***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: The Fast Track prevention trial was used to test hypotheses from the Early-Starter Model of the development of chronic conduct problems . We r and omly assigned 891 high-risk first- grade boys and girls ( 51 % African American ) to receive the long-term Fast Track prevention or not . After 4 years , outcomes were assessed through teacher ratings , parent ratings , peer nominations , and child self-report . Positive effects of assignment to intervention were evident in teacher and parent ratings of conduct problems , peer social preference scores , and association with deviant peers . Assessment s of proximal goals of intervention ( e.g. , hostile attributional bias , problem-solving skill , harsh parental discipline , aggressive and prosocial behavior at home and school ) collected after grade 3 were found to partially mediate these effects . The findings are interpreted as consistent with developmental theory 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 CONTEXT Most studies of the long-term effects of early childhood educational interventions are of demonstration programs rather than large-scale public programs . Previous studies of one of the oldest federally funded preschool programs have reported positive effects on school performance , but effects on educational attainment and crime are unknown . OBJECTIVE To determine the long-term effectiveness of a federal center-based preschool and school-based intervention program for urban low-income children . DESIGN , SETTING , AND PARTICIPANTS Fifteen-year follow-up of a nonr and omized , matched-group cohort of 1539 low-income , mostly black children born in 1980 and enrolled in alternative early childhood programs in 25 sites in Chicago , Ill. INTERVENTIONS The  Chicago Child-Parent Center ( CPC ) Program ( n = 989 children ) provides comprehensive education , family , and health services and includes half-day preschool at ages 3 to 4 years , half- or full-day kindergarten , and school-age services in linked elementary schools at ages 6 to 9 years . The comparison group ( n = 550 ) consisted of children who participated in alternative early childhood programs ( full-day kindergarten ) : 374 in the preschool comparison group from 5 r and omly selected schools plus 2 others that provided full-day kindergarten and additional instructional re sources and 176 who attended full-day kindergartens in 6 CPCs without preschool participation . MAIN OUTCOME MEASURES Rates of high school completion and school dropout by age 20 years , juvenile arrests for violent and nonviolent offenses , and grade retention and special education placement by age 18 years . RESULTS Relative to the preschool comparison group and adjusted for several covariates , children who participated in the preschool intervention for 1 or 2 years had a higher rate of high school completion ( 49.7 % vs 38.5 % ; P = .01 ) ; more years of completed education ( 10.6 vs 10.2 ; P = .03 ) ; and lower rates of juvenile arrest ( 16.9 % vs 25.1 % ; P = .003 ) , violent arrests ( 9.0 % vs 15.3 % ; P = .002 ) , and school dropout ( 46.7 % vs 55.0 % ; P = .047 ) . Both preschool and school-age participation were significantly associated with lower rates of grade retention and special education services . The effects of preschool participation  on educational attainment were greater for boys than girls , especially in reducing school dropout rates ( P = .03 ) . Relative to less extensive participation , children with extended program participation from preschool through second or third grade also experienced lower rates of grade retention ( 21.9 % vs 32.3 % ; P = .001 ) and special education ( 13.5 % vs 20.7 % ; P = .004 ) . CONCLUSIONS Participation in an established early childhood intervention for low-income children was associated with better educational and social outcomes up to age 20 years . These findings are among the strongest evidence that established programs administered through public schools can promote children 's long-term success Annual screenings of preschool children at kindergarten registration identified 158 children having high levels of aggressive , hyperactive , impulsive , and inattentive behavior . These " disruptive " children were r and omly assigned to four treatment conditions lasting the kindergarten school year : no treatment , parent training only , full-day treatment classroom only , and the combination of parent training with the classroom treatment . Results showed that parent training produced no significant treatment effects , probably owing largely to poor attendance . The classroom treatment produced improvement in multiple domains : parent ratings of adaptive behavior , teacher ratings of attention , aggression , self-control , and social skills , as well as direct observations of externalizing behavior in the classroom . Neither treatment improved academic achievement skills or parent ratings of home behavior problems , nor were effects evident on any lab measures of attention , impulse control , or mother-child interactions . It is concluded that when parent training is offered at school registration to parents of disruptive children identified through a brief school