***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: The aim was to explore the relationships between degree of participation in a culturally adapted lifestyle intervention and stages of change for healthy eating and weight loss among Pakistani immigrant women in Norway . The intervention lasted 7 months and included 198 women , r and omized into control and intervention groups . The odds of losing weight from baseline to follow-up , and being in action stages of change ( compared to pre-action stages ) with regard to intake of amount and type of fat , sugar and white flour at follow-up , increased significantly with number of group sessions attended . Those in action stage of reducing intake of fat and increasing intake of vegetables , as well as of reducing weight , were significantly more likely than others to have experienced weight loss at follow-up . Participation in the culturally adapted intervention was related to increase in intentions to change dietary behaviours and to weight loss This study explored a community-based after-school program ’s effect on obesity in minority children . Study participants included 178 third through fifth grade rs ( 47 % Latino , 25 % Asian , and 18 % African-American ) enrolled in America SCORES Bay Area . Outcomes were attendance , change in fitness ( 20-meter shuttle test ) , and body mass index ( BMI ) z-score over eight months . At baseline , 52 percent of children were overweight or obese .  Children attended SCORES > 4 days/week and fitness significantly improved ( p < 0.01 ) . BMI z-score decreased by 0.04 ( p = 0.10 ) overall , and by 0.05 ( p = 0.08 ) among obese children , but increased among African-American children . These results suggest that SCORES increases fitness and may improve BMI in some minority children . Effect modification by race may relate to differential growth patterns or engagement in SCORES . These findings suggest community-based programs could effectively address obesity . A r and omized trial of the SCORES program is warranted to rigorously examine this type of after-school program ’s impact on child health Background South Asian migrants are at particularly high risk of type 2 diabetes . Previous studies have shown that intensive lifestyle interventions may prevent the onset of diabetes . Such interventions have not been culturally adapted and evaluated among South Asians in industrialized countries . Therefore , we have set up a r and omized controlled trial to study the effectiveness of a targeted lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old Hindustani Surinamese ( South Asians ) in The Hague , the Netherl and s. Here we present the study design and describe the characteristics of those recruited . Methods Between May 18 , 2009 and October 11 , 2010 , we screened 2307 Hindustani Surinamese ( 18–60 years old ) living in The Hague . We sent invitations to participate to those who had an impaired fasting glucose of 5.6 - 6.9 mmol/l , an impaired glucose tolerance of 7.8 - 11.0 mmol/L , a glycated hemoglobin level of 6.0 % or more and /or a value of 2.39 or more for the homeostasis model assessment of estimated insulin resistance . In total , 536 people ( 56.1 % of those eligible ) participated . People with a higher level of education and a family history of type 2 diabetes were more likely to participate . The control and intervention groups were similar with regard to important background characteristics . The intervention group will receive a culturally targeted intervention consisting of dietary counseling using motivational interviewing and a supervised physical activity program . The control group will receive generic lifestyle advice . To determine the effectiveness , a physical examination ( anthropometrics , cardiorespiratory test , lipid profile , and measures of oral glucose tolerance , glycated hemoglobin , and insulin ) and interview ( physical activity , diet , quality of life , and intermediate outcomes ) were carried out at baseline and will be repeated at 1 year and 2 years . The process and the costs will be evaluated . Discussion This trial will provide insight into the feasibility and effectiveness of a targeted , intensive , lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old South Asians . Trial registration Dutch Trial Register : OBJECTIVE The present study was design ed to assess the impact of intensive and repetitive nutrition education and lifestyle interventions on insulin resistance , β-cell function , disposition index ( DI ) , and sub clinical inflammation in Asian Indian adolescents ( 15 - 17 years ) residing in North India . METHOD In this prospect i ve study , two matched schools were r and omly allocated to the intervention ( n = 56 ; 31 boys and 25 girls ) or control group ( n = 50 ; 30 boys and 20 girls ) . The intervention consisted of seven components : ( 1 ) Dissemination of health-related information through