***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: BACKGROUND Seeking screening and treatment for chlamydia ( CT ) and gonorrhea ( GC ) by young women is critical to reduction of asymptomatic cervicitis and its complications . OBJECTIVES To evaluate the efficacy of a client-centered motivational behavioral intervention ( MBI ) , to promote seeking of  sexually tranmitted infection ( STI ) checkups by young women . METHODS Three hundred seventy-six of 770 eligible sexually active , nonpregnant , English-speaking women ( mean age 18.5 years ) were recruited from an urban reproductive health clinic and r and omized to two groups : intervention plus st and ard care ( MBI ) or st and ard care alone ( SC ) . MBI ( two sessions plus booster ) was based on the Transtheoretical Model of Change and employed motivational interviewing . Outcome measures monitored for 12 months included : client-initiated clinic visits for STI checkups in response to seven high-risk sexual behaviors by self-report ( primary ) , consistent condom use , number of CT and GC episodes , and movement along the stages of change obtained at baseline and 6- and 12-month follow-up assessment s ( secondary ) . Analyses included chi-square , logistic regression , and generalized estimating equations . RESULTS At baseline , more than 70 % endorsed the action stage of change for seeking STI checkups for three of seven high-risk sexual behaviors . No significant differences were noted between the two groups for the primary or secondary outcomes . Across groups , having multiple partners and being pregnant or thinking one might be pregnant were associated with STI checkups . CONCLUSIONS This is the first known client-centered clinical trial to promote STI screening . Risk-taking and health-seeking behaviors are complex and interrelated with STI and pregnancy concerns . The intervention may have an effect if it is targeted to women in a less medically connected community-based sample The goal of evidence -based medicine is ultimately to improve patient outcomes and quality of care .  Systematic review s of the available published evidence are required to identify interventions that lead to improvements in behavior , health , and well-being . Authoritative literature review s depend on the quality of published research and research reports . The Consoli date d St and ards for Reporting Trials ( CONSORT ) Statement ( www.consort-statement.org ) was developed to improve the design and reporting of interventions involving r and omized clinical trials ( RCTs ) in medical journals . We describe the 22 CONSORT guidelines and explain their application to behavioral medicine research and to evidence -based practice . Additional behavioral medicine-specific guidelines ( e.g. , treatment adherence ) are also presented . Use of these guidelines by clinicians , educators , policymakers , and research ers who design , report , and evaluate or review RCTs will strengthen the research itself and accelerate efforts to apply behavioral medicine research to improve the processes and outcomes of behavioral medicine practice Background As HIV infection continues unabated , there is a need for effective interventions targeting at-risk men who have sex with men ( MSM ) . Engaging MSM online where they meet sexual partners is critical for HIV prevention efforts . Methods A r and omized controlled trial ( RCT ) conducted online among U.S. MSM recruited from several gay sexual networking websites assessed the impact of 2 HIV prevention videos and an HIV prevention webpage compared to a control condition for the study outcomes HIV testing , serostatus disclosure , and unprotected anal intercourse ( UAI ) at 60-day follow-up . Video conditions were pooled due to reduced power from low retention ( 53 % , n = 1,631 ) . No participant incentives were provided . Principal Findings Follow-up was completed by 1,631 ( 53 % ) of 3,092 eligible men . In the 60 days after the intervention , men in the pooled video condition were significantly more likely than men in the control to report full serostatus disclosure ( ‘ asked and told ’ ) with their last sexual partner ( OR 1.32 , 95 % CI 1.01–1.74 ) . Comparing baseline to follow-up , HIV-negative men in the pooled video ( OR 0.70 , 95 % CI 0.54–0.91 ) and webpage condition ( OR 0.43 , 95 % CI 0.25–0.72 ) significantly reduced UAI at follow-up . HIV-positive men in the pooled video condition significantly reduced UAI ( OR 0.38 , 95 % CI 0.20–0.67 ) and serodiscordant UAI ( OR 0.53 , 95 % CI 0.28–0.96 ) at follow-up . Conclusions / Significance Findings from this online RCT of MSM recruited from sexual networking websites suggest that a low cost , brief digital media intervention design ed to engage critical thinking can increase HIV disclosure to sexual partners and decrease sexual risk . Effective , brief HIV prevention interventions featuring digital media that are made widely available may serve as a complementary part of an overall behavioral and biomedical strategy for reducing sexual risk by addressing the specific needs and circumstances of the target population , and by changing individual knowledge , motivations , and community norms . Trial Registration Clinical Trials.gov Background : HIV counseling prevents sexually transmitted diseases ( STDs ) , with most of the benefit accumulating in the first 6 months . Study : The authors conducted a multicenter , r and omized , controlled trial of a 20-minute additional ( booster ) counseling session 6 months after HIV counseling compared with no additional counseling for prevention of STDs ( gonorrhea , chlamydia , trichomoniasis ) . Participants were 15- to 39-year-old STD clinic patients in Denver , Long Beach , and Newark . Results : Booster counseling was completed by 1120 ( 67.8 % ) of 1653 assigned to receive it . An incident STD during the 6 to 12 months after initial counseling ( and within the 6 months after scheduled booster counseling ) was detected in 141 of 1653 ( 8.5 % ) participants in the booster counseling group and 144 of 1644 ( 8.8 % ) in the no-booster group ( relative risk , 0.97 ; 95 % confidence interval , 0.78–1.22 ) . Three months after booster counseling , sexual risk behaviors were reported less frequently by the booster group than the no-booster group . Conclusions : Booster counseling 6 months after HIV testing and counseling reduced reported sexual risk behavior but did not prevent STDs The performance of a predictive model is overestimated when simply determined on the sample of subjects that was used to construct the model . Several internal validation methods are available that aim to provide a more accurate estimate of model performance in new subjects . We evaluated several variants of split- sample , cross-validation and bootstrapping methods with a logistic regression model that included eight predictors for  30-day mortality after an acute myocardial infa rct ion . R and om sample s with a size between n = 572 and n = 9165 were drawn from a large data set ( GUSTO-I ; n = 40,830 ; 2851 deaths ) to reflect modeling in data sets with between 5 and 80 events per variable . Independent performance was determined on the remaining subjects . Performance measures included discriminative ability , calibration and overall accuracy . We found that split- sample analyses gave overly pessimistic estimates of performance , with large variability . Cross-validation on 10 % of the sample had low bias and low variability , but was not suitable for all performance measures . Internal validity could best be estimated with bootstrapping , which provided stable estimates with low bias . We conclude that split- sample validation is inefficient , and recommend bootstrapping for estimation of internal validity of a predictive logistic regression model Background Sexually transmitted disease ( STD ) prevention remains a public health priority . Simple , practical interventions to reduce STD incidence that can be easily and inexpensively administered in high-volume clinical setting s are needed . We evaluated whether a brief video , which contained STD prevention messages targeted to all patients in the waiting room , reduced acquisition of new infections after that clinic visit . Methods and Findings In a controlled trial among patients attending three publicly funded STD clinics ( one in each of three US cities ) from December 2003 to August 2005 , all patients ( n = 38,635 ) were systematic ally assigned to either a theory-based 23-min video depicting couples overcoming barriers to safer sexual behaviors , or the st and ard waiting room environment . Condition assignment alternated every 4 wk and was determined by which condition ( intervention or control ) was in place in the clinic waiting room during the patient 's first visit within the study period . An intent-to-treat analysis was used to compare STD incidence between intervention and control patients . The primary endpoint was time to diagnosis of incident laboratory-confirmed infections ( gonorrhea , chlamydia , trichomoniasis , syphilis , and HIV ) , as identified through review of medical records and county STD surveillance registries . During 14.8 mo ( average ) of follow-up , 2,042 patients ( 5.3 % ) were diagnosed with incident STD ( 4.9 % , intervention condition ; 5.7 % , control condition ) . In survival analysis , patients assigned to the intervention condition had significantly fewer STDs compared with the control condition ( hazard ratio [ HR ] , 0.91 ; 95 % confidence interval [ CI ] , 0.84 to 0.99 ) . Conclusions Showing a brief video