***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: Background : Patient navigation has been an effective intervention to increase cancer screening rates . This study focuses on predicting outcomes of  screening colonoscopy  for colorectal cancer among African Americans using different patient navigation formats . Methods : In a r and omized clinical trial , patients more than 50 years of age without significant comorbidities were r and omized into three navigation groups : peer-patient navigation ( n = 181 ) , pro-patient navigation ( n = 123 ) , and st and ard ( n = 46 ) . Pro-patient navigations were health care professionals who conducted culturally targeted navigation , whereas peer-patient navigations were community members trained in patient navigation who also discussed their personal experiences with screening colonoscopy . Two assessment s gathered sociodemographic , medical , and intrapersonal information . Results : Screening colonoscopy completion rate was 75.7 % across all groups with no significant differences in completion between the three study arms . Annual income more than $ 10,000 was an independent predictor of screening colonoscopy adherence . Unexpectedly , low social influence also predicted screening colonoscopy completion . Conclusions : In an urban African American population , patient navigation was effective in increasing screening colonoscopy rates to 15 % above the national average , regardless of patient navigation type or content . Impact : Because patient navigation successfully increases colonoscopy adherence , cultural targeting may not be necessary in some population s. Cancer Epidemiol Biomarkers Prev ; 22(9 ) ; 1577–87 . © 2013 AACR Background : Research comparing the effects of culturally targeted and generic but linguistically appropriate intervention programs is limited . We conducted a r and omized controlled trial comparing the efficacy of a culturally targeted video , a generic video , and a fact sheet ( control ) in promoting mammography screening among Chinese-American immigrants . Methods : We r and omized 664 Chinese-American women from the Washington , DC , and New York City areas who were older than 40 years and nonadherent to annual mammography screening guidelines to three study arms ( each with ∼221 women ) . The outcome was self-reported mammography screening 6 months post intervention . Measures of knowledge , Eastern cultural views , and health beliefs were administered before and after the intervention . Results : The culturally targeted video , the generic video , and the fact sheet increased mammography use by 40.3 % , 38.5 % , and 31.1 % from baseline , respectively . A significant intervention effect was observed only in one subgroup : The culturally targeted video significantly increased mammography screening among low-acculturated women over the fact sheet [ OR , 1.70 ; 95 % confidence interval ( CI ) , 1.04–2.78 ] . Overall , women who obtained a mammogram during the follow-up period reported significantly fewer barriers to screening after intervention than those who had not obtained screening . Both of the video groups reported fewer barriers after intervention than the control group . Conclusions : Both theoretically guided videos increased the likelihood of mammography use to a similar extent . Cultural targeting was only effective for low-acculturated women . Both videos reduced perceived barriers to screening and consequently increased screening behavior . Impact : The results of this study provide empirical evidence on the efficacy of cultural targeting for minority immigrants . Cancer Epidemiol Biomarkers Prev ; 21(11 ) ; 1923–32 . © 2012 AACR In this pilot trial , 15 phobic Asian Americans were r and omly assigned to st and ard one-session treatment ( OSTS ) , culturally adapted one-session treatment ( OST-CA ) , or manualized self-help . At posttreatment , OST ( combined st and ard and culturally adapted ) led to greater reductions in phobic avoidance and anxiety than self-help . Moreover , analyses comparing the two active treatments showed trends favoring OST-CA over OST-S. Results suggest that Asian Americans may benefit most from empirically supported treatments that consider Asian cultural values . ( PsycINFO Data base Record ( c ) 2010 APA , all rights reserved ) BACKGROUND Communication between African American patients and white health care providers has been shown to be of poorer quality when compared with race-concordant patient-provider communication . Fear on the part of patients that providers stereotype them negatively might be one cause of this poorer communication . This stereotype threat may be lessened by a values-affirmation intervention . METHODS In a blinded experiment , we r and omized 99 African American patients with hypertension to perform a values-affirmation exercise or a control exercise before a visit with their primary care provider . We compared patient-provider communication for the 2 groups using audio recordings of the visit analyzed with the Roter Interaction Analysis System . We also evaluated visit satisfaction , trust , stress , and mood after the visit by means of a question naire . RESULTS Patients in the intervention group requested and provided more information about their medical condition ( mean [ SE ] number of utterances , 66.3 [ 6.8 ] in the values-affirmation group vs 48.1 [ 5.9 ] in the control group [ P = .03 ] ) . Patient-provider communication in the intervention group was characterized as being more interested , friendly , responsive , interactive , and respectful ( P = .02 ) and less depressed and distressed ( P = .03 ) . Patient question naires did not detect differences in visit satisfaction , trust , stress , or mood . Mean visit duration did not differ significantly between the groups ( 19.2 minutes in the control group vs 20.5 minutes in the intervention group [ P = .29 ] ) . CONCLUSIONS A values-affirmation exercise improves aspects of patient-provider communication in race-discordant primary care visits . The clinical impact of the intervention must be defined before widespread implementation can be recommended OBJECTIVE Many targeted interventions have been developed and tested with African Americans ( AA ) ; however , AAs are a highly heterogeneous group . One characteristic that varies across AAs is Ethnic Identity ( EI ) . Little research has been conducted on how to incorporate EI into the design of health messages and programs . DESIGN We tested whether tailoring a print-based fruit and vegetable ( F & V ) intervention on EI would enhance program impact . AA adults were recruited from two integrated healthcare delivery systems and then r and omized to receive three newsletters focused on F & V behavior change over three months . One set of newsletters was tailored only on demographic and social cognitive variables ( control condition ) , whereas the other ( experimental condition ) was additionally tailored on EI . MAIN OUTCOME MEASURES The primary outcome for the study was F & V intake , assessed at baseline and three months later using the composite of two brief self-report frequency measures . RESULTS A total of 560 eligible participants were enrolled , of which 468 provided complete 3-month follow-up data . The experimental group increased their daily mean F & V intake by 1.1 servings compared to .8 servings in the control group ( p = .13 ) . Afrocentric experimental group participants showed a 1.4 increase in F & V servings per day compared to a .43 servings per day increase among Afrocentric controls ( p < .05 ) . CONCLUSIONS Although the overall between-group effects were not significant , tailoring dietary messages on ethnic identity may improve intervention impact for some AA subgroups Background : Limited empirical data are available on the effects of genetic counseling and testing among African American women . Objective : To evaluate the effects of genetic counseling and testing in African American women based on different levels of exposure : ( a ) women who were r and omized to culturally tailored ( CTGC ) and st and ard genetic counseling ( SGC ) to women who declined r and omization ( non-r and omized group ) , ( b ) participants and non- participants in genetic counseling , and ( c ) BRCA1 and BRCA2 ( BRCA1/2 ) test result acceptors and decliners . Design : R and omized trial of genetic counseling conducted from February 2003 to November 2006 . Measures : We evaluated changes in perceived risk of developing breast cancer and cancer worry . Results : Women r and omized to CTGC and SGC did not differ in terms of changes in risk perception and cancer worry compared to decliners . However , counseling participants had a significantly greater likelihood of reporting reductions in perceived risk compared to non- participants ( p = 0.03 ) . Test result acceptors also had a significantly greater likelihood of reporting decreases in cancer worry ( p = 0.03 ) . However , having a cancer history ( p = 0.03 ) and a BRCA1/2 prior probability ( p = 0.04 ) were associated with increases in cancer worry . Conclusions : Although CTGC did not lead to significant improvements in perceived risk or psychological functioning , African American women may benefit from genetic counseling and testing . Continued efforts should be made to increase access to genetic counseling and testing among African American women at increased risk for hereditary disease . But , follow-up support may be needed for women who have a personal history of cancer and those with a greater prior probability of having a BRCA1/2 mutation Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommo date d counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice . This r and omized clinical trial was conducted to compare the efficacy of an empirically supported st and ard version of a group-based cognitive-behavioral treatment ( S-CBT ) to a culturally accommo date d version ( A-CBT ) with a sample of Latino adolescents primarily recruited from the juvenile justice system . Development of the culturally accommo date d treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment ( CAM-SAT ) . Seventy Latino adolescents ( mean age = 15.2 ; 90 % male ) were r and omly assigned to 1 of 2 group-based treatment conditions ( S-CBT = 36 ; A-CBT = 34 ) with assessment s conducted at pretreatment , posttreatment , and 3-month follow-up . Longitudinal Poisson mixed models for count data were used to conduct the major analyses . The primary outcome variable in the analytic models was the number of days any substance was used ( including alcohol , except tobacco ) in the past 90 days . In addition , the variables ethnic identity , familism , and acculturation were included as cultural moderators in the analysis . Although both conditions produced significant decreases in substance use , the results did not support a time by treatment condition interaction ; however , outcomes were moderated by ethnic identity and familism . The findings are discussed with implication s for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders Colorectal cancer screening has clear benefits in terms of mortality reduction ; however , it is still underutilized and especially among medically underserved population s , including African Americans , who also suffer a disproportionate colorectal cancer burden . This study consisted of a theory-driven ( health belief model ) spiritually based intervention aim ed at increasing screening  among African Americans through a community health advisor-led educational series  in 16 churches . Using a r and omized design , churches were assigned to receive either the spiritually based intervention or a nonspiritual comparison , which was the same in every way except that it did not contain spiritual/religious content and themes . Trained and certified peer community health advisors in each church led a series of two group educational sessions on colorectal cancer and screening . Study enrollees completed a baseline , 1-month , and 12-month follow-up survey at their churches . The interventions had significant pre – post impact on awareness of all four screening modalities , and self-report receipt of fecal occult blood test , flexible sigmoidoscopy , and colonoscopy . There were no significant study group differences in study outcomes , with the exception of fecal occult blood test utilization , whereas those in the nonspiritual intervention reported significantly greater pre – post change . Both of these community-engaged , theory-driven , culturally relevant approaches to increasing colorectal cancer awareness and screening appeared to have an impact on study outcomes . Although adding spiritual/religious themes to the intervention was appealing to the audience , it may not result in increased intervention efficacy What kinds of evidence reliably support predictions of effectiveness for health and social care interventions ? There is increasing reliance , not only for health care policy and practice but also for more general social and economic policy deliberation , on evidence that comes from studies whose basic logic is that of JS Mill 's method of difference . These include r and omized controlled trials , case-control studies , cohort studies , and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics . The topic of this paper is the ' external validity ' of causal conclusions from these kinds of studies . We shall argue two cl aims . Cl aim , negative : external validity is the wrong idea ; cl aim , positive : ' capacities ' are almost always the right idea , if there is a right idea to be had . If we are right about these cl aims , it makes big problems for policy decisions . Many advice guides for grading policy predictions give top grade s to a proposed policy if it has two good Mill's- method -of difference studies that support it . But if capacities are to serve as the conduit for support from a method -of-difference study to an effectiveness prediction , much more evidence , and much different in kind , is required . We will illustrate the complexities involved with the case of multisystemic therapy , an internationally adopted intervention to try to diminish antisocial behaviour in young people Fotonovelas — small booklets that portray a dramatic story using photographs and captions — represent a powerful health education tool for low-literacy and ethnic minority audiences . This study evaluated the effectiveness of a depression fotonovela in increasing depression knowledge , decreasing stigma , increasing self-efficacy to recognize depression , and increasing intentions to seek treatment , relative to a text pamphlet .  Hispanic adults attending a community adult school ( N = 157 , 47.5 % female , mean age = 35.8 years 
    Output:
    
Research ers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group .