lectures and focused group discussion s , ( 2 ) planning of activities such as quizzes , ( 3 ) individual counseling of students , ( 4 ) promotion of physical activity , ( 5 ) change in the canteen menu to healthier alternatives , ( 6 ) conducting health camps involving parents and teachers , and ( 7 ) training of student volunteers for sustainability of the program in school . Impact of intervention was studied on surrogate markers of insulin resistance , β-cell function , disposition index , and sub clinical inflammation . RESULTS At 6 months follow-up , significantly higher ( P = 0.037 ) mean value of homeostasis model assessment denoting β-cell function ( HOMA-βCF ) was seen in the intervention group compared to the control group , whereas high sensitivity C-reactive protein ( hs-CRP ) was significantly lowered ( P < 0.001 ) . The increase ( 30.3 ± 73.4 ; P < 0.037 ) observed in the DI in adolescents in the intervention group was significantly higher compared to the control group . The Pearson 's coefficient of correlation in the intervention group showed that the Δ-decrease in mean waist circumference was significantly correlated ( r = 0.267 , P < 0.05 ) with Δ-decrease in homeostasis model assessment of insulin resistance ( HOMA-IR ) . CONCLUSION The intervention model developed by us could be used for amelioration of insulin resistance with potential of preventing type 2 diabetes mellitus in Asian Indian adolescents High prevalence of type 2 diabetes ( T2D ) is seen in some immigrant groups in Western countries , particularly in those from the Indian subcontinent . Our aims were to increase the physical activity ( PA ) level  in a group of Pakistani immigrant men , and to see whether any increase was associated with reduced serum glucose and insulin concentrations . The intervention was developed in collaboration with the Pakistani community . It used a social cognitive theory framework and consisted of structured supervised group exercises , group lectures , individual counselling and telephone follow-up .  One- hundred and fifty physically inactive Pakistani immigrant men living in Oslo , Norway , were r and omised to either a control group or an intervention group . The 5-month intervention focused on increasing levels of PA  , which were assessed by use of accelerometer ( Actigraph MTI 7164 ) recordings . Risk of diabetes was assessed by serum glucose and insulin concentrations determined in a fasted state , and after an oral glucose tolerance test ( OGTT ) . ANCOVA was used to assess differences between groups . There was a mean difference in PA between the two groups of 49 counts per minute per day , representing a 15 % ( 95 % CI = 8.7–21.2 ; P = 0.01 ) higher increase in total PA level in the intervention group than in the control group . Insulin values taken 2 h after an OGTT were reduced in the intervention group by 27 % ( 95 % CI = 18.9–35.0 ; P = 0.02 ) more than those in the control group . There were no differences in fasting or postpr and ial glucose values between the groups at the follow-up test . This type of intervention can increase PA and reduce serum insulin in Pakistani immigrant men , thereby presumably reducing their risk of T2D OBJECTIVE Pakistani women in Oslo have high risk of overweight and type 2 diabetes . The objective is to present the effect of an intervention study on Pakistani women 's intentions to change dietary behaviour and changes made in dietary intake . DESIGN The intervention group received culturally adapted lifestyle education , including diet and physical activity . The question naire , applied before and after the 7-month intervention , included FFQ and questions on intentions to change . SETTING Oslo , Norway . SUBJECTS A total of 198 Pakistani women , aged 25 - 63 years , r and omised into control and intervention groups . RESULTS There was a shift in distribution of intentions to change the intake of selected foods in the intervention group after the intervention , result ing in significant differences between the groups . The daily intake of vegetables , fruits and fruit juice had increased ( P = 0.043 ) , and the intake of red meats ( P = 0.001 ) , full fat milk/yoghurt ( P = 0.027 ) and sugar-rich drinks ( P < or= 0.007 ) was reduced in the intervention group . The differences between intervention and control after the intervention were significant for sugar-rich drinks ( P < or= 0.022 ) . More women in the intervention group used olive and rapeseed oil  and fewer used  ' vegetable ' oil  after than before intervention ( P < 0.011 ) . Differences between intervention and control were significant ( P = 0.001 ) for rapeseed oil . Comparing those who attended at least 60 % of the group sessions with the control group result ed in minor changes in these estimates . CONCLUSIONS Culturally adapted education has the potential to change Norwegian-Pakistani women;s intentions to make their