***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: Acquired immunodeficiency syndrome ( AIDS ) continues to be a significant concern for adolescents , especially in minority population s. There is a scarcity of knowledge of the cultural context of sexual behavior in this age group and the influences that lead to early initiation of sex and unsafe sex . Few efforts targeting young adolescents have been community based , although there has been an increased awareness of the need for such research and intervention programs . Four key processes have been defined in gaining community participation in health education programs : ( a ) defining the community and reaching the community ; ( b ) recognizing tensions among service , research , and community participation ; ( c ) involving community residents ; and ( d ) considering cultural differences in a community . These processes are used to describe the " Focus on Kids " project , a human immunodeficiency virus ( HIV ) risk reduction intervention that result ed in significant increases in condom use demonstrated by a r and omized controlled trial To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results OBJECTIVE To test the efficacy of a prevention intervention to reduce sexual risk behavior among Latino adolescents . DESIGN R and omized controlled trial from April 2000 through March 2003 , with data collection before and after intervention and at 3 , 6 , and 12 months . SETTING Northeast Philadelphia schools . PARTICIPANTS Latinos aged 13 through 18 years ( 249 males and 304 females ) ; 81.6 % retained at 12-month follow-up . INTERVENTIONS The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small , mixed-gender groups  in English or Spanish . Main Outcome Measure Self-reported sexual behavior . RESULTS Analyses using generalized estimation equations over the follow-up period revealed that adolescents in the HIV intervention were less likely to report sexual intercourse ( odds ratio , 0.66 ; 95 % confidence interval [ CI ] , 0.46 - 0.96 ) , multiple partners ( odds ratio , 0.53 ; 95 % CI , 0.31 - 0.90 ) , and days of unprotected intercourse ( relative risk , 0.47 ; 95 % CI , 0.26 - 0.84 ) and more likely to report using condoms consistently ( odds ratio , 1.91 ; 95 % CI , 1.24 - 2.93 ) . Baseline sexual experience and language use moderated intervention efficacy . Adolescents assigned to the HIV intervention who were sexually inexperienced at baseline reported fewer days of unprotected sex ( relative risk , 0.22 ; 95 % CI , 0.08 - 0.63 ) ; Spanish speakers were more likely to have used a condom at last intercourse ( odds ratio , 4.73 ; 95 % CI , 1.72 - 12.97 ) and had a greater proportion of protected sex ( mean difference , 0.35 ; P<.01 ) compared with similar adolescents in the health-promotion intervention . CONCLUSION Results provide evidence for the efficacy of HIV intervention in decreasing sexual activity and increasing condom use among Latino adolescents The aim of this project was to conduct an initial evaluation among sexually transmitted disease ( STD ) patients of the psychometric properties of two instruments : the National Institute of Mental Health ( NIMH ) multisite condom use self-efficacy scale and the NIMH multisite condom use outcome expectancy scale . The condom use self-efficacy scale was design ed to measure one 's degree of confidence in various aspects of condom use , whereas the outcome expectancy scale was design ed to measure one 's belief about the consequences of using condoms . Using a sample of 641 patients from five geographically diverse STD clinics in the eastern United States , initial reliability coefficients were computed . The alpha coefficient for the self-efficacy scale was .91 and for the outcome expectancy scale .88 , indicating high internal consistency for both scales . Both scales were analyzed using common factor analytic procedures . Five factors emerged from the analysis of the self-efficacy scale and six factors from the analysis of the outcome expectancy scale . Reliability coefficients for the individual factors ranged from .76 to .86 . Construct validity of each scale was assessed by hypothesis testing . As predicted , participants with higher levels of self-efficacy and more positive outcome expectancies were more likely to use condoms A series of interactive videodisc programs design ed to reduce HIV/STD risk behaviors was developed and evaluated . Separate programs were developed for each of three race/ethnicities ( African American , Hispanic , and Caucasian ) at each of two age levels ( middle school and high school ) using extensive formative procedures . Each program uses scenarios with extensive branching story lines to teach decision-making skills and socially appropriate responses to potentially risky sexual situations . In a r and omized experiment with 827 students , significant changes were observed at posttest for the four constructs assessed : ( 1 ) belief that sex occurs as a result of decisions ( vs. " it just happens " ) , ( 2 ) belief that even a single incident of unprotected sex can result in an STD or pregnancy , ( 3 ) intentions and attitudes toward use of condoms , and ( 4 ) self-efficacy in remaining abstinent ( i.e. , avoiding sex ) . At 30-day follow-up , three of the four measures remained significant OBJECTIVE To determine whether the addition of a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) alone or with " boosters " could enhance ( either broaden or sustain or both ) the effect of a small group , face-to-face adolescent risk reduction intervention Focus on Kids ( FOK ) . METHODS A longitudinal , r and omized , community-based cohort study was conducted of 35 low-income , community-based , in-town setting s. A total of 817 black youths aged 12 to 16 years at baseline were studied . After completion of baseline measures , youths were r and omized to receive a face-to-face intervention alone ( FOK only ) , a face-to-face intervention and a parental monitoring intervention ( FOK plus ImPACT ) , or both of the above plus boosters ( FOK plus ImPACT plus boosters ) .  