***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 The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence . The aim of the study was to examine the effectiveness of a 10-week health promotion intervention , followed by a 6-month follow-up period in individuals with mental disorders living in sheltered housing in the Fl and ers region ( Belgium ) . Methods The study had a cluster preference r and omized controlled design . Twenty-five sheltered housing organisations agreed to participate ( 16 in the intervention group , nine in the control group ) . In the intervention group , 225 individuals agreed to participate , while in the control group 99 individuals entered into the study . The main outcomes were changes in body weight , Body Mass Index , waist circumference and fat mass . Secondary outcomes consisted of changes in physical activity levels , eating habits , health-related quality of life and psychiatric symptom severity . Results A significant difference was found between the intervention group and the control group regarding body weight ( −0.35 vs. + 0.22 kg ; p=0.04 ) , Body Mass Index ( −0.12 vs. + 0.08 kg/m2 ; p=0.04 ) , waist circumference ( −0.29 vs. + 0.55 cm ; p<0.01 ) , and fat mass ( −0.99 vs. −0.12 % ; p<0.01 ) . The decrease in these outcomes in the intervention group disappeared during the follow up period , except for fat mass . Within the intervention group , a larger decrease in the primary outcomes was found in the participants who completed the intervention . No significant differences between the two groups in changes in the secondary outcomes were found , except for the pedometer-determined steps/day . In the intervention group , the mean number of daily steps increased , while it decreased in the control group . Conclusions The study demonstrated that small significant improvements in the primary outcomes are possible in individuals with mental disorders .  Integration of health promotion activities targeting physical activity and healthy eating into daily care are , however , necessary to maintain the promising results .Trial registration This study is registered at Clinical Trials.gov Objective : Overweight and obesity are epidemic in population s with serious mental illnesses . We developed and pilot-tested a behavioral weight-loss intervention appropriately tailored for persons with serious mental disorders . Methods : We conducted a single-arm pilot study in two psychiatric rehabilitation day programs in Maryl and , and enrolled 63 overweight or obese adults . The 6-month intervention provided group and individual weight management and group physical activity classes . The primary outcome was weight change from baseline to 6 months . Results : A total of 64 % of those potentially eligible enrolled at the centers . The mean age was 43.7 years ; 56 % were women ; 49 % were white ; and over half had schizophrenia or a schizoaffective disorder . One-third had hypertension and one-fifth had diabetes . In total , 52 ( 82 % ) completed the study ; others were discharged from psychiatric centers before completion of the study . Average attendance across all weight management sessions was 70 % ( 87 % on days participants attended the center ) and 59 % for physical activity classes ( 74 % on days participants attended the center ) . From a baseline mean of 210.9 lbs ( s.d . 43.9 ) , average weight loss for 52 participants was 4.5 lb ( s.d . 12.8 ) ( P<0.014 ) . On average , participants lost 1.9 % of body weight . Mean waist circumference change was 3.1 cm ( s.d . 5.6 ) . Participants on average increased the distance on the 6-minute walk test by 8 % . Conclusion : This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers . The results may have implication s for developing weight-loss interventions in other institutional setting s such as schools or nursing homes Despite the well known mental and physical health benefits of exercise , persons with schizophrenia spectrum disorders remain sedentary . While the exercise barriers ( i.e. , lack of motivation , poor concentration , sedative effects of medication , poverty , and lack of access to exercise education/programs ) of persons with SSDs are numerous , lack of motivation is considered foremost among them . Exercise interventions have been shown to improve exercise behavior , but there is a need for longitudinal documentation of physical activity after interventions conclude . This pilot study describes the physical activity level of 22 persons with SSDs 14 to 34 ( mean 22 ) months after the conclusion of an exercise intervention provided in a r and omized controlled trial ( RCT ) . Eighteen months after the RCT , 22 participants wore  pedometers daily for one week without altering their activity .  