diet healthier , and also to induce some beneficial , however modest , self-reported changes in diet Objectives To describe the design and baseline population characteristics of an adapted lifestyle intervention trial aim ed at reducing weight and increasing physical activity in people of Indian and Pakistani origin at high risk of developing type 2 diabetes . Design Cluster , r and omised controlled trial . Setting Community-based in Edinburgh and Glasgow , Scotl and , UK . Participants 156 families , comprising 171 people with impaired glycaemia , and waist sizes ≥90 cm ( men ) and ≥80 cm ( women ) , plus 124 family volunteers . Interventions Families were r and omised into either an intensive intervention of 15 dietitian visits providing lifestyle advice , or a light ( control ) intervention of four visits , over a period of 3 years . Outcome measures The primary outcome is a change in mean weight between baseline and 3 years . Secondary outcomes are changes in waist , hip , body mass index , plasma blood glucose and physical activity . The cost of the intervention will be measured . Qualitative work will seek to underst and factors that motivated participation and retention in the trial and families ’ experience of adhering to the interventions . Results Between July 2007 and October 2009 , 171 people with impaired glycaemia , along with 124 family volunteers , were r and omised . In total , 95 % ( 171/196 ) of eligible participants agreed to proceed to the 3-year trial . Only 13 of the 156 families contained more than one recruit with impaired glycaemia . We have recruited sufficient participants to undertake an adequately powered trial to detect a mean difference in weight of 2.5 kg between the intensive and light intervention groups at the 5 % significance level . Over half the families include family volunteers . The main participants have a mean age of 52 years and 64 % are women . Conclusions Prevention of Diabetes & Obesity in South Asians ( PODOSA ) is one of the first community-based , r and omised lifestyle intervention trials in a UK South Asian population . The main trial results will be su bmi tted for publication during 2013 . Trial registration Current controlled trials IS RCT N25729565 ( http://www.controlled-trials.com/is rct n/ ) Introduction Interventions that make extensive use of theory tend to have larger effects on behaviour . The Intervention Mapping ( IM ) framework incorporates theory into intervention design , implementation and evaluation , and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population . Methods IM was applied as follows : 1 ) Needs assessment of the community and culture ; consideration of evidence -base , policy and practice ; 2 ) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants ( e.g. knowledge , self-efficacy , intention ) ; 3 ) Selection of theory-based methods and practical applications to address barriers to behaviour change ( e.g. , strategies for responsive feeding ) ; 4 ) Design of the intervention by developing evidence -based interactive activities and re sources ( e.g. , visual aids to show babies stomach size ) . The activities were integrated into an existing parenting programme ; 5 ) Adoption and implementation : parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres . Results HAPPY ( Healthy and Active Parenting Programme for Early Years ) is aim ed at overweight and obese pregnant women ( BMI > 25 ) ; consists of 12 × 2.5 hr . sessions ( 6 ante-natal from 24 weeks ; 6 postnatal up to 9 months ) ; it addresses mother ’s diet and physical activity , breast or bottle feeding , infant diet and parental feeding practice s 
    Output:
    
Effective or promising trials include physical activity interventions in South Asian men in Norway and South Asian school-children in the UK .
A home-based , family-orientated diet and physical activity intervention  improved obesity outcomes in South Asian adults in the UK , when adjusted for baseline differences .
Meta-analyses of interventions in children showed no significant difference between intervention and control for body mass index or waist circumference .
Conclusions : Meta- analysis of a limited number of controlled trials found an unclear picture of the effects of interventions on body mass index for South Asian children .
Meta-analyses of a limited number of controlled trials showed significant improvement in weight for adults but no significant differences in body mass index and waist circumference .
One high quality study in South Asian children found that a school-based physical activity intervention that was delivered within the normal school day which was culturally sensitive , was effective .
There is also evidence of culturally appropriate approaches to , and characteristics of , effective interventions in adults which we believe could be transferred and used to develop effective interventions in children