***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 evaluate the effect of the middle and junior high school Drug Abuse Resistance Education ( D.A.R.E. ) and D.A.R.E. Plus programs on drug use and violence . DESIGN R and omized controlled trial of 24 schools , with 3 conditions : D.A.R.E. only , D.A.R.E. Plus , and delayed program control . SETTING Schools and neighborhoods , primarily in Minneapolis-St Paul . PARTICIPANTS All seventh- grade students in 24 schools in the academic year 1999 - 2000 ( N = 6237 at baseline , 67.3 % were white , and there was 84.0 % retention at final follow-up ) . INTERVENTIONS The middle and junior high school D.A.R.E. curriculum in the 16 schools that received D.A.R.E. only and D.A.R.E. Plus . In the 8 schoolts that received D.A.R.E. Plus , additional components included a peer-led parental involvement classroom program called " On the VERGE , " youth-led extracurricular activities , community adult action teams , and postcard mailings to parents . The interventions were implemented during 2 school years , when the cohort was in the seventh and eighth grade s. MAIN OUTCOME MEASURES Self-reported tobacco , alcohol , and marijuana use ; multidrug use ; violence ; and victimization , assessed at the beginning and end of seventh grade and at the end of eighth grade . Growth curve analytic methods were used to assess changes over time by condition . RESULTS There were no significant differences between D.A.R.E. only and the controls ; significant differences among boys between D.A.R.E. Plus and controls for tobacco , alcohol , and multidrug use and victimization ; significant differences among boys between D.A.R.E. Plus and D.A.R.E. only in tobacco use and violence ; and no significant behavioral differences among girls . CONCLUSION D.A.R.E. Plus significantly enhanced the effectiveness of the D.A.R.E. curriculum among boys and was more effective than the delayed program controls , underscoring the potential for multiyear , multicomponent prevention programs and demonstrating sex differences in response to intervention programs This study examined the effects of the  Iowa Strengthening Families Program ( ISFP ) and the Preparing for the Drug-Free Years program ( PDFY ) on young adolescent transitions from nonuse of substances to initiation and progression of substance use . Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents . Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses . Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up . Also at this follow-up , the PDFY showed effects on delayed progression of use among those previously reporting initiation This article review s major risk factors for cigarette smoking , alcohol , and other drug abuse and promising community-based approaches to primary prevention . In a longitudinal experimental study , 8 representative Kansas City communities were assigned r and omly to program ( school , parent , mass media , and community organization ) and control ( mass media and community organization only ) conditions . Programs were delivered at either 6th or 7th grade , and panels were followed through Grade 9 or 10 . The primary findings were ( a ) significant reductions at 3 years in tobacco and marijuana use and ( b ) equivalent reductions for youth at different levels of risk . This study provides evidence that a comprehensive community program-based approach can prevent the onset of substance abuse and that the benefits are experienced equally by youth at high and low risk BACKGROUND Interventions design ed to prevent tobacco and alcohol use targeting high-risk adolescents are limited . In addition , few studies have attempted to improve parent-child communication skills as a way of improving and maintaining healthy youth decision-making . METHODS A total of 660 Hispanic migrant families participated in a r and omized pre-post control group study that was utilized to determine the impact of the intervention on parent-child communication . Both treatment and attention-control groups of youth were exposed to an eight-session culturally sensitive program presented by bilingual/bicultural college students . Parents jointly attended three of the eight sessions and participated in helping their child complete homework assignments supporting the content of each session . The content of the treatment intervention included ( 1 ) information about tobacco and alcohol effects , ( 2 ) social skills training ( i.e. , refusal skills ) , and ( 3 ) the specific development of parent-child communication skills to support healthy youth decisions . RESULTS Significant intervention by household size interactions for both parent and youth perceptions of communication were found indicating that the treatment was effective in increasing communication in families with fewer children . Based on the effect size and the previously established relationship between communication and susceptibility to tobacco and alcohol use , it was determined that the intervention effect could be translated into a future 5 to 10 % decrease in susceptibility for these smaller families . CONCLUSIONS A culturally sensitive family-based intervention for migrant Hispanic youth was found to be effective in increasing perceived parent-child communication in families with fewer children . It is expected that increases in this important protective factor will lead to later observed decreases in tobacco and alcohol use Introduction Motivational interviewing techniques have been minimally research ed as a function of a teenage smoking intervention . The present study examined the efficacy of a theory-based motivational tobacco intervention ( MTI ) . Methods A r and omized two-group design was used to compare 6-month post-baseline quit and reduction rates among teenagers who received the MTI  with those who received brief advice or care as usual .  Participants were smokers aged 14 to 19 years ( N = 75 ) who presented for treatment in a university-affiliated hospital emergency department ( ED ) .  Motivational interviewing techniques were used by trained providers to facilitate individual change ; stage-based take-home material s also were provided . Results Similar to past clinic-based studies of motivational interviewing with teenage smokers , our study found negative results in terms of intervention efficacy for cessation . Six-month follow-up cessation rates were nonsignificant — two teenagers quit smoking . Among teenagers who were available at follow-up , a medium effect size ( Cohen 's h = .38 ) was found for reduction and a large effect size ( Cohen 's h = .69 ) was found for percentage reduction , although these results also were not statistically significant . Conclusion Although the major findings of this study were not significant , the reductions in tobacco use suggest that motivational interviewing may be a clinical ly relevant counseling model for use in teenage smoking interventions . However , many questions remain , and the current literature lacks studies on trials with significant outcomes using motivational interviewing in smoking cessation . Additionally , more research is needed to examine the suitability of the ED for MTI-type interventions Background A strong increase in smoking is noted especially among adolescents . In the Netherl and s , about 5 % of all 10-year olds , 25 % of all 13-year olds and 62 % of all 17-year olds report ever smoking . In the U.S. , an intervention program called ' Smoke-free Kids ' was developed to prevent children from smoking . The present study aims to assess the effects of this home-based smoking prevention program in the Netherl and s. Methods / Design A r and omized controlled trial is conducted among 9 to 11-year old children of primary schools . Participants are r and omly assigned to the intervention and control conditions . The intervention program consists of five printed activity modules design ed to improve parenting skills specific to smoking prevention and parent-child communication regarding smoking . These modules will include additional sheets with communication tips . The modules for the control condition will include solely information on smoking and tobacco use . Initiation of cigarette smoking ( first instance of puffing on a lighted cigarette ) , susceptibility to cigarette smoking , smoking-related cognitions , and anti-smoking socialization will be the outcome measures . To collect the data , telephone interviews with mothers as well as with their child will be conducted at baseline . Only the children will be examined at post-intervention follow-ups ( 6 , 12 , 24 , and 36 months after the baseline ) . Discussion This study protocol describes the design of a r and omized controlled trial that will evaluate the effectiveness of a home-based smoking prevention program . We expect that a significantly lower number of children will start smoking in the intervention condition compared to control condition as a direct result of this intervention . If the program is effective , it is applicable in daily live , which will facilitate implementation of the prevention protocol .Trial registration Netherl and s Trial Register OBJECTIVE To determine whether the addition of a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) alone or with " boosters " could enhance ( either broaden or sustain or both ) the effect of a small group , face-to-face adolescent risk reduction intervention Focus on Kids ( FOK ) . METHODS A longitudinal , r and omized , community-based cohort study was conducted of 35 low-income , community-based , in-town setting s. A total of 817 black youths aged 12 to 16 years at baseline were studied . After completion of baseline measures , youths were r and omized to receive a face-to-face intervention alone ( FOK only ) , a face-to-face intervention and a parental monitoring intervention ( FOK plus ImPACT ) , or both of the above plus boosters ( FOK plus ImPACT plus boosters ) .  