Experimental participants walked more steps and covered more distance on average than control participants on six of the seven days . This pilot study is among the first to document the physical activity level of persons with SSDs after exercise intervention . While our findings confirm the low activity level of persons with SSDs reported by others , experimental participants demonstrated higher activity levels than controls on most days . Future studies should increase the sample size and recruit participants from multiple sites to enhance power and generalizability BACKGROUND : Persons with schizophrenia spectrum disorders ( SSDs ) contend with multiple barriers to exercise . Interventions are needed to enhance attitudes theoretically linked to exercise behavior . OBJECTIVE : To examine the effect of Walk , Address Sensations , Learn About Exercise , Cue Exercise for SSDs ( WALC-S ) intervention on exercise self-efficacy ( SEE ) and outcome expectations ( OEES ) in 97 out patients with SSDs . DESIGN : Experimental , pre- and posttest . R and omization to experimental ( WALC-S ) or time- and -attention control ( TAC ) after baseline SEE and OEES measures . Measures repeated after WALC-S or TAC . RESULTS : N = 97 , 46 % female , 43 % African American , average age 46.9 years ( SD = 2.0 ) .  Mean SEE scores were significantly higher in WALC-S participants after intervention , F(1 , 95 ) = 5.92 , p = .0168 , however , mean OEES scores were significantly higher in control participants after intervention , F(1 , 95 ) = 5.76 , p = .0183 . CONCLUSION : This is the first study to examine SEE and OEES in SSDs . Interventions to enhance exercise attitudes  are a critical first step toward the ultimate goal of increasing exercise participation Background There is overwhelming evidence that behavioural factors influence health , but their combined impact on the general population is less well documented . We aim ed to quantify the potential combined impact of four health behaviours on mortality in men and women living in the general community . Methods and Findings We examined the prospect i ve relationship between lifestyle and mortality in a prospect i ve population study of 20,244 men and women aged 45–79 y with no known cardiovascular disease or cancer at baseline survey in 1993–1997 , living in the general community in the United Kingdom , and followed up to 2006 . Participants scored one point for each health behaviour : current non-smoking , not physically inactive , moderate alcohol intake ( 1–14 units a week ) and plasma vitamin C > 50 mmol/l indicating fruit and vegetable intake of at least five servings a day , for a total score ranging from zero to four . After an average 11 y follow-up , the age- , sex- , body mass– , and social class – adjusted relative risks ( 95 % confidence intervals ) for all-cause mortality(1,987 deaths ) for men and women who had three , two , one , and zero compared to four health behaviours were respectively , 1.39 ( 1.21–1.60 ) , 1.95 ( 1.70–-2.25 ) , 2.52 ( 2.13–3.00 ) , and 4.04 ( 2.95–5.54 ) p < 0.001 trend . The relationships were consistent in subgroups stratified by sex , age , body mass index , and social class , and after excluding deaths within 2 y. The trends were strongest for cardiovascular causes . The mortality risk for those with four compared to zero health behaviours was equivalent to being 14 y younger in chronological age . Conclusions Four health behaviours combined predict a 4-fold difference in total mortality in men and women , with an estimated impact equivalent to 14 y in chronological age Background : Increasingly alarmed by the health risks ( that is , weight gain , elevated lipids , and poor glucose tolerance ) posed by novel antipsychotic medications , clinicians who treat schizophrenia are attempting to help patients improve lifestyle factors . Unfortunately , schizophrenia research has neglected exercise as a legitimate adjunctive treatment for schizophrenia . Objective : To assess the extent to which stable patients with schizophrenia would adhere to an exercise program if offered access to a fitness facility . Methods : Ten of 20 stable patients with schizophrenia or schizoaffective disorder who were treated with olanzapine for at least 4 weeks had the opportunity to receive access to a Young Men 's Christian Association ( YMCA ) fitness facility , based on r and om