***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: AIMS Despite widespread prevention efforts to decrease adolescent risk-taking , substance use and driving after drinking ( DD ) are prevalent in the United States . The current study compared the efficacy of an abbreviated version of Drug Abuse and Resistance Education ( DARE-A ) to a new Risk Skills Training Program ( RSTP ) . DESIGN Adolescent participation in drinking , drug use , DD and riding with a drunk driver was examined longitudinally . After baseline assessment s , adolescents were r and omly assigned to the RSTP . DARE-A or a no intervention control group and then completed 2-month post-test and 6-month follow-up assessment s. SETTING Adolescents attended a mid-sized suburban high school . PARTICIPANTS The sample ( N = 300 ) was comprised of 58 % females and the age range was 14 - 19 years . INTERVENTION The RSTP was developed to target several risk behaviors and to examine the feasibility of conducting a brief personalized prevention program in a group setting . DARE-A focused on increasing knowledge and underst and ing the deleterious effects of substance use . MEASUREMENTS Risk-taking behavior , perception of peer risk-taking and positive and negative alcohol expectancies were assessed . FINDINGS RSTP participants decreased participation in several risk behaviors at post-test , but reductions were not maintained at 6-month follow-up . The control and DARE-A groups increased their positive and decreased their negative alcohol expectancies . The control group increased their alcohol consumption . CONCLUSIONS Results suggest that a brief , personalized , group prevention program is a feasible approach to reducing adolescent risk-taking . Strategies must be developed to solidify these positive changes so that they are longer-lasting 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 effectiveness of the universal component of the Fast Track prevention model : the PATHS ( Promoting Alternative THinking Strategies ) curriculum and teacher consultation . This r and omized clinical trial involved 198 intervention and 180 comparison classrooms from neighborhoods with greater than average crime in 4 U.S. locations . In the intervention schools , Grade 1 teachers delivered a 57-lesson social competence intervention focused on  self-control , emotional awareness , peer relations , and problem solving .  Findings indicated significant effects on peer ratings of aggression and hyperactive-disruptive behavior and observer ratings of classroom atmosphere . Quality of implementation predicted variation in assessment s of classroom functioning . The results are discussed in terms of both the efficacy of universal , school-based prevention models and the need to examine comprehensive , multiyear programs Background Violence in families affects children . Exposure to violence is seen as child abuse . Figures show that about one third of children exposed to violence become victim or perpetrator in their adult life : known as intergenerational transmission . Violence also affects sexual and reproductive health . To prevent problems in adult life , children need help and support . However , while trying to protect their parents , children often do not seek help , or perceive the threshold as too high . Since almost all children of the current generation have access to the internet , an online intervention will make help better available for this target group . In 2011 , an internet-based self-support method for children , adolescents and young adults exposed to family violence was developed in the Netherl and s : “ Feel the ViBe ” . The intervention was developed in close collaboration with the target group . This article describes the protocol of the RCT to study the effectiveness of this intervention . Methods / design This study is a r and omized controlled trial using the method of minimization to r and omize the participants in two parallel groups with a 1:1 allocation ratio , being an intervention group , having access to “ Feel the ViBe ” and usual care ( UC ) , and a control group , having access to minimally enhanced usual care ( mEUC ) followed by access to the intervention after twelve weeks . Outcomes are measured with question naires on PTSD symptoms , mental health and sexual and reproductive health . Routine Outcome Measurement ( ROM ) will be used to measure a direct effect of participating in the intervention . Data from a web evaluation question naire ( WEQ ) , user statistics and qualitative analysis of online data will be used to support the findings . To compare results Cohen ’s d effect sizes will be used . Discussion A RCT and process evaluation will test effectiveness and provide information of how the effects can be explained , how the intervention meets the expectation of participants and which possible barriers and facilitators for implementation exist . A qualitative analysis of the data will add information to interpret the quantitative data . This makes “ Feel the ViBe ” unique in its field . Trial registration The Netherl and s National Trial Register ( NTR ) , trial ID NTR3692 BACKGROUND Twenty-four-hour recalls were used to assess the change in nutrient intake among elementary-age school children exposed to the Child and Adolescent Trial for Cardiovascular Health ( CATCH ) . The purpose of this paper is to compare changes in nutrient intakes between treatment groups , sexes , ethnic groups , and the four CATCH sites . METHODS Twenty-four-hour recalls were administered to a sub sample of the CATCH cohort at baseline in third grade and following the intervention in fifth grade ( n = 1,182 ) . Changes in nutrient levels for total energy , dietary cholesterol , and dietary fiber and changes in the proportion of energy from fat , protein , carbohydrate , and fatty acids were studied looking at differences by treatment group , sex , ethnicity , and site . Mixed-model analysis of variance was used to examine the change in nutrient intake , defined as intake at follow-up minus intake at baseline . RESULTS Students in the intervention schools showed statistically significant differences in the changes in total energy and proportion of energy from total fat , saturated fat , protein , and monounsaturated fat compared with students in the control group . Students in the intervention group decreased their total fat intake from 32.7 % of energy to 30.3 % of energy and saturated fat from 12.8 % of energy to 11.4 % of energy . There were no significant differences in intervention effects by ethnic group , sex , or site . Differences in nutrient change between the school-only and the school-plus-family intervention groups were nonsignificant . CONCLUSION The results show that a school-based intervention can positively influence  children 's intakes of total fat and saturated fat , suggesting that population -based approaches for reducing cardiovascular risk factors in children are feasible and effective . The results are also important in showing that the intervention was effective in Caucasian , African-American , and Hispanic students , in boys and girls , and across four regions of the United States The Coping Power program is an indicated prevention program for at-risk aggressive preadolescent children , and has had demonstrated short-term effects on antisocial outcomes . This study provided a longer-term 3-year follow-up for a sample of 245 fourth grade children who had been r and omly assigned to Coping Power or to a care-as-usual Comparison condition .  