***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: Purpose . To assess changes in children 's  health behaviors and weight status after participation in community-originated interventions . Design . Prospect i ve cohort study following body mass index ( BMI ) z-score trajectory over time . Setting . Schools and community setting s in 19 locations in North Carolina . Subjects . A total of 1144 children , with an average age of 9.5 years , participating in community-originated physical activity and nutrition interventions , such as active recess and healthy cafeteria offerings , and environment and policy changes  design ed to prevent and reduce the prevalence of childhood obesity . Retention from baseline to final collection was 54 % . Measures . Self-reported physical activity and eating behaviors ; measured height and weight were collected at baseline and after interventions ( average of 20 months ) . Z-score was compared with expected growth without intervention . Analysis . Descriptive statistics , χ2 tests and t-tests , and ANOVA analyses of variance to assess changes in health behaviors and weight status . Results . More than 11 % of children improved their weight status , and 86 % of children who began at a healthy weight remained there . The average BMI for children who were overweight at enrollment was significantly lower after intervention ( 1.1 kg/m2 lower for boys and 0.88 kg/m2 lower for girls ) . Overweight and obese children who made improvements in key health behaviors showed greater decreases in BMI z-score than those who did not improve those behaviors ( increased fruit [ −.2207 vs. −.0793 ] and vegetable [ −.2215 vs. −.0855 ] intake , and drinking less soda [ −.1985 vs. −.0912 ] ) . There were no significant increases in physical activity , and changes in physical activity were not related to decreases in BMI z-score in this study . Conclusion . Community-originated interventions to raise awareness about food choices and to change policies and environments may improve BMI z-scores OBJECTIVE This report examines how sources of fat and patterns of fat-related dietary habits differed between black , Hispanic and white women participating in a r and omized trial of a low-fat diet intervention .  DESIGN The intervention consisted of group sessions , which met weekly for 6 weeks , biweekly for 6 weeks and monthly for 9 months , and included didactic nutrition education and activities to provide motivation for sustained dietary change . Outcomes included total fat and fat from nine food groups from a food frequency question naire ( FFQ ) , and a summary scale and five subscales that measure fat-related dietary habits . SETTING /SUBJECTS Data are from 1702 post-menopausal women , recruited from clinical centres in Atlanta , Birmingham and Miami , with dietary assessment s at baseline and 6 months post-r and omization . RESULTS Total fat intake was similar across race/ethnic groups at baseline , yet there were many differences in sources of fat and fat-related dietary habits . For example , blacks consumed less fat from dairy foods and more fat from meats than whites . Effects of the intervention on total fat intake or the summary fat-related dietary habits scale did not differ across race/ethnicity groups . There were , however , many differences in how the intervention affected sources of fat and fat-related dietary habits . For example , the intervention effect for added fats ( e.g. butter and salad dressings ) was -8.9 g for blacks and -12.0 g for whites ( P<0.05 ) . The intervention effect for adopting low-fat meat purchasing and preparation methods was larger for blacks than whites , and the intervention effect for replacing high-fat foods with fruits and vegetables was larger for Hispanics than whites . CONCLUSIONS This study demonstrates that , if properly design ed , a single nutrition intervention programme can work well even in groups with culturally diverse dietary patterns Background : The positive effects of computer-tailored dietary fat intake interventions have been demonstrated in adults , but few studies have investigated the impact on adolescents . Purpose : The purpose is to evaluate the acceptability , feasibility and effectiveness of a computer-tailored dietary fat intake education program for adolescents . Methods : A r and om sample of 10 schools , 5 with general and 5 with technical-vocational education programs , were selected to participate . In each of the 10 schools , 2 classes of 7th grade rs were r and omly assigned to the intervention ( n=153 ) or control ( no-intervention , n=151 ) condition . Students were exposed once in class to a 50-min theory-based computer-tailored