Risk and protective behaviors were assessed at 6 and 12 months after intervention . RESULTS At 6 months ' follow-up , youths in families that were assigned to FOK plus ImPACT reported significantly lower rates of sexual intercourse , sex without a condom , alcohol use , and cigarette use and marginally lower rates of " risky sexual behavior " compared with youths in families that were assigned to FOK only . At 12 months after intervention , rates of alcohol and marijuana use were significantly lower and cigarette use and overall risk intention were marginally lower among FOK plus ImPACT youths compared with FOK only youths . With regard to the boosters delivered at 7 and 10 months , 2 risk behaviors -- use of crack/cocaine and drug selling -- were significantly lower among the youths who were assigned to receive the additional boosters compared with youths without the boosters . The rates of the other risk behaviors and intentions did not differ significantly . CONCLUSIONS The results of this r and omized , controlled trial indicate that the inclusion of a parental monitoring intervention affords additional protection from involvement in adolescent risk behaviors 6 and 12 months later compared with the provision of an intervention that targets adolescents only . At the same time , the results of the present study do not provide sufficient evidence that booster sessions further improve targeted behaviors enough to include them in a combined parent and youth intervention Few studies have tested schoolwide interventions to reduce sexual risk behavior , and none have demonstrated significant schoolwide effects . This study evaluates the schoolwide effects of Safer Choices , a multicomponent , behavioral theory – based HIV , STD , and pregnancy prevention program , on risk behavior , school climate , and psychosocial variables . Twenty urban high schools were r and omized , and cross-sectional sample s of classes were surveyed at baseline , the end of intervention ( 19 months after baseline ) , and 31 months after baseline . At 19 months , the program had a positive effect on the frequency of sex without a condom . At 31 months , students in Safer Choices schools reported having sexual intercourse without a condom with fewer partners . The program positively affected psychosocial variables and school climate for HIV/STD and pregnancy prevention . The program did not influence the prevalence of recent sexual intercourse . Schoolwide changes in condom use demonstrated that a school-based program can reduce the sexual risk behavior of adolescents BACKGROUND Although numerous interventions have been demonstrated to reduce targeted adolescent risk behaviors for brief periods , sustained behavior changes covering multiple risk behaviors have been elusive . OBJECTIVE To determine whether a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) with and without boosters can further reduce adolescent truancy , substance abuse , and sexual risk behaviors and can alter related perceptions 24 months after intervention among youth who have all received an adolescent risk-reduction intervention ,  Focus on Kids ( FOK ) . DESIGN R and omized , controlled , 3-celled longitudinal trial . SETTING Thirty-five low-income , urban community sites . PARTICIPANTS Eight hundred seventeen African American youth aged 13 to 16 at baseline . Intervention All youth participated in FOK , an 8-session , theory-based , small group , face-to-face risk-reduction intervention , 496 youth and parents received the  1-session ImPACT intervention ( a videotape and discussion ) , 238 of the ImPACT youth also received four 90-minute FOK boosters delivered in small groups . MAIN OUTCOME MEASURES Responses at baseline and 24 months after intervention to a question naire assessing risk and protective behaviors and perceptions . Analyses used General Linear Modeling , intraclass correlation coefficient , analysis of covariance , and multiple comparisons with least significant difference test adjustment . RESULTS After adjusting for the intraclass correlation coefficient , 6 of 16 risk behaviors were significantly reduced ( P < or = .05 ) among youth receiving ImPACT compared with youth who only received FOK ( respectively , mean number of days suspended , 0.65 vs 1.17 ; carry a bat as a weapon , 4.1 % vs 9.6 % ; smoked cigarettes , 12.5 % vs 22.7 % ; used marijuana , 18.3 % vs 26.8 % ; used other illicit drugs , 1.4 % vs 5.6 % ; and , asked sexual partner if condom always used , 77.9 % vs 64.9 % ) . Four of the 7 theory-based subscales reflected significant protective changes among youth who received ImPACT . ImPACT did not produce any significant adverse effects on behaviors or perceptions . CONCLUSION A parent monitoring intervention can significantly broaden and sustain protection beyond that conferred through an adolescent risk-reduction intervention PURPOSE To identify correlates of sexual risk variations among African-American adolescents , and to examine the influence of prior sexual experience on response to a HIV risk-reduction intervention . METHODS Eight hundred seventeen African-American youth aged 13 to 16 years living in and around urban public housing in Baltimore were recruited to participate in a HIV risk-reduction intervention targeting multiple risk behaviors . An instrument design ed to measure three levels of sexual risk ( " abstinent , " " protected sex " [ having sex with a condom ] , and " unprotected sex " [ having sex without a condom ] ) was administered at baseline , 6 months and 12 months postintervention . Multiple regression analyses were conducted to identify predictors of the degree of sexual risk using longitudinal data . Repeated measure analyses were conducted to assess behavioral changes over time among the three groups . RESULTS Data confirmed the co-variation of sexual risk behavior and other problem behaviors among adolescents , cross-sectionally and longitudinally . After exposure to an 8-session risk-reduction intervention , youth engaging in the highest degree of sexual risk demonstrated the greatest reduction in both sexual risk and other risks . These improvements were seen at both 6 months and 12 months postintervention . Youth who were abstinent at baseline maintained the lowest levels in risk involvement throughout the study period when compared with sexually active youth . However , abstinent youth risk involvement significantly increased at 6 months and 12 months after baseline . Youth engaging in protected sex at baseline demonstrated a significant increase in non-condom use and a significant decrease in multiple risk involvement over time . CONCLUSIONS Results support HIV risk-reduction intervention efforts that target multiple risk behaviors . Response of adolescents to the intervention is directly related to the sexual risk behavior at baseline . These data may suggest that the response to risk behavior intervention depends in part on the risk behavior profile of the population to which it is being applied The effect 
    Output:
    
Results showed no evidence that abstinence-plus programs can affect self-reported sexually transmitted infection ( STI ) incidence , and limited evidence that programs can reduce self-reported pregnancy incidence .
Consistently favorable program effects were found for HIV knowledge .
No adverse effects were observed .
Many abstinence-plus programs appear to reduce short-term and long-term HIV risk behavior among youth in high-income countries .
Evidence for program effects on biological measures is limited .
Evaluations consistently show no adverse program effects for any outcomes , including the incidence and frequency of sexual activity .