***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 To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors . METHODS In St Louis , Missouri from 2005 to 2006 , 151 employees ( 134 F , 17 M , 81 % overweight/obese ) participated in a cohort-r and omized trial comparing assessment s + intervention ( worksite A ) with assessment s only ( worksite B ) for 1 year . All participants received personal health reports containing their assessment results . The intervention was design ed to promote physical activity and favorable dietary patterns using pedometers , healthy snack cart , WeightWatchers(R ) meetings , group exercise classes , seminars , team competitions , and participation rewards . Outcomes included BMI , body composition , blood pressure , fitness , lipids , and Framingham 10-year coronary heart disease risk . RESULTS 123 participants , aged 45+/-9 yr , with BMI 32.9+/-8.8 kg/m(2 ) completed 1 year . Improvements ( P < or = 0.05 ) were observed at both worksites for fitness , blood pressure , and total- , HDL- , and LDL-cholesterol . Additional improvements occurred at worksite A in BMI , fat mass , Framingham risk score , and prevalence of the metabolic syndrome ; only the changes in BMI and fat mass were different between worksites . CONCLUSION A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors , but many of the improvements were achieved with worksite health assessment s and personalized health reports in the absence of an intervention Background Worksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain . The purpose of this study was to examine the effectiveness of Go ! , an innovative 12-month multi-component worksite obesity prevention intervention . Methods A quasi-experimental non-equivalent control group design was utilized ; 407 eligible hospital employees ( intervention arm ) and 93 eligible clinic employees ( comparison arm ) participated . The intervention involved pedometer distribution , labeling of all foods in the worksite cafeteria and vending machines ( with calories , step equivalent , and a traffic light based on energy density signaling recommended portion ) , persuasive messaging throughout the hospital , and the integration of influential employees to reinforce healthy social norms .  Changes in weight , BMI , waist circumference , physical activity , and dietary behavior after 6 months and 1 year were primary outcomes . Secondary outcomes included knowledge , perceptions of employer commitment to employee health , availability of information about diet , exercise , and weight loss , perceptions of coworker support and frequency of health discussion s with coworkers . A process evaluation was conducted as part of the study . Results Repeated measures ANCOVA indicated that neither group showed significant increases in weight , BMI , or waist circumference over 12 months . The intervention group showed a modest increase in physical activity in the form of walking , but decreases in fruit and vegetable servings and fiber intake . They also reported significant increases in knowledge , information , perceptions of employer commitment , and health discussion s with peers . Employees expressed positive attitudes towards all components of the Go ! intervention . Conclusions This low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months . Such results are consistent with other worksite obesity prevention studies using ecological approaches . Implementing low-impact physical activity ( e.g. , walking , stair use ) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity . Trial Registration This study was registered with clinical trials.gov ( NCT01585480 ) on April 24 , 2012 Background The work setting provides an opportunity to introduce overweight ( i.e. , Body Mass Index ≥ 25 kg/m2 ) adults to a weight management programme , but new approaches are needed in this setting . The main purpose of this study was to investigate the effectiveness of lifestyle counselling by phone or e-mail on body weight , in an overweight working population . Secondary purpose s were to establish effects on waist circumference and lifestyle behaviours , and to assess which communication method is the most effective . Methods A r and omized controlled trial with three treatments : intervention material s with phone counselling ( phone group ) ; a web-based intervention with e-mail counselling ( internet group ) ; and usual care , i.e. lifestyle brochures ( control group ) . The interventions used lifestyle modification and lasted a maximum of six months . Subjects were 1386 employees , recruited from seven companies ( 67 % male ; mean age 43 ( SD 8.6 ) y ; mean BMI 29.6 ( SD 3.5 ) kg/m2 ) .  