Intervention took place during the fifth and sixth grade years , at the time of transition to middle school . Growth curve analyses indicate that Coping Power had linear effects through the 3 years after the end of intervention on reductions in children ’s aggressive behavior and academic behavior problems , children ’s expectations that aggression would lead to positive outcomes , and parents ’ lack of supportiveness with their children . Participants ’ homes were geocoded into census tracts , and neighborhood qualities which may have moderated outcomes involved neighborhood disadvantage based on census tract information , and parent-reported social organization of neighborhoods . There was limited support for the hypothesis that intervention effects would be greater in less problematic neighborhoods . Intervention produced the greatest improvement in parental supportiveness for families living in communities with less neighborhood disadvantage , but there were no similar effects for the behavioral and social cognitive outcomes , or in analyses using neighborhood social organization as a moderator . Counter the hypothesis , intervention produced the greatest reduction in children ’s aggression in neighborhoods characterized by poor social organization A population -based r and omized intervention trial for the prevention of conduct problems ( i.e. , oppositional defiant disorder and conduct disorder ) is described . The LIFT ( Linking the Interests of Families and Teachers ) intervention was design ed for all first- and fifth- grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency . The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems . From 12 elementary schools , 671 first and fifth grade rs and their families participated either in the theory-based universal preventive intervention or in a control condition . The intervention consisted of parent training , a classroom-based social skills program , a playground behavioral program , and systematic communication between teachers and parents . A multiple measure assessment strategy was used to evaluate participant satisfaction and participation , fidelity of implementation , and the immediate impacts of the program on targeted antecedents Prevention research continues to focus on school-based substance use programs aim ed at adolescents . These programs are design ed to reduce substance use and risk behavior by targeting key mediators , such as normative beliefs , which in turn reduce substance use .  All Stars is a newly developed program that was recently evaluated in a r and omized field trial in 14 middle schools in Lexington and Louisville , Kentucky . The authors examined targeted and nontargeted variables as possible mediators of program effectiveness . Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators : normative beliefs , lifestyle incongruence , and manifest commitment to not use drugs . The program was not successful when it was delivered by specialists . At least in part , this failure is attributable to specialists ’ inability to change mediators as intended by the program Purpose : This article describes the development , implementation , and effectiveness of 2 interactive websites design ed to support health behavior change around healthy eating , physical activity , smoking , and use of alcohol for primary care patients . Methods : Patients from 6 primary care practice s were recruited and r and omized to a basic website ( including a health assessment with feedback of the results and educational material s about health behavior change ) or an enhanced website that included the features of the basic site plus an action planning component . Patients were prompted to return for follow-up assessment s at 3 and 6 months after enrollment . Results : Of 7706 participants , 169 ( 2.2 % ) targeted for recruitment actually used the website . Both web-based interventions seemed to assist patients with making positive changes in their behavior , especially activity level and healthful diet . There were no significant differences in the effectiveness of the basic and enhanced websites . Conclusions : Interactive behavior-change technology interventions can assist primary care patients and practice s in health behavior change activities . Difficulties with patient recruitment and the lack of added effectiveness of the enhanced website suggest that such interventions work better if integrated into the interaction between primary care clinicians and patients rather than as a st and alone intervention This paper estimates the rate of return to the  High/Scope Perry Preschool Program  , an early intervention program targeted toward disadvantaged African-American youth . Estimates of the rate of return to the Perry program are widely cited to support the cl aim of substantial economic benefits from preschool education programs . Previous studies of the rate of return to this program ignore the compromises that occurred in the r and omization protocol . They do not report st and ard errors . The rates of return estimated in this paper account for these factors . We conduct an extensive analysis of sensitivity to alternative plausible assumptions . Estimated annual social rates of return generally fall between 7 - 10 percent , with most estimates substantially lower than those previously reported in the literature . However , returns are generally statistically significantly different from zero for both males and females and are above the historical return on equity . Estimated benefit-to-cost ratios support this conclusion The current study examined 12-month outcomes for girls enrolled in an implementation trial of Multid 
    Output:
    
Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours , demonstrating that they may be effective in preventing engagement in tobacco use , alcohol use , illicit drug use , and antisocial behaviour , and in improving physical activity among young people , but not in preventing other risk behaviours .
Results of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied .