***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: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results OBJECTIVES Body and Soul was a collaborative effort among two research universities , a national voluntary agency ( American Cancer Society ) , and the National Institutes of Health to disseminate and evaluate under real-world conditions the impact of previously developed dietary interventions for African Americans . METHODS Body and Soul was constructed from two successful research -based interventions conducted in African-American churches . Components deemed essential from the prior interventions were combined , and then tested in a cluster r and omized-effectiveness trial . The primary outcome was fruit and vegetable intake measured with two types of food frequency question naires  at baseline and 6-month follow-up . RESULTS At the 6-month follow-up , intervention participants showed significantly greater fruit and vegetable ( F&V ) intake relative to controls . Post-test differences were 0.7 and 1.4 servings for the 2-item and 17-item F&V frequency measures , respectively . Statistically significant positive changes in fat intake , motivation to eat F&V , social support , and efficacy to eat F&V were also observed . CONCLUSIONS The results suggest that research -based interventions , delivered collaboratively by community volunteers and a health-related voluntary agency , can be effectively implemented under real-world conditions OBJECTIVES This study assessed the effects of the Black Churches United for Better Health project on increasing fruit and vegetable consumption among rural African American church members in North Carolina . METHODS Ten counties comprising 50 churches were pair matched and r and omly assigned to either intervention or delayed intervention ( no program until after the follow-up survey ) conditions . A multicomponent intervention was conducted over approximately 20 months . A total of 2519 adults ( 77.3 % response rate ) completed both the baseline and 2-year follow-up interviews . RESULTS The 2 study groups consumed similar amounts of fruits and vegetables at baseline . AT the 2-year follow-up , the intervention group consumed 0.85 ( SE = 0.12 ) servings more than the delayed intervention group ( P < .0001 ) . The largest increases were observed among people 66 years or older ( 1 serving ) , those with education beyond high school ( 0.92 servings ) , those widowed or divorced ( 0.96 servings ) , and those attending church frequently ( 1.3 servings ) . The last improvement occurred among those aged 18 to 37 years and those who were single . CONCLUSIONS The project was a successful model for achieving dietary change among rural African Americans BACKGROUND Many question whether mass media , in the absence of other programming , can produce significant and sustained behavior change . METHODS The 1 % Or Less campaign  in Wheeling , West Virginia ( population 35,000 ) , used paid advertising and public relations to encourage members of one community to switch from whole or 2 % milk ( high-fat milk ) to 1 % or fat-free milk ( low-fat milk ) . The study used a quasi-experimental research design with one intervention city and one comparison city . The effectiveness of the campaign was evaluated by collecting milk sales data from supermarkets and conducting pre- and post-intervention telephone surveys in intervention and comparison cities . RESULTS In the intervention city , low-fat milk sales increased from 29 % of overall milk sales before the campaign to 46 % of sales in the month following the campaign . The increase was maintained at the 6-month follow up . According to the telephone surveys , 34.1 % of high-fat-milk drinkers reported switching to low-fat milk in the intervention community compared with 3.6 % in the comparison community ( z = 13.1 , P < 0.0001 ) . CONCLUSIONS A media-only approach was sufficient to encourage a significant proportion of the people in one community to alter the dietary habit targeted by the intervention The purpose of this study was to evaluate the effects of a revised worksite health promotion program that featured an employee steering committee/menu approach to intervention . The “ Take Heart II ” program was evaluated using a quasi-experimental matched-pair design with worksite as the unit of analysis . Experimental and control worksites did not differ on baseline organizational or employee demographic variables or on baseline levels of dependent variables . Outcome and process results revealed consistent , but modest effects favoring intervention worksites on most measures . Cross-sectional analyses generally failed to produce statistically significant intervention effects , but cohort analyses revealed significant beneficial effects of the Take Heart II intervention on eating patterns , behavior change attempts , and perceived social support . Neither analysis detected a beneficial effect of intervention on cholesterol levels Environmental interventions such as labeling and an increased availability of healthy foods may help consumers to meet guidelines for a healthy diet . This article describes a study into the effectiveness of two environmental programs to be used in worksite cafeterias along with an educational program . The aim of the interventions was to reduce fat intake , and to increase fruit and vegetable intake . In the labeling program , low-fat products were labeled . The food supply program comprised an increased availability of low-fat products and fruits and vegetables in worksite cafeterias . The educational program consisted of information about healthy nutrition through brochures , table tents , a self-help manual and posters . The design consisted of a pre-test-post-test experimental control group design , with four conditions : the educational program ; the food supply program plus educational program ; the labeling program plus educational program ; and a control group .  Seventeen worksites were r and omly assigned to one of the four research conditions . Total fat , fruit and vegetable intake was measured with a quantitative , self-administered food frequency question naire ( 35 questions ) . Intake during lunch was measured by asking respondents to write down which food items they had purchased during their last lunch in the cafeteria . Furthermore , sales data for some targeted product categories were collected ( milk , butter , cheese , meat products , desserts ) . For the whole study population , no significant effects on consumption data were found for any of the programs . The data showed a beneficial and significant treatment effect of the labeling program on total fat intake for respondents who believed they ate a high-fat diet . Sales data revealed a significant effect of the labeling program on desserts , but not for the other products BACKGROUND Reducing dietary fat has been identified as a potential means of preventing chronic disease . Several studies have identified methods of changing dietary fat consumption in small , intensive intervention setting s. Fewer studies have examined how to improve dietary habits of individuals in the general public . METHODS The Eating for a Healthy Life ( EHL ) project was