Body weight was measured by research personnel and by question naire . Secondary outcomes fat , fruit and vegetable intake , physical activity and waist circumference were assessed by question naire . Measurements were done at baseline and after six months . Missing body weight was multiply imputed . Results Body weight reduced 1.5 kg ( 95 % CI -2.2;-0.8 , p < 0.001 ) in the phone group and 0.6 kg ( 95 % CI -1.3 ; -0.01 , p = 0.045 ) in the internet group , compared with controls . In completers analyses , weight and waist circumference in the phone group were reduced with 1.6 kg ( 95 % CI -2.2;-1.0 , p < 0.001 ) and 1.9 cm ( 95 % CI -2.7;-1.0 , p < 0.001 ) respectively , fat intake decreased with 1 fatpoint ( 1 to 4 grams)/day ( 95 % CI -1.7;-0.2 , p = 0.01 ) and physical activity increased with 866 METminutes/week ( 95 % CI 203;1530 , p = 0.01 ) , compared with controls . The internet intervention result ed in a weight loss of 1.1 kg ( 95 % CI -1.7;-0.5 , p < 0.001 ) and a reduction in waist circumference of 1.2 cm ( 95 % CI -2.1;-0.4 , p = 0.01 ) , in comparison with usual care . The phone group appeared to have more and larger changes than the internet group , but comparisons revealed no significant differences . Conclusion Lifestyle counselling by phone and e-mail is effective for weight management  in overweight employees and shows potential for use in the work setting .Trial registration ISCRTN04265725 Objectives : This study aim ed to evaluate the effectiveness of supervised exercise among nurses conducting shift work for health promotion . Methods : A total of 30 healthy female nurses conducting shift work participated in this study and they were r and omly assigned to one of the following 2 groups : The supervised exercise group ( SG ; participants exercised under the supervision of a physical therapist ( PT ) ) and the voluntary exercise group ( VG ; participants exercised without supervision ) . The study participants were asked to exercise twice/week for 12 weeks for 24 sessions . The primary outcome was aerobic fitness , and the secondary outcomes were muscle strength , anthropometric data , biochemical parameters , and mental health . We compared all the outcomes before and after the intervention within each group and between both groups at follow-up . Results : Aerobic fitness increased in the SG whereas it decreased in the VG , but these changes were not statistically significant ( p=0.053 and 0.073 , respectively ) . However , the between-group difference was significant in the intervention effect ( p=0.010 ) . Muscle strength , high-density lipoprotein cholesterol and metabolic profile ( high-molecular weight adiponectin ) , and depressive symptom significantly improved in the SG over time , even though the SG exercised less as compared with the VG . Moreover , significant differences in muscle strength , and low-density lipoprotein cholesterol and reactive oxygen metabolite levels were observed between both groups , and these parameters were better in the SG than in the VG . Conclusions : Our data -suggest the effectiveness of exercise supervised by a PT at the workplace of nurses conducting shift work for health promotion Background Overweight ( Body Mass Index [ BMI ] ≥ 25 kg/m2 ) and obesity ( BMI ≥ 30 kg/m2 ) are associated with increased cardiovascular risk , posing a considerable burden to public health . The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in healthy overweight employees . Methods Participants were 276 healthy overweight employees ( 69.2 % male ; mean age 44.0 years [ SD 9.2 ] ; mean BMI 29.7 kg/m2 [ SD 3.1 ] ) . They were r and omized to one of two intervention groups receiving a six month lifestyle intervention with behavior counseling by phone ( phone group ) or e-mail ( Internet group ) , or to a control group receiving usual care .  Body weight , height , waist circumference , sum of skinfolds , blood pressure , total cholesterol level and predicted aerobic fitness were measured at baseline , at 6 and at 24 months . Regression analyses included the 141 participants with complete data . Results At 6 months a significant favorable effect on total cholesterol level ( -0.2 mmol/l , 95%CI -0.5 to -0.0 ) was observed in the phone group and a trend for improved aerobic fitness ( 1.9 ml/kg/min , 95%CI -0.2 to 3.9 ) in the Internet group . At two years , favorable trends for body weight ( -2.1 kg , 95%CI -4.4 to 0.2 ) and aerobic fitness ( 2.3 ml/kg/min , 95%CI -0.2 to 4.8 ) were observed in the Internet group . Conclusions The intervention effects were independent of the used communication mode . However short-term results were in favor of the phone group and long-term results in favor of the internet group . Thus , we found limited evidence for our lifestyle intervention to be effective in reducing cardiovascular risk in a group of apparently healthy overweight workers . Trial registration IS RCT CONTEXT Rapid increases in access to the Internet have made it a viable mode for public health intervention . No controlled studies have evaluated this re source for weight loss . OBJECTIVE To determine whether a structured Internet behavioral weight loss program produces greater initial weight loss and changes in waist circumference than a weight loss education Web site . DESIGN R and omized , controlled trial conducted from April to December 1999 . SETTING AND PARTICIPANTS Ninety-one healthy , overweight adult hospital employees aged 18 to 60 years with a body mass index of 25 to 36 kg/m(2 ) . Analyses were performed for the 65 who had complete follow-up data . INTERVENTIONS Participants were r and omly assigned to a 6-month weight loss program of either Internet education ( education ; n = 32 with complete data ) or Internet behavior therapy ( behavior therapy ; n = 33 with complete data ) . All participants were given 1 face-to-face group weight loss session and access to a Web site with organized links to Internet weight loss re sources . Participants in the behavior therapy group received additional behavioral procedures , including a sequence of 24 weekly behavioral lessons via e-mail , weekly online su bmi ssion of self-monitoring diaries with individualized therapist feedback via e-mail , and an online bulletin board . MAIN OUTCOME MEASURES Body weight and waist circumference , measured at 0 , 3 , and 6 months , compared the 2 intervention groups . RESULTS Repeated- measures analyses showed that the behavior therapy group lost more weight than the education group ( P = .005 ) . The behavior therapy group lost a mean ( SD ) of 4.0 ( 2.8 ) kg by 3 months and 4.1 ( 4.5 ) kg by 6 months . Weight loss in the education group was 1.7 ( 2.7 ) kg at 3 months and 1.6 ( 3.3 ) kg by 6 months . More participants in the behavior therapy than education group achieved the 5 % weight loss goal ( 45 % vs 22 % ; P = .05 ) by 6 months . Changes in waist circumference were also greater in the behavior therapy group than in the education group at both 3 months ( P = .001 ) and 6 months ( P = .005 ) . CONCLUSIONS Participants who were given a structured behavioral treatment program with weekly contact and individualized feedback had better weight loss compared with those given links to educational Web sites . Thus , the Internet and e-mail appear to be viable methods for delivery of structured behavioral weight loss programs OBJECTIVES To evaluate the efficacy of an Internet behavioral weight loss program ; and determine if adding periodic in-person sessions to an Internet intervention improves outcomes . METHODS 481 healthy overweight adults ( 28 % minority ) were r and omized to one of 3 delivery methods of a behavioral weight loss program with weekly meetings : Internet ( n=161 ) , InPerson ( n=158 ) , or Hybrid ( Internet+InPerson , n=162 ) . Outcome variables were weight at baseline and 6 months and percent of subjects achieving a 5 and 7 % weight loss . The study took place in two centers in Vermont and Arkansas from 2003 to 2008 . RESULTS Conditions differed significantly in mean weight loss [ 8.0 ( 6.1 ) kg vs. 5.5 ( 5.6 ) kg vs. 6.0 ( 5.5 ) kg ] , for InPerson , Internet , and Hybrid respectively , p<0.01 , n=462 ) . Weight loss for InPerson was significantly greater than the Internet and Hybrid conditions ( p<0 
    Output:
    
Overall , moderate- to high-intensity behavioral strategies , using any mode of intervention delivery ( phone , face-to-face , or Internet ) , delivered by a trained professional were effective in improving weight-related outcomes .
Environmental strategies were effective in improving healthier habits .
Self-directed strategies worked better for motivated employees .
Discussion : Multicomponent interventions offered in health care setting s may be successful in improving employee weight .