dietary fat intake intervention . Question naires were completed 1 week before ( food frequency question naire for dietary fat intake + psychosocial determinants ) and 3 months after ( process evaluation + food frequency question naire for dietary fat intake + psychosocial determinants ) the intervention . Results : About one in three students evaluated the intervention as interesting ( 34 % ) , novel ( 38 % ) , personally relevant ( 26 % ) , credible ( 34 % ) , and correct ( 38 % ) . Half of the students evaluated the intervention messages to be too long , and one fourth did not read the intervention messages . A decrease in dietary fat consumption was shown in girls enrolled in technical-vocational schools ( F=3.5 , p≤.05 ) and in boys and girls undertaking general education who reported to have read the intervention messages ( F=3.6 , p≤.05 ) ; however , no intervention effects were detected for the total sample . Conclusions : Further improvements to the intervention for use in adolescents should be evaluated . Given that a positive impact was shown in most adolescents and that a computer-tailored dietary fat intake education program has the capability of reaching large groups at low cost , this study shows that using such interventions in adolescents has potential OBJECTIVE A multidimensional lifestyle intervention performed in 652 preschoolers ( 72 % of migrant , 38 % of low educational level ( EL ) parents ) reduced body fat , but not BMI and improved fitness . The objective of this study is to examine whether the intervention was equally effective in children of migrant and /or low EL parents . METHODS Cluster-r and omized controlled single blinded trial , conducted in 2008/09 in 40 r and omly selected preschools in Switzerl and . The culturally tailored intervention consisted of a physical activity program and lessons on nutrition , media use and sleep . Primary outcomes included BMI and aerobic fitness . Secondary outcomes included % body fat , waist circumference and motor agility . RESULTS Children of migrant parents benefitted similarly from the intervention compared to their counterparts ( p for interaction≥ 0.09 ) . However , children of low EL parents benefitted less , although these differences did not reach statistical significance ( p for interaction≥ 0.06 ) . Average intervention effect sizes for BMI were -0.10 , -0.05 , -0.11 and 0.04 kg/m(2 ) and for aerobic fitness were 0.55 , 0.20 , 0.37 and -0.05 stages for children of non-migrant , migrant , middle/high EL and low EL parents , respectively . CONCLUSIONS This intervention was similarly effective among preschoolers of migrant parents compared to their counterparts , while children of low EL parents benefitted less BACKGROUND This study evaluated the effects of a school-based dietary intervention program to increase fruit and vegetable consumption among fourth- grade rs . METHODS Twenty-eight elementary schools were r and omized to an immediate intervention condition or to a delayed intervention control condition . Measures of diet and psychosocial variables were collected at base line and 1 and 2 years post-baseline . The intervention included classroom , parent , and cafeteria components . RESULTS Mean daily consumption of fruit and vegetables was higher for the intervention children compared with controls at Follow-up 1 ( X(t ) = 3.96 , X(c ) = 2.28 ) and at Follow-up 2 ( X(t ) = 3.20 , X(c ) = 2.21 ) . Macro- and micronutrient changes favoring the intervention children were also observed at both Follow-up 1 and Follow-up 2 . Mean daily consumption of fruit and vegetables was higher for intervention parents compared with controls at Follow-up 1 ( X(t ) = 4.23,X(c ) = 3.94 ) but not at Follow-up 2 . CONCLUSIONS Strong effects were found for the High 5 intervention on fruit and vegetable consumption , on macro- and micro-nutrients , and on psychosocial variables . Future work is needed to enhance the intervention effects on parents ' consumption and to test the effectiveness of the intervention when delivered by classroom teachers 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 OBJECTIVE To measure the effects of two school-based interventions on  children 's intake of fruit and vegetables ( F&V ) . DESIGN AND METHODS A total of six primary schools were r and omly assigned to ( 1 ) a free F&V distribution programme , or ( 2 ) a multicomponent programme , consisting of a classroom curriculum and parental involvement . The two interventions were evaluated on their effects and compared with six control schools in a pre-test-post-test design . Two methods were used for dietary assessment : a pre-structured food recall and a food-frequency question