in STD clinic waiting rooms reduced new infections nearly 10 % overall in three clinics . This simple , low-intensity intervention may be appropriate for adoption by clinics that serve similar patient population s. Trial registration : http://www . Clinical Trials.gov ( # NCT00137670 ) OBJECTIVE To determine the effect of an individualized safer sex intervention on condom use and recurrent sexually transmitted disease ( STD ) among female adolescents diagnosed as having an STD . DESIGN R and omized controlled trial . SETTING Urban children 's hospital adolescent clinic and inpatient service . PARTICIPANTS One hundred twenty-three adolescents with cervicitis or pelvic inflammatory disease . INTERVENTION Participants completed a question naire and then were r and omized to receive st and ard STD education or to watch a videotape and have an individualized intervention session . Follow-up question naires were completed at 1 , 3 , 6 , and 12 months . Intervention participants met with an educator at 1 , 3 , and 6 months to discuss interim sexual history and review the intervention . MAIN OUTCOME MEASURES Change in self-reported condom use and recurrence of STD . Other self-reported behaviors , sexual risk knowledge , attitudes toward condoms , and condom use negotiation skills were also assessed . RESULTS At 1 month , compared with control participants , intervention participants had increased sexual risk knowledge and more positive attitudes toward condoms and tended to use condoms more with a nonmain partner . At 6 months , fewer intervention participants than controls had sex with a nonmain sexual partner in the previous 6 months . At 12 months , intervention participants were less likely to have a current main partner and had a lower rate of recurrent STD than controls , but these differences were not significant . CONCLUSIONS This individualized safer sex intervention may improve condom use and decrease the number of partners among adolescent girls who have had an STD . Studies with larger sample s are needed to determine definitive intervention effects on recurrent STD in this high-risk population Background Chlamydia infection is the most common notifiable sexually transmitted infection ( STI ) in Australia and mostly affects young people ( 15 – 25 years ) . This paper presents baseline data from a r and omised controlled trial that aim ed to increase chlamydia testing among sexually active young people . The objectives were to identify associations between sexual behaviour , substance use and STI history and explore attitudes to chlamydia testing . Methods This study was conducted in cyberspace . Study recruitment , allocation , delivery of interventions and baseline and follow up data collection all took place online . Participants were 16 – 25 years old and resided in Australia . Substance use correlates of sexual activity ; predictors of history of STIs ; barriers to and facilitators of chlamydia testing were analysed . Results Of 856 participants ( 79.1 % female ) , 704 had experienced penetrative intercourse .  Sexually active participants were more likely to smoke regularly or daily , to drink alcohol , or to have binge drunk or used marijuana or other illicit substances recently . Risk factors for having a history of any STI were 3 or more sexual partners ever , 6 or more partners in the past 12 months , condom non-use and being 20 years or older . Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it . Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours . Where one health risk behaviour is identified , it is important to seek information about others . Chlamydia testing can be facilitated by doctors and nurses recommending it . Primary care providers have a useful role in chlamydia control . Trial Registration Australian and New Zeal and Trials Registry Objectives Chlamydia notifications have been rising in Australia for over a decade and are highest in young people . This study aim ed to evaluate the impact of an internet-based intervention on chlamydia testing among young people 16–25 years . Methods In this r and omised controlled trial , recruitment , data collection , study interventions and follow-up occurred entirely in cyberspace , facilitated by a website . Eligible participants were aged 16–25 years and resided in Australia . The intervention group received personalised emails inviting interaction about chlamydia testing , while the control group received regular impersonal emails . Primary outcome was self-reported chlamydia testing at 6- 
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Several barriers were found to intervention implementation , including a lack of trained staff time and clinic space .
The intervention package was theoretically acceptable , but we observed poor engagement .