***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: OBJECTIVE To compare short-term and long-term effectiveness of the Arthritis Self-Help Course ( ASHC ) and the Chronic Disease Self-Management Program ( CDSMP ) for persons with arthritis concerning health care use , health-related quality of life , health behaviors , and arthritis self-efficacy . METHODS Forty-eight workshops were r and omized to the  ASHC ( n = 26 ) or CDSMP ( n = 22 ) . A total of 416 individuals , including 365 African Americans , participated . The mean age for each group was 64 years , mean years of education was 11.7 , mean number of chronic conditions was 4 , and 75 - 80 % of participants in each group were female . Multivariate statistical tests were used to assess effectiveness within and between programs for all workshop participants and African Americans . RESULTS At 4 months all ASHC participants including African Americans , had significant improvements ( P < or= 0.05 ) in self-efficacy , stretching and strengthening exercises , aerobic exercises , and general health . All CDSMP participants had statistically significant improvements in self-efficacy , disability , pain , and general health . African American CDSMP participants showed statistically significant improvements in general health . Trends toward improvement ( P = 0.051 - 0.100 ) were shown in 5 variables among African American CDSMP participants and in 4 variables among all CDSMP participants . Statistically significant differences between the 2 programs at 4 months were seen in pain and disability in both groups . The CDSMP produced stronger results . Significant results at 1 year within and between programs were minimal for both groups . CONCLUSION When population s with arthritis and multiple comorbid conditions are targeted , the CDSMP may be most cost effective Affordable and effective antiretroviral therapy ( ART ) adherence interventions are needed for many patients to promote positive treatment outcomes and prevent viral resistance . We conducted a two-arm r and omized trial ( n = 40 men and women receiving and less than 95 % adherent to ART ) to test a single office session followed by four biweekly cell phone counseling sessions that were grounded in behavioral self-management model of medication adherence using data from phone-based unannounced pill counts to provide feedback-guided adherence strategies . The control condition received usual care and matched office and cell phone/pill count contacts . Participants were baseline assessed and followed with biweekly unannounced pill counts and 4-month from baseline computerized interviews ( 39/40 retained ) . Results showed that the self-regulation counseling delivered by cell phone demonstrated significant improvements in adherence compared to the control condition ; adherence improved from 87 % of pills taken at baseline to 94 % adherence 4 months after baseline , p < 0.01 . The observed effect sizes ranged from moderate ( d = 0.45 ) to large ( d = 0.80 ) . Gains in adherence were paralleled with increased self-efficacy ( p < 0.05 ) and use of behavioral strategies for ART adherence ( p < 0.05 ) . We conclude that the outcomes from this test of concept trial warrant further research on cell phone-delivered self-regulation counseling in a larger and more rigorous trial BACKGROUND Love , Sex , and Choices ( LSC ) is a soap opera video series created to reduce HIV sex risk in women . METHODS LSC was compared to text messages in a r and omized trial in 238 high-risk mostly Black young urban women . 117 received 12-weekly LSC videos , 121 received 12-weekly HIV prevention messages on smartphones . Changes in unprotected sex with high risk partners were compared by mixed models . RESULTS Unprotected sex with high risk men significantly declined over 6 months post-intervention for both arms , from 21 - 22 acts to 5 - 6 ( p < 0.001 ) . This reduction was 18 % greater in the video over the text arm , though this difference was not statistically significant . However , the LSC was highly popular and viewers wanted the series to continue . CONCLUSION This is the first study to report streaming soap opera video episodes to reduce HIV risk on smartphones . LSC holds promise as an Internet intervention that could be scaled-up and combined with HIV testing BACKGROUND People living with human immunodeficiency virus (HIV)/AIDS ( PLWHA ) have a substantially higher prevalence of cigarette smoking compared to the general population . In addition , PLWHA are particularly susceptible to the adverse health effects of smoking . Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA . METHODS Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population . Participants received smoking cessation treatment either through usual care ( UC ) or counseling delivered by a cell phone intervention ( CPI ) . The 7-day point prevalence abstinence was evaluated at 3 , 6 , and 12 months using logistic regression and generalized linear mixed models . RESULTS We r and omized 474 HIV-positive smokers to either the UC or CPI group . When evaluating the overall treatment effect ( 7-day abstinence outcomes from 3- , 6- , and 12-month follow-ups ) , participants in the CPI group were 2.41 times ( P = .049 ) more likely to demonstrate abstinence compared to the UC group . The treatment effect was strongest at the 3-month follow-up ( odds ratio = 4.3 , P < .001 ) , but diminished at 6 and 12 months ( P > .05 ) . CONCLUSIONS Cell phone-delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach . Future research should focus on strategies for sustaining the treatment effect in the long term OBJECTIVES To evaluate the effects of using an audiovisual animation ( i.e. , digital video ) displayed on a personal digital assistant ( PDA ) for patient education in a clinical setting . METHODS Quasi-experimental study of a prospect i ve technology intervention conducted in an outpatient infectious diseases clinic at an academic medical center . Subjects responded to questions immediately before , immediately after , and 4 - 6 weeks after watching a digital video on a PDA . Outcome measures include participant knowledge of disease , knowledge of medications , and knowledge of adherence behaviors ; attitudes toward the video and PDA ; self-reported adherence ; and practicality of the intervention . RESULTS Fifty-one English-speaking adults who were initiating or taking medications for the treatment of HIV/AIDS participated in the study . At visit one , statistically significant improvements in knowledge of disease ( p<0.005 ; paired t-test ) , knowledge of medications ( p<0.005 ; paired t-test ) , and knowledge of adherence behaviors ( p<0.05 ; ANOVA ) were measured after participants watched the PDA-based video . At visit two ( 4 - 6 weeks later ) , statistically significant improvements in self-reported adherence to the medication regimens ( p<0.005 ; paired t-test ) were reported . Participants liked the PDA-based video and indicated that it was an appropriate medium for learning , regardless of their baseline literacy skills . The video education process was estimated to take 25 min of participant time and was viewed in both private and semi-private locations . CONCLUSIONS Technology-assisted education using a digital video delivered via PDA is a convenient and potentially powerful way to deliver health messages . The intervention was implemented efficiently with participants of a variety of ages and educational levels , and in a range of locations within clinical environments . Additional study of this methodology is warranted We describe the development of a two-way text messaging intervention tool for substance users who are non-adherent with HIV medications , and examine message flow data for feasibility and acceptability . The assessment and intervention tool , TxText , is fully automated , sending participants mood , substance use , and medication adherence queries by text message . Participants respond , the tool recognizes the category of response , and sends the personalized intervention message that participants design ed in return . In 10months , the tool sent 16,547 messages ( half initial , half follow-up ) to 31 participants assigned to the TxText condition , who sent 6711 messages in response to the initial messages . Response rates to substance use ( n=2370 ) , medication ( n=2918 ) and mood ( n=4639 ) queries were 67 , 69 , and 64 % , respectively . Responses indicating medication adherence , abstinence from substances , and good moods were more common than negative responses . The TxText tool can send messages daily over a 3month period , receive responses , and decode them to deliver personalized affirming or intervention messages . While we await the outcomes of a pilot r and omized trial , the process analysis shows that TxText is acceptable and feasible for substance abusers with HIV , and may serve as a complement to HIV medical care Chronic hepatitis C ( HCV ) infection afflicts millions of people worldwide . While antiviral treatments are effective for some patients , many either can not or choose not to receive antiviral treatment . Education about behavioural changes like alcohol avoidance and symptom management , in contrast , is universally recommended , particularly in HCV-infected persons from disadvantaged groups where liver risk factors are most prevalent .  