registration screening , it may not be a useful approach to treating the home and community behavioral problems of such children . The kindergarten classroom intervention was far more effective in reducing the perceived behavioral problems and impaired social skills of these children . Even so , most treatment effects were specific to the school environment and did not affect achievement skills . These findings must be viewed as tentative until follow-up evaluations can be done to determine the long-term outcomes of these interventions BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes OBJECTIVE This study compared the efficacy of a media literacy program and a self-esteem program design ed to reduce general and specific risk factors for eating disorders . METHOD Four classes of 86 grade 8 students ( 53 boys and 33 girls ) , mean age of 13 years , were r and omly assigned to either a control condition or one of the two intervention conditions .  Assessment of general and specific risk factors was carried out at baseline , postintervention and 3-month follow-up . RESULTS At postintervention the media literacy group had lower mean scores on weight concern than the control group ( p = 0.007 ) but the self-esteem group did not . There were some differences on self-esteem measures at the 3-month follow-up . DISCUSSION Media literacy programs combined with an interactive , student-centered framework may potentially be a safe and effective way of reducing risk factors for eating disorders . The impact of teaching style needs to be further evaluated in prevention research OBJECTIVE As psychoeducational eating disorder prevention programs have not been shown to reduce bulimic pathology , we developed and evaluated a dissonance-based intervention for high-risk population s. METHOD Young women ( N = 87 ) with body image concerns were r and omized to this intervention , which involves verbal , written , and behavioral exercises requiring them to critique the thin-ideal , or to a healthy weight management control group . Participants completed a baseline , termination , and 4-week follow-up survey . RESULTS Participants in the dissonance intervention reported decreased thin-ideal internalization , body dissatisfaction , dieting , negative affect , and bulimic symptoms at termination and at 4-week follow-up . Unexpectedly , participants in the healthy weight management control group also reported some benefits . DISCUSSION Taken in conjunction with past findings , these preliminary results suggest that the dissonance intervention , and to a lesser extent the healthy weight management intervention , may reduce bulimic pathology and risk factors for eating disturbances OBJECTIVES We examined the effectiveness of the Signs of Suicide ( SOS ) prevention program in reducing suicidal behavior . METHODS Twenty-one hundred students in 5 high schools in Columbus , Ga , and Hartford , Conn , were r and omly assigned to intervention and control groups . Self-administered question naires were completed by students in both groups approximately 3 months after program implementation . RESULTS Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group . The modest changes in knowledge and attitudes partially explained the beneficial effects of the program . CONCLUSIONS SOS is the first school-based suicide prevention program to demonstrate significant reductions in self-reported suicide attempts Project Northl and was a r and omized trial to reduce alcohol use among adolescents in 24 school districts in northeastern Minnesota . Phase 1 ( 1991 - 1994 ) , when the targeted cohort was in grade s 6 - 8 , included school curricula , parent involvement , peer leadership and community task forces . The Interim Phase ( 1994 - 1996 ) involved minimal intervention . Phase 2 ( 1996 - 1998 ) , when the cohort was in grade s 11 and 12 , included a classroom curriculum , parent education , print media , youth development and community organizing . Outcomes of these interventions were assessed by annual student surveys from 1991 to 1998 , alcohol purchase attempts by young-looking buyers in 1991 , 1994 and 1998 , and parent telephone surveys in 1996 and 1998 . Growth curve analysis was used to examine the student survey data over time . Project Northl and was most successful when the students were young adolescents . The lack of intervention in the Interim Phase when the students were in grade s 9 and 10 had a significant and negative impact on alcohol use . The intervention used with the high school students as those in grade s 11 and 12 made a positive impact on their tendency to use alcohol use , binge drinking and ability to obtain alcohol . There was no impact in Phase 2 on other student-level behavioral and psychosocial factors . Developmentally appropriate , multi-component , community-wide programs throughout adolescence appear to be needed to reduce alcohol use Thirty-seven families who had a child between the ages of 8 and 15 ( mean age = 12.0 years ) and had at least one parent , who had experienced a recent episode of affective disorder were assigned r and omly to one of two psy 
    Output:
    
Telepsychiatry and the internet seem to be the most promising strategies to diffuse knowledge with lower costs .