allocation . The intervention included a free membership to the YMCA for 6 months , with access to all the fitness amenities and equipment . The mean dosage of olanzapine was 11.5 mg daily for the YMCA group . Results : Of the 10 subjects , 2 did not attend at all . One subject met criteria for full attendance for each of the 6 months and lost 15 kg . Dropout rates were as follows : 90 % at 6 months , 70 % at 5 months , and 40 % at 4 months . The main reason they gave for poor attendance was lack of motivation . The mean weight gain was 2 kg in the YMCA group . Conclusion : Most subjects did not regularly exercise or attend . They cited poor motivation as the main reason . The subject who exercised regularly lost a significant amount of weight BACKGROUND Depression in elderly people may be contributed to by the multiple losses of aging . Exercise has the potential to positively impact many of these losses simultaneously . We tested the hypothesis that progressive resistance training ( PRT ) would reduce depression while improving physiologic capacity , quality of life , morale , function and self-efficacy without adverse events in an older , significantly depressed population . METHODS We conducted a 10-week r and omized controlled trial of volunteers aged 60 and above with major or minor depression or dysthymia . Subjects were r and omized for 10 weeks to either a supervised PRT program three times a week or an attention-control group . RESULTS A total of 32 subjects aged 60 - 84 , mean age 71.3 + /- 1.2 yr , were r and omized and completed the study . No significant adverse events occurred . Median compliance was 95 % . PRT significantly reduced all depression measures ( Beck Depression Inventory in exercisers 21.3 + /- 1.8 to 9.8 + /- 2.4 versus controls 18.4 + /- 1.7 to 13.8 + /- 2 , p = .002 ; Hamilton Rating Scale of Depression in exercisers 12.3 + /- 0.9 to 5.3 + /- 1.3 versus controls 11.4 + /- 1.0 to 8.9 + /- 1.3 , p = .008 ) . Quality of life subscales of bodily pain ( p = .001 ) , vitality ( p = .002 ) , social functioning ( p = .008 ) , and role emotional ( p = .02 ) were all significantly improved by exercise compared to controls . Strength increased a mean of 33 % + /- 4 % in exercisers and decreased 2 % + /- 2 % in controls ( p < .0001 ) . In a multiple stepwise regression model , intensity of training was a significant independent predictor of decrease in depression scores ( r2 = .617 , p = .0002 ) . CONCLUSIONS PRT is an effective antidepressant in depressed elders , while also improving strength , morale , and quality of life This pilot study examined whether participation in the individualized , community-integrated In SHAPE health promotion program would result in improved physical activity and dietary behaviors , health indicators , and psychological functioning or symptoms in 76 adults with schizophrenia , bipolar disorder , major depression , or other mental disorders . Over a 9-month period , participation was associated with increased exercise , vigorous activity , and leisurely walking ( P < .01 ) , and a trend toward improved readiness to reduce caloric intake ( P = .053 ) . Participants demonstrated a reduction in waist circumference ( P < .05 ) , but no change in BMI . Satisfaction with fitness ( P < .001 ) and mental health functioning ( P < .05 ) improved , and severity of negative symptoms decreased ( P < .01 ) . This study demonstrated the feasibility and potential effectiveness of the In SHAPE program , which consisted of exercise and dietary modification . Based on these promising results , r and omized controlled trials of the In SHAPE program are necessary to establish its effectiveness compared with usual care and alternative approaches to enhancing fitness BACKGROUND Despite various studies , supportive evidence for the efficacy of exercise in treatment of mental illness is still weak . OBJECTIVE The aim of this study was to compare two forms of exercise , namely running therapy ( RT ) and physiotraining therapy ( PT ) , on stationary devices . METHODS Patients in a day treatment programme for treatment of affective disorders  were r and omly allocated to one of the exercise groups or to a control group .  Depression scores , self-efficacy , physical conditions and appreciations of 
    Output:
    
Altogether these studies yielded mixed results with respect to change in motivational constructs .
Due to the exploratory nature of most of these studies , findings from intervention studies do not so far give very clear directions for motivational work with the patients .