naire including only F&V. SUBJECTS A total of 939 parents of children aged 4 - 12 years filled out the question naire at both pre-test and post-test . The response rate was 54 % . RESULTS Multilevel analyses showed that both programmes were equally effective in increasing children 's fruit consumption by 0.2 portions per day . The free F&V distribution increased vegetable intake among non-native children and the oldest age group , and the multicomponent programme among the oldest children and girls . The distribution also caused an increased 24 h fruit , juice and vegetable intake among the youngest and the oldest age groups , and the multicomponent programme among all children . CONCLUSION The results of this study indicate that both interventions were shown to be effective for different subgroups regarding age , gender and ethnicity . When comparing both interventions , the distribution programme was shown to be more effective , especially in increasing vegetable consumption . An important next step will be to investigate which intervention has the greatest potential to be implemented in primary schools OBJECTIVES This National Cancer Institute-funded study sought to increase fruit and vegetable consumption among women served by the WIC program in Maryl and . METHODS Over a 2-year period , a multifaceted intervention program using a r and omized crossover design sought to increase fruit and vegetable consumption at 16 WIC program sites in Baltimore City and 6 Maryl and counties . Participants were surveyed at baseline , 2 months postintervention , and 1 year later . RESULTS Two months postintervention , mean daily consumption had increased by 0.56 + /- 0.11 servings in intervention participants and 0.13 + /- 0.07 servings in control participants ( P = .002 ) . Intervention participants also showed greater changes in stages of change , knowledge , attitudes , and self-efficacy . Changes in consumption were closely related to number of nutrition sessions attended , baseline stage of change , race , and education . One year later , mean consumption had increased by an additional 0.27 servings in both intervention and control participants . CONCLUSIONS Dietary changes to prevent cancer can be achieved and sustained in this hard-to-reach , low-income population . However , many obstacles must be overcome to achieve such changes This r and omized clinical trial examined the feasibility of low-fat dietary interventions among postmenopausal women of diverse background s. During 1992 - 1994 , 2,208 women aged 50 - 79 years , 28 % of whom were black and 16 % Hispanic , enrolled at clinics in Atlanta , Georgia , Birmingham , Alabama , and Miami , Florida . Intervention/support groups met periodically with a nutritionist to reduce fat intake to 20 % of energy and to make other diet modifications . At 6 months postr and omization , the intervention group reduced fat intake from 39.7 % of energy at baseline to 26.4 % , a reduction of 13.3 % of energy , compared with 2.3 % among controls . Saturated fatty acid and cholesterol intakes were reduced , but intakes of fruits and vegetables , but not grain products , increased . Similar effects were observed at 12 and 18 months . Black and non-Hispanic white women had similar levels of reduction in fat , but the decrease in Hispanic women was less . Changes did not vary significantly by education . While bias in self-reported intakes may have result ed in somewhat overestimated changes in fat intake , the reported 
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Price ” interventions were most effective in groups with lower SEP , and may therefore appear likely to reduce inequalities .
All interventions that combined taxes and subsidies consistently decreased inequalities .
Conversely , interventions categorised as “ Person ” had a greater impact with increasing SEP , and may therefore appear likely to reduce inequalities .
All four dietary counselling interventions appear likely to widen inequalities .
We did not find any “ Prescriptive ” interventions and only one “ Product ” intervention that presented differential results and had no impact by SEP .
More “ Place ” interventions were identified and none of these interventions were judged as likely to widen inequalities .
Conclusions : Interventions categorised by a “ 6 Ps ” framework show differential effects on healthy eating outcomes by SEP .
“ Upstream ” interventions categorised as “ Price ” appeared to decrease inequalities , and “ downstream ” “ Person ” interventions , especially dietary counselling seemed to increase inequalities .
However the vast majority of studies identified did not explore differential effects by SEP .