Self-management interventions are one option for fostering improved HCV knowledge and health-related quality of life ( HRQOL ) .  One hundred and thirty-two patients with VA with HCV ( mean age of 54.6 , 95 % men , 41 % ethnic minority , 83 % unmarried , 72 % unemployed/disabled , 48 % homeless in last 5 years ) were r and omized to either a 6-week self-management workshop or an information-only intervention . The weekly 2-h self-management sessions were based on cognitive-behavioural principles and were adapted from an existing self-management programme that has been efficacious with other chronic diseases . HCV-specific modules were added . Outcomes including HRQOL , HCV knowledge , self-efficacy , depression , energy and health distress were measured at baseline and 6 weeks later . Data were analysed using ANOVA . When compared to the information-only group , participants attending the self-management workshop improved more on HCV knowledge ( P < 0.001 ) , HCV self-efficacy ( P = 0.011 ) , and SF-36 energy/vitality ( P = 0.040 ) . Similar trends were found for SF-36 physical functioning ( P = 0.055 ) and health distress ( P = 0.055 ) . Attending the self-management programme improved disease knowledge and HRQOL 6 weeks later in this disadvantaged population . The intervention can improve the health of  people with hepatitis C , independent of antiviral therapy . Future research will study longer-term outcomes , effects on antiviral treatment and costs Background : The small-group Chronic Disease Self-Management Program ( CDSMP ) has proven effective in changing health-related behaviors and improving health statuses . An Internet-based CDSMP was developed to reach additional chronic-disease patients . Objectives : We sought to determine the efficacy of the Internet-based CDSMP . Design : We compared r and omized intervention participants with usual-care controls at 1 year . We compared intervention participants with the small-group CDSMP at 1 year . Subjects : Nine-hundred fifty-eight patients with chronic diseases ( heart , lung , or type 2 diabetes ) and Internet and e-mail access were r and omized to intervention ( 457 ) or usual care control ( 501 ) . Measures : Measures included 7 health status variables ( pain , shortness of breath , fatigue , illness intrusiveness , health distress , disability , and self-reported global health ) , 4 health behaviors ( aerobic exercise , stretching and strengthening exercise , practice of stress management , and communication with physicians ) , 3 utilization variables ( physician visits , emergency room visits , and nights in hospital ) , and self-efficacy . Results : At 1 year , the intervention group had significant improvements in health statuses compared with usual care control patients . The intervention group had similar results to the small-group  CDSMP participants . Change in self-efficacy at 6 months was found to be associated with better health status outcomes at 1 year . Conclusions : The Internet-based CDSMP proved effective in improving health statutes by 1 year and is a viable alternative to the small-group Chronic Disease Self Management Program OBJECTIVE Numerous mobile health ( mHealth ) interventions are being developed to aid in management of complex chronic medical conditions . However , the acceptance of mHealth programs by low-income , bilingual population s has not yet been evaluated . The Trial to Examine Text-based mHealth for  Emergency department patients with Diabetes ( TExT-MED ) program is a text message-based mHealth program design ed specifically for re source -poor patients with diabetes . We conducted a prospect i ve proof-of-concept trial to assess satisfaction and preliminary effectiveness of the TExT-MED program . RESEARCH DESIGN AND METHODS A consecutive sample of adult patients in the emergency department with diabetes and a text message-capable mobile phone was enrolled in the TExT-MED program .  Participants received three text messages daily for 3 weeks in English or Spanish in the following domains : educational/motivational , medication reminders , healthy living challenges , diabetes trivia , and links to free diabetes management tools . RESULTS Twenty-three patients with diabetes ( median hemoglobin A1c , 8.9 % ) were enrolled in TExT-MED .  In the week before TExT-MED , 56.5 % of subjects reported eating fruits/vegetables daily versus 83 % after , 43 
    Output:
    
After an extensive search using the PRISMA approach and review ing 450 records ( 411 published studies and 39 ongoing trials at clinical trials.gov ) , we found little completed research that tested mHealth HIV self-management interventions for AA women .