a r and omized trial [ n = 40 religious organizations ( ROs ) and 2175 individuals , 1099 in intervention ] . The study tested an intervention package of self-help books , motivational messages , and social interactions design ed to change dietary behaviors ( lowering fat , increasing fruit and vegetable consumption ) among members of religious organizations aged 18 and over . The primary outcomes are fat- and fruit- or vegetable-related behaviors measured using the Fat and Fiber Behavior ( FFB ) Question naire . RESULTS Religious organizations and their members participated fully in the initial study activities . CONCLUSIONS This study will support a rigorous test of the intervention package Abstract Objective : To assess the net 5 year effects of intervention of a community based demonstration project , the Heartbeat Wales programme , on modifiable behavioural risks for prevention of cardiovascular disease . Design and setting : Quasi-experimental design comparing results from two independent cross sectional population surveys conducted in 1985 and 1990 in Wales and a matched reference area in north east Engl and . Subjects : R and om , stratified sample s of people aged 18 - 64 years ( 18 538 in 1985 and 13 045 in 1990 ) in Wales and in north east Engl and ( 1483 and 4534 , respectively ) . Intervention : A coordinated range of activities for heart health promotion in Wales entailing public education campaigns along with supportive policy and infrastructure change . In the reference area no additional community heart health promotion was planned , though considerable activity did take place , “ contaminating ” the reference area . Main outcome measures : Fifteen self reported behavioural indicators relating to dietary choice , smoking , frequency of exercise , and weight . Results : Positive changes ( for health ) in behavioural outcomes were observed among the population in Wales , including a reduction in reported smoking prevalence and improvements in dietary choice . There was no net intervention effect for the programme over and above observed change in the reference area . Conclusions : No definite conclusions can be drawn concerning the efficacy of the programme in terms of behavioural outcomes . With hindsight , the difficulties of evaluating such a complex multifaceted intervention were underestimated . Further debate on the most appropriate methods for assessing the effectiveness of community based health promotion programmes is called for . Key messages Heartbeat Wales was set up in 1985 as a community based programme to demonstrate risk reduction for cardiovascular disease Important changes were observed in modifiable risks for cardiovascular disease in Wales between 1985 and 1990 There was an unexpectedly rapid uptake of heart health promotion activity in the reference area No net intervention effects were found for the programme over and above changes in the reference area Improvements in methods of evaluation for community based health promotion programmes are Objective . The authors tested the impact on cardiovascular risk profiles of African American women ages 40 years and older after one year of participation in one of three church-based nutrition and physical activity strategies : a st and ard behavioral group intervention , the st and ard intervention supplemented with spiritual strategies , or self-help strategies . Methods . Women were screened at baseline and after one year of participation . The authors analyzed intention-to-treat within group and between groups using a generalized estimating equations adjustment for intra-church clustering . Because spiritual strategies were added to the st and ard intervention by participants themselves , the results from both active groups were similar and , thus , combined for comparisons with the self-help group . Results . A total of 529 women from 16 churches enrolled . Intervention participants exhibited significant improvements in body weight ( −1.1 lbs ) , waist circumference ( −0.66 inches ) , systolic blood pressure ( −1.6 mmHg ) , dietary energy ( −117 kcal ) , dietary total fat ( −8 g ) , and sodium intake ( −145 mg ) . The self-help group did not . In the active intervention group , women in the top decile for weight loss at one year had even larger , clinical ly meaningful changes in risk outcomes ( −19.8 lbs ) . Conclusions . Intervention participants achieved clinical ly important improvements in cardiovascular disease risk profiles one year after program initiation , which did not occur in the self-help group . Church-based interventions can significantly benefit the cardiovascular health of African American women BACKGROUND This paper describes the study design , recruitment , measurement , and initial recruitment outcomes of Australia 's largest workplace intervention trial , the National Workplace Health Project . METHODS This was a cluster-r and omized trial of socio-behavioral and environmental interventions focusing on key behaviors of physical activity , healthy food choices , cigarette smoking , and alcohol consumption , as well as motivational readiness for change . Twenty worksites were r and omized separately for each intervention using a two-by-two factorial design . All participants underwent a health risk appraisal and measurements were made at baseline and at 1 and 2 years . RESULTS The overall response rate for the baseline survey was 73 % with 61 % attending the health risk appraisal . The sample was predominantly male , English-speaking , married , blue-collar workers . Overall , 12 % reported unsafe alcohol consumption , 26 % were current smokers , 44 % were physically inactive , 74 % ate at most one piece of fruit per day , and 26 % ate at most one serving of vegetables per day . Intervention and control conditions were similar at baseline for the primary outcomes , except that a higher proportion of the sociobehavioral intervention condition was more physically active ( 59 % ) than the corresponding control condition ( 53 % ) . CONCLUSIONS This study will permit the rigorous evaluation of the efficacy of sociobehavioral and environ mental intervention approaches to workplace health promotion . Although participants were r and omized by worksite , intervention and control conditions were similar at baseline ; any differences in the primary out come variables will be controlled for in the analysis OBJECTIVE The purpose of this study is to assess population -based changes in  vegetable and fruit consumption and psychosocial correlates . DESIGN Two nationally representative r and om digit dial surveys conducted in 1991 and 1997 ; respondents were queried regarding consumption of and attitudes and knowledge about vegetables and fruit . SUBJECTS/ SETTING Respondents were 2,755 and 2,544 adults 
    Output:
    
Interventions which targeted fruit and vegetable intake were most likely to be successful , particularly in worksites and churches .
There was also evidence of small positive effects on reducing fat intake in worksites and churches .
Overall the community-based interventions showed little effect .
Dietary changes are reported in the relatively short-term studies review ed here but may not be sustained in the long term .