***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 : Despite the proven survival benefits associated with cervical cancer screening , use of the Pap test continues to be suboptimal in some population subgroups , such as among Korean-American women who face considerable barriers to screening . Therefore , we evaluated a multifaceted intervention that combined psychoeducational counseling with patient navigation to address both psychosocial and access barriers to screening . Method : Women ( n = 102 ) were recruited from Korean community centers and assigned to the intervention or control condition . The intervention group received cervical cancer education and patient navigation delivered by bilingual Korean health educators . The control group received general health education , including information about cervical cancer and screening . Assessment s were obtained at baseline and postintervention . Screening behavior was assessed at 6 months postintervention . Results : At baseline , 17 % of participants reported having had a Pap test in the previous year . At 6 months postintervention , 83 % of women in the intervention group had obtained screening compared with 22 % in the control group , χ2(1 ) = 41.22 , P < 0.001 . Multivariate logistic regression analyses indicated that participation in the intervention was associated with screening ( P < 0.001 ) . Fewer psychosocial barriers ( e.g. , discomfort at having a stranger perform Pap ) and greater self-efficacy were also associated with screening ( P < 0.05 ) . Conclusion : A combined modality intervention that delivers education with patient navigation training and assistance result ed in increased screening rates . Multifaceted approaches may be effective in reducing the psychosocial , access , and language barriers that contribute to cancer health disparities in underserved population s. ( Cancer Epidemiol Biomarkers Prev 2007;16(6):1–5 Objective To explore food perceptions in terms of health among Pakistani immigrant women , and if such perceptions could be altered through a culturally adapted intervention . Methods The study is a culturally adapted lifestyle intervention aim ing at reducing diabetes risk among Pakistani women , Oslo , Norway . There were 198 participants ( 25–62 years ) recruited through a multi-recruitment strategy and r and omly assigned into intervention and control groups . Data were collected through interviews with the help of a structured question naire with open-ended questions . Results Baseline data showed that many women emphasised vegetables ( 87 % ) and fish ( 52 % ) as important in a healthy diet , and perceived that the consumption of sugar ( 66 % ) , oil ( 60 % ) and hard fat ( 39 % ) should be limited . After intervention , there was an increased proportion of women in the intervention group who perceived that consumption of sugar ( p = 0.021 ) and white flour ( p = 0.010 ) should be limited , in line with the emphasis of the intervention . Conclusions Food perceptions in terms of health were generally in line with public dietary advice , however , with large variation among the women . A culturally adapted intervention had the potential to alter such perceptions Background : There are no effective breast cancer education programs targeting Samoan women . We tested the effectiveness of a theory-guided , culturally appropriate breast cancer education program ( the intervention ) design ed to increase mammography use among Samoan women . Methods : This community-based participatory cluster-r and omized controlled intervention trial used a parallel two-group design . The sample consisted of 776 women aged 42 and older who had not had a mammogram in the preceding 2 years . The primary outcome was self-reported mammogram use between pretest and posttest . Results : Overall , there was no statistically significant intervention effect , although the odds of self-reported mammogram use were higher in the intervention than the control group ( odds ratio ( OR ) , 1.26 ; 95 % confidence interval ( 95 % CI ) , 0.74 , 2.14 ; P = 0.39 ) . Exploratory subgroup analyses found that the intervention was effective only among women who were aware of mammograms but had never previously obtained one ( OR , 1.99 ; 95 % CI , 1.03 , 3.85 ; P = 0.04 ) . Low need for social support and lack of endorsement of culture-specific beliefs about breast cancer were associated with mammogram use in this group . In women unaware of mammography at pretest , high perceived susceptibility to breast cancer and endorsement of culture-specific beliefs were associated with mammogram use . For women who had previously obtained a mammogram , lower self-efficacy was associated with mammogram use . Intervention compared with control group women had significantly higher levels of knowledge of risk factors and lower endorsement of culture-specific beliefs at posttest . Conclusions : Results suggest that a multifaceted education intervention may improve mammogram usage for certain subgroups of Samoan women . ( Cancer Epidemiol Biomarkers Prev 2007;16(12):2594–604 Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies Background : In the United States , Korean immigrants experience a disproportionately high burden of chronic hepatitis B ( HBV ) viral infection and associated liver cancer compared with the general population . However , despite clear clinical guidelines , HBV serologic testing among Koreans remains persistently suboptimal . Methods : We conducted a cluster-r and omized trial to evaluate a church-based small group intervention to improve  HBV testing among Koreans in Los Angeles . Fifty-two Korean churches , stratified by size ( small , medium , large ) and location ( Koreatown versus other ) , were r and omized to intervention or control conditions . Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing , and control church participants attended a similar session on physical activity and nutrition . Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews . Results : We recruited 1,123 individuals , 18 to 64 years of age , across the 52 churches . Ninety-two percent of the sample attended the assigned intervention session and 86 % completed the 6-month follow-up . Sample characteristics included were as follows : mean age 46 years , 65 % female , 97 % born in Korea , 69 % completed some college , and 43 % insured . In an intent-to-treat analysis , the intervention produced a statistically significant effect ( OR = 4.9 , P < 0.001 ) , with 19 % of intervention and 6 % of control group participants reporting a HBV test . Conclusion : Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae . Impact : The intervention was fairly re source efficient and thus has high potential for replication in other high-risk Asian groups . Cancer Epidemiol Biomarkers Prev ; 24(9 ) ; 1341–9 . © 2015 AACR This report presents the final evaluation of Language for Health , part of a federally funded initiative to develop heart disease prevention interventions for low-literate population s. Language for Health specifically intervened with recent immigrants enrolled in English-as-a-second- language classes , incorporating nutritional behavior change material s into English- language curricula . Latino participants ( n = 732 ) were exposed to either nutrition education or stress management classes ( attention-placebo group ) design ed specifically for low-English-literate adults . Participants completed physiological measures assessing blood pressure , total and high-density lipoprotein ( HDL ) cholesterol , waist and hip circumference , and weight . Self-report surveys were administered to collect students ’ nutrition-related knowledge , attitudes , self-reported fat avoidance behaviors , and demographic information . Data were collected at baseline , 3-month posttest , and 6-month follow-up . Results indicated long-term effects of the intervention on nutrition knowledge and fat avoidance , yet only short-term effects on total cholesterol : HDL ratio and systolic blood pressure OBJECTIVE Hypertension is known to have high rates among Chinese Americans . Identifying culturally specific interventions to reduce sedentary behavior may be effective in reducing hypertension . This study examines the effects of an 8-week walking program with and without cultural modification . DESIGN The study used a 2-group , pretest and posttest , quasi-experimental design . SAMPLE A total sample of 128 Chinese American immigrants with hypertension were assigned to walking groups . RESULTS The results showed that the walking program had no significant effects upon participant blood pressure or walking endurance . The results also revealed that individuals in the maintenance stage walked longer than those in the preparation stage . A comparison of demographic data showed that subjects with a lower level of education walked more minutes per week , which contributed to lower systolic blood pressures among this group as compared with those with a higher level of education . CONCLUSIONS These results suggest that this walking protocol , when translated into Chinese and when accompanied by a weekly telephone reminder and other interactions with a Chinese-speaking nurse , is appropriate to use without additional cultural modification . Future research should examine other components of Chinese culture or should apply this protocol for a longer period of time Asian communities in North America include large numbers of immigrants with limited English proficiency . Hepatitis B virus ( HBV ) infection is endemic in most Asian countries and , therefore , Asian immigrant groups have high rates of chronic HBV infection . We conducted a group-r and omized trial to evaluate the effectiveness of a hepatitis B English as a second language ( ESL ) educational curriculum for Asian immigrants . Eighty ESL classes were r and omized to experimental ( hepatitis B education ) or control ( physical activity education ) status . Students who reported they had not received a HBV test ( at baseline ) completed a follow-up survey 6 months after r and omization . The follow-up survey assessed recent HBV testing and HBV-related knowledge . Provider reports were used to verify self-reported HBV tests . The study group included 218 students who reported they had not been tested for HBV . Follow-up surveys were completed by 180 ( 83 % ) of these students . Provider records verified HBV testing for 6 % of the experimental group students and 0 % of the control group students ( P = 0.02 ) . Experimental group students were significantly ( P < 0.05 ) more likely than control group students to know that immigrants have high HBV infection rates , HBV can be spread during sexual intercourse and by sharing razors , and HBV infection can cause liver cancer . Our ESL curriculum had a meaningful impact on HBV-related knowledge and a limited impact on HBV testing levels . Future research should evaluate the effectiveness of ESL curricula for other immigrant groups and other health topics , as well as other intervention approaches to increasing levels of HBV testing in Asian immigrant communities Background . Latinas in the United States have higher morbidity and mortality rates for breast and cervical cancers ( compared with non-Latina Whites ) , often due to lower screening rates . A community-based participatory research ( CBPR ) approach could help to improve screening rates by creating a culturally customized educational program for Latino men and women addressing low knowledge , gender roles , and spirituality . Objectives . This study was design ed to assess the effectiveness of a culturally customized program ( Esperanza y Vida [ Hope and Life ] ) in increasing breast and cervical cancer screening among Latinas , and to examine how screening rates related to changes in cancer knowledge , differences in ethnic origins , and geographic location . Methods . Participants were recruited to attend either a breast and cervical ( intervention ) or diabetes ( control ) education program , within a r and omized plan . Sixty-nine programs ( 44 intervention ; 25  control ) were conducted in Arkansas ( AR ; n = 39 ) and New York City ( NYC ; n = 30 ) with a total of 847 Latino men and women . Telephone follow-up data were collected on 49 % of the women who consented to being contacted 2 months postintervention . Results . At the 2-month follow-up call , screening rates were significantly higher for the intervention versus the control group for clinical breast examination  ( CBE ; 48 % vs. 31 % ; adjusted odds ratio [ aOR ] , 2.2 ; 95 % confidence interval [ CI ] , 1.1–4.2 ) ,  breast self-examination ( 45 % vs. 27 % ; aOR , 2.3 ; 95 % CI , 1.1–5.0 ) , and Pap testing ( 51 % vs. 30 % ; aOR , 3.9 ; 95 % CI , 1.1–14.1 ) , but not for mammography ( 67 % vs. 58 % ; aOR , 0.7 ; 95 % CI , 0.1–3.6 ) . The aORs accounted for the significant effects of study site ( AR vs. NYC ) and marital status . Conclusions .Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection OBJECTIVES To compare the tolerance , adherence and effectiveness of two approaches for the treatment of latent tuberculosis infection ( LTBI ) : 6 months of isoniazid ( 6H ) vs. 3 months of isoniazid plus rifampicin ( 3RH ) . POPULATION Immigrants with LTBI . METHODS Participants were enrolled in a controlled , r and omised clinical trial in 
    Output:
    
However , although some associations were found none of the included studies demonstrated the effect of the intervention on reducing inequity .