***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 Using peer volunteers as delivery agents may improve translation of evidence -based physical activity promotion programs for older adults . This study examined whether tailored support from older peer volunteers could improve initiation and long-term maintenance of physical activity behavior . METHODS Participants were r and omized to 2 16-week , group-based  programs : ( 1 ) peer-delivered , theory-based support for physical activity behavior change ; or ( 2 ) an intervention typically available in community setting s ( basic education , gym membership , and pedometer for self-monitoring ) , attention-matched with health education .  Moderate-to-vigorous physical activity ( MVPA ) was assessed via daily self-report logs at baseline , at the end of the intervention ( 16 weeks ) , and at follow-up ( 18 months ) , with accelerometry validation ( RT3 ) in a r and om sub sample . RESULTS Seven peer volunteers and 81 sedentary adults were recruited .  Retention at the end of the trial was 85 % and follow-up at 18 months was 61 % . Using intent-to-treat analyses , at 16 weeks , both groups had similar significant improvements in MVPA . At 18 months , the group supplemented with peer support had significantly more MVPA . CONCLUSIONS Trained peer volunteers may enhance long-term maintenance of physical activity gains from a community-based intervention . This approach has great potential to be adapted and delivered inexpensively in community setting Background : Attempts to study the translation of evidence -based physical activity interventions in community setting s are scarce . Purpose : This project was an investigation of whether 13 diverse local lead agencies could effectively implement a choice-based , telephone-assisted physical activity promotion program for older adults based on intervention models proven efficacious in research setting s. Methods : At baseline , participants developed their own physical activity programs through an individualized planning session based on preference , health status , readiness to change , and available community re sources . Thereafter , participants received regular telephone calls over a 1-year period from a trained staff member or volunteer support buddy . Additional program components consisted of health education workshops , newsletters , and group-based physical activities .  Self-report data on caloric expenditure due to all and moderate or greater intensity physical activities were collected from 447 participants ( M age = 68 ± 8.6 years ) . Results : A significant increase ( p ≤ .0001 ) from baseline to midintervention and intervention endpoint was observed for total weekly caloric expenditure ( Mdn change = 644–707 kcal/week ) and moderate or greater weekly caloric expenditure ( Mdn change = 149–265 kcal/week ) , as well as for weekly physical activity duration and frequency . These changes were observed in participants across all sites . Conclusions : The increases in weekly caloric expenditure were commensurate with findings from several previous r and omized clinical trials . The utilization of community agency staff and volunteers receiving basic training to implement essential program components proved feasible . Very favorable levels of program satisfaction expressed by community staff , volunteer support buddies , and participants , combined with the significant increases in physical activity , warrant further dissemination of the intervention model Background Few studies have evaluated how to combine dietary and physical activity ( PA ) interventions to enhance adherence . Purpose We tested how sequential versus simultaneous diet plus PA interventions affected behavior changes . Methods Two hundred participants over age 44 years not meeting national PA and dietary recommendations ( daily fruit and vegetable servings and percent of calories from saturated fat ) were r and omized to one of four 12-month telephone interventions : sequential ( exercise first or diet first ) , simultaneous , or attention control . At 4 months , the other health behavior was added in the sequential arms . Results Ninety-three percent of participants were retained through 12 months . At 4 months , only exercise first improved PA , and only the simultaneous and diet-first interventions  improved dietary variables . At 12 months , mean levels of all behaviors in the simultaneous arm met recommendations , though not in the exercise- and diet-first arms . Conclusions We observed a possible behavioral suppression effect of early dietary intervention on PA that merits investigation Abstract Background Evidence from a limited number of short-term trials indicates the difficulty in achieving population -level improvements in physical activity ( PA ) through community-wide interventions ( CWIs ) . We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster r and omized design . Methods We r and omized 12 communities in Unnan , Japan , to either intervention ( 9 ) or control ( 3 ) . Additionally , intervention communities were r and omly allocated to three subgroups by different PA types promoted . R and omly sample d residents aged 40–79 years responded to the baseline survey ( n = 4414 ; 74 % ) and were followed at 1 , 3 and 5 years ( 78–83 % response rate ) . The intervention was a 5-year CWI using social marketing to promote PA . The primary outcome was a change in recommended levels of PA . Results Compared with control communities , adults achieving recommended levels of PA increased in intervention communities [ adjusted change difference = 4.6 percentage points ( 95 % confidence interval : 0.4 , 8.8 ) ] . The intervention was effective for promoting all types of recommended PAs , i.e. aerobic ( walking , 6.4 % ) , flexibility ( 6.1 % ) and muscle-strengthening activities ( 5.7 % ) . However , a bundled approach , which attempted to promote all forms of PAs above simultaneously , was not effective ( 1.3–3.4 % , P ≥ 0.138 ) . Linear dose – response relationships between the CWI awareness and changes in PA were observed ( P ≤ 0.02 ) . Pain intensity decreased in shoulder ( intervention and control ) and lower back ( intervention only ) but there was little change difference in all musculoskeletal pain outcomes between the groups . Conclusions The 5-year CWI using the focused social marketing strategy increased the population -level of PA Background Prolonged sitting time has been associated with adverse health outcomes . Interventions at work may contribute to reduced sitting . The objective was to test if a multicomponent work-based intervention can reduce sitting time and the number of prolonged sitting periods ( > 30 min ) , increase the number of sit-to-st and transitions and decrease  waist circumference and body fat percentage among office workers . Primary outcomes were : change in sitting time , prolonged sitting periods and sit-to-st and transitions at follow-up 1 month later . Methods At four workplaces , 19 offices ( 317 workers in total ) were cluster r and omized for intervention or control . The intervention included the appointment of local ambassadors , management support , environmental changes , a lecture and a workshop . Sitting time was measured using an ActiGraph GT3X+ fixed on the thigh . Data were processed using Acti4 software providing data on time spent sitting , st and ing and doing other activities . Control participants were instructed to behave as usual . Follow-up measurements were obtained after 1 and 3 months . Results At 1 and 3 months , total sitting time was 71 ( P < 0.001 ) and 48 min ( P < 0.001 ) lower per 8-h workday in the intervention group compared with the control group . At 1 month , the number of prolonged sitting periods was lower ( -0.79/8-h workday , P < 0.001 ) and sit-to-st and transitions were higher ( + 14%/sitting hour , P = 0.001 ) in the intervention compared with the control group . After 3 months , trends persisted . The body fat percentage was lower by 0.61 percentage points ( P = 0.011 ) in the intervention group compared with the control group after 3 months . Conclusions The multicomponent workplace-based intervention was effective in reducing sitting time , prolonged sitting periods and body fat percentage , and in increasing the number of sit-to-st and transitions OBJECTIVE To evaluate the short-term impact of comprehensive community based intervention on physical activity ( PA )  of adults living in the three urban communities of Hangzhou city . METHODS Within the framework of Community Interventions for Health ( CIH ) Program , a community trial was conducted in two urban areas ( Xiacheng district and Gongshu district ) and an urban area(Xihu district)as control , by a parallel comparison and r and om grouping based quasi-experimental design . Two independent question naire-based surveys of cross-sectional sample s in the intervention and comparison areas were used to assess the short-term impact of the intervention program . RESULTS A total of 2016 adults at baseline and 2016 adults at follow-up stages , completed the survey , including 1016 adults from the intervention areas and 1000 from the comparison area . Over the two-year intervention period , the cognitive level on benefits of physical activity in the intervention areas were trending downward . The changes observed in the comparison area did not show statistical significance . Intervention areas showed a statistically significant increase ( 1204 vs. 1386 , P = 0.023 ) in the level of physical activity(metabolic equivalent , MET-minutes/week)compared with the comparison area(918 vs. 924 , P = 0.201 ) . And results remained the same after eliminating the possible effects of age factor . CONCLUSION After a two-year intervention , beneficial changes were noted in the intervention areas with respect to the level of physical activity .  