Risk and protective behaviors were assessed at 6 and 12 months after intervention . RESULTS At 6 months ' follow-up , youths in families that were assigned to FOK plus ImPACT reported significantly lower rates of sexual intercourse , sex without a condom , alcohol use , and cigarette use and marginally lower rates of " risky sexual behavior " compared with youths in families that were assigned to FOK only . At 12 months after intervention , rates of alcohol and marijuana use were significantly lower and cigarette use and overall risk intention were marginally lower among FOK plus ImPACT youths compared with FOK only youths . With regard to the boosters delivered at 7 and 10 months , 2 risk behaviors -- use of crack/cocaine and drug selling -- were significantly lower among the youths who were assigned to receive the additional boosters compared with youths without the boosters . The rates of the other risk behaviors and intentions did not differ significantly . CONCLUSIONS The results of this r and omized , controlled trial indicate that the inclusion of a parental monitoring intervention affords additional protection from involvement in adolescent risk behaviors 6 and 12 months later compared with the provision of an intervention that targets adolescents only . At the same time , the results of the present study do not provide sufficient evidence that booster sessions further improve targeted behaviors enough to include them in a combined parent and youth intervention BACKGROUND Although numerous interventions have been demonstrated to reduce targeted adolescent risk behaviors for brief periods , sustained behavior changes covering multiple risk behaviors have been elusive . OBJECTIVE To determine whether a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) with and without boosters can further reduce adolescent truancy , substance abuse , and sexual risk behaviors and can alter related perceptions 24 months after intervention among youth who have all received an adolescent risk-reduction intervention ,  Focus on Kids ( FOK ) . DESIGN R and omized , controlled , 3-celled longitudinal trial . SETTING Thirty-five low-income , urban community sites . PARTICIPANTS Eight hundred seventeen African American youth aged 13 to 16 at baseline . Intervention All youth participated in FOK , an 8-session , theory-based , small group , face-to-face risk-reduction intervention , 496 youth and parents received the  1-session ImPACT intervention ( a videotape and discussion ) , 238 of the ImPACT youth also received four 90-minute FOK boosters delivered in small groups . MAIN OUTCOME MEASURES Responses at baseline and 24 months after intervention to a question naire assessing risk and protective behaviors and perceptions . Analyses used General Linear Modeling , intraclass correlation coefficient , analysis of covariance , and multiple comparisons with least significant difference test adjustment . RESULTS After adjusting for the intraclass correlation coefficient , 6 of 16 risk behaviors were significantly reduced ( P < or = .05 ) among youth receiving ImPACT compared with youth who only received FOK ( respectively , mean number of days suspended , 0.65 vs 1.17 ; carry a bat as a weapon , 4.1 % vs 9.6 % ; smoked cigarettes , 12.5 % vs 22.7 % ; used marijuana , 18.3 % vs 26.8 % ; used other illicit drugs , 1.4 % vs 5.6 % ; and , asked sexual partner if condom always used , 77.9 % vs 64.9 % ) . Four of the 7 theory-based subscales reflected significant protective changes among youth who received ImPACT . ImPACT did not produce any significant adverse effects on behaviors or perceptions . CONCLUSION A parent monitoring intervention can significantly broaden and sustain protection beyond that conferred through an adolescent risk-reduction intervention This study reports findings on a combined family and school-based competency-training intervention from an in-school assessment 2.5 years past baseline , as a follow-up to an earlier study of substance initiation . Increased rates of observed alcohol use and an additional wave of data allowed evaluation of regular alcohol use and weekly drunkenness , with both point-in-time and growth curve analyses . Thirty-six rural schools were r and omly assigned to ( a ) a combined family and school intervention condition , ( b ) a school-only condition , or ( c ) a control condition . The earlier significant outcome on a substance initiation index was replicated , and positive point-in-time results for weekly drunken 
    Output:
    
Some well-executed RCTs show family interventions may prevent adolescent smoking , but RCTs which were less well executed had mostly neutral or negative results .