliefs about the positive outcomes of placing fissure sealants and building a habit of placing them as part of patient management . However a number of conceptual and method ological challenges remain This paper describes findings from the Community Youth Development Study ( CYDS ) , a r and omized controlled trial of the Communities That Care ( CTC ) prevention system , on the adoption and implementation fidelity of science-based prevention programming in 24 communities . Data were collected using the Community Re source Documentation ( CRD ) , which entailed a multi-tiered sampling process and phone and web-based surveys with directors of community-based agencies and coalitions , school principals , service providers , and teachers . Four years after the initiation of the CTC prevention system , the results indicated increased use of tested , effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities , and significant differences favoring the intervention communities in the numbers of children and families 
    Output:
    
Results indicate that organization , provider , and innovation-level constructs have the greatest number of measures available for use , whereas structural and patient-level constructs have the least .
Additionally , relatively few measures demonstrated criterion validity , or reliable association with an implementation outcome ( e.g. , fidelity ) .