A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou Importance Effective long-term treatments are needed to address the obesity epidemic . Numerous wearable technologies specific to physical activity and diet are available , but it is unclear if these are effective at improving weight loss . Objective To test the hypothesis that , compared with a st and ard behavioral weight loss intervention ( st and ard intervention ) , a technology-enhanced weight loss intervention ( enhanced intervention ) would result in greater weight loss . Design , Setting , Participants R and omized clinical trial conducted at the University of Pittsburgh and enrolling 471 adult participants between October 2010 and October 2012 , with data collection completed by December 2014 . Interventions Participants were placed on a low-calorie diet , prescribed increases in physical activity , and had group counseling sessions . At 6 months , the interventions added telephone counseling sessions , text message prompts , and access to study material s on a website . At 6 months , participants r and omized to the st and ard intervention group initiated self-monitoring of diet and physical activity using a website , and those r and omized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity . Main Outcomes and Measures The primary outcome of weight was measured over 24 months at 6-month intervals , and the primary hypothesis tested the change in weight between 2 groups at 24 months . Secondary outcomes included body composition , fitness , physical activity , and dietary intake . Results Among the 471 participants r and omized ( body mass index [ BMI ] , 25 to < 40 ; age range , 18 - 35 years ; 28.9 % nonwhite , 77.2 % women ) , 470 ( 233 in the st and ard intervention group , 237 in the enhanced intervention group ) initiated the interventions as r and omized , and 74.5 % completed the study . For the enhanced intervention group , mean base line weight was 96.3 kg ( 95 % CI , 94.2 - 98.5 ) and 24-month weight 92.8 kg ( 95 % CI , 90.6- 95.0 ) [ corrected ] . For the st and ard intervention group , mean baseline weight was 95.2 kg ( 95%CI,93.0 - 97.3 ) and 24-month weight was 89.3 kg ( 95%CI , 87.1 - 91.5 ) [ corrected ] . Weight change at 24 months differed significantly by intervention group ( estimated mean weight loss , 3.5 kg [ 95 % CI , 2.6 - 4.5 } in the enhanced intervention group and 5.9 kg [ 95 % CI , 5.0 - 6.8 ] in the st and ard intervention group ; difference , 2.4 kg [ 95 % CI , 1.0 - 3.7 ] ; P = .002 ) . Both groups had significant improvements in body composition , fitness , physical activity , and diet , with no significant difference between groups . Conclusions and Relevance Among young adults with a BMI between 25 and less than 40 , the addition of a wearable technology device to a st and ard behavioral intervention result ed in less weight loss over 24 months . Devices that monitor and provide feedback on physical activity may not offer an advantage over st and ard behavioral weight loss approaches . Trial Registration clinical trials.gov Identifier : NCT01131871 OBJECTIVE Older adults have low rates of physical activity participation , but respond positively to telephone-mediated support programs . Programs are often limited by reliance on professional staff . This study tested telephone-based physical activity advice delivered by professional staff versus trained volunteer peer mentors . DESIGN A 12-month , r and omized , controlled clinical trial was executed from 2003 - 2008 . Twelve volunteer peer mentors and 181 initially inactive adults ages 50 years and older were recruited from the San Francisco Bay Area . Participants were r and omized to : ( 1 ) telephone-based physical activity advice delivered by professional staff , ( 2 ) telephone-based physical activity advice delivered by trained volunteer peers , or ( 3 ) an attention-control arm of staff-delivered telephone support for nutrition . MAIN OUTCOME MEASURES Moderate-intensity or more vigorous physical activity ( MVPA ) was assessed at baseline , 6 , and 12 
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Results Effective physical activity promotion strategies were identified at each level of impact , including those based on behavior change theories and those occurring at different setting s throughout the community .
A range of built environment features were associated with more transit-based and recreational physical activity in children and adults .
Effective sedentary reduction  interventions were found for youth and in the workplace .
Conclusions A promising number of interventions with demonstrated effectiveness were identified .