***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: Implementation intentions , namely specific plans regarding when , where and how an individual will act , increase the likelihood of action . There is evidence that implementation intentions should be particularly efficacious when combined with motivational interventions . However , this is yet to be tested in relation to the reduction of unhealthy behaviour . Thus the aim of this study was to examine the efficacy of combined motivation and implementation intention interventions for the reduction of saturated fat intake . It also tested a new form of implementation intention ( reasoning implementation intentions ) . Participants from the UK ( n = 210 ) were r and omized to condition and asked either to form st and ard implementation intentions , reasoning implementation intentions , or received no implementation intention manipulation ; and were exposed to protection motivation-based information , or not . Results showed that st and ard and reasoning implementation intentions were successful in reducing the proportion of food energy derived from saturated fat but the effects of the st and ard implementation intention were dependent on whether participants read the motivational message or not Background Studies have shown that lifestyle  behavior changes are most effective to prevent onset of diabetes in high-risk patients . Primary care providers are charged with encouraging behavior change among their patients at risk for diabetes , yet the practice environment and training in primary care often do not support effective provider counseling . The goal of this study is to develop an electronic health record-embedded tool to facilitate shared patient-provider goal setting to promote behavioral change and prevent diabetes . Methods The ADAPT ( Avoiding Diabetes Thru Action Plan Targeting ) trial leverages an innovative system that integrates evidence -based interventions for behavioral change with already-existing technology to enhance primary care providers ' effectiveness to counsel about lifestyle behavior changes . Using principles of behavior change theory , the multidisciplinary design team utilized in-depth interviews and in vivo usability testing to produce a prototype diabetes prevention counseling system embedded in the electronic health record . Results The core element of the tool is a streamlined , shared goal - setting module within the electronic health record system . The team then conducted a series of innovative , " near-live " usability testing simulations to refine the tool and enhance workflow integration . The system also incorporates a pre-encounter survey to elicit patients ' behavior-change goals to help tailor patient-provider goal setting during the clinical encounter and to encourage shared decision making . Lastly , the patients interact with a website that collects their longitudinal behavior data and allows them to visualize their progress over time and compare their progress with other study members . The finalized ADAPT system is now being piloted in a small r and omized control trial of providers using the system with prediabetes patients over a six-month period . Conclusions The ADAPT system combines the influential powers of shared goal setting and feedback , tailoring , modeling , contracting , reminders , and social comparisons to integrate evidence -based behavior-change principles into the electronic health record to maximize provider counseling efficacy during routine primary care clinical encounters . If successful , the ADAPT system may represent an adaptable and scalable technology-enabled behavior-change tool for all primary care providers . Trial Registration Clinical Trials.gov Identifier In cardiac rehabilitation programs , patients learn how to adopt a healthier lifestyle , including regular , strenuous physical activity . Long-term success is only modest despite good intentions . To improve exercise adherence , a 3-group experiment was design ed that included innovative psychological interventions . All 3 groups underwent a st and ard care rehabilitation program . Patients in the 2 treatment groups were instructed not only to produce detailed action plans but also to develop barrier-focused mental strategies . On top of this , in 1 of these groups a weekly diary was kept for 6 weeks to increase a sense of action control . At the end of a st and ard cardiac rehabilitation program , 240 patients were r and omly assigned to these treatment groups plus a st and ard care control group . Treatments result ed in more physical activity at follow-up and better adherence to recommended levels of exercise intensity . Moreover , self-regulatory skills such as planning and action control were improved by the treatments . Follow-up analyses demonstrated the mediating mechanisms of self-regulatory skills in the process of physical exercise maintenance . Findings imply that interventions targeting self-regulatory skills can enable postrehabilitation patients to reduce behavioral risk factors and facilitate intended lifestyle changes Background Adherence to preventive medication is often poor , and current interventions have had limited success . Purpose This study was conducted to pilot a r and omised controlled trial aim ed at increasing adherence to preventive medication  in stroke survivors using a brief , personalised intervention . Methods Sixty-two stroke survivors were r and omly allocated to either a two-session intervention aim ed at increasing adherence via ( a ) introducing a plan linked to environmental cues ( implementation intentions ) to help establish a better medication-taking routine ( habit ) and ( b ) eliciting and modifying any mistaken patient beliefs regarding medication/stroke or a control group . Primary outcome was adherence to antihypertensive medication  measured objective ly over 3 months using an electronic pill bottle . Results Fifty-eight people used the pill bottle and were analysed as allocated ; 54 completed treatment . The intervention result ed in 10 % more doses taken on schedule ( intervention , 97 % ; control , 87 % ; 95 % CI for difference ( 0.2 , 16.2 ) ; p = 0.048 ) . Conclusions A simple , brief intervention increased medication adherence in stroke survivors , over and above any effect of increased patient contact or mere measurement . ( http://controlled-trials.com , number IS RCT N38274953 . This study tests whether the effectiveness of implementation intention-based interventions to increase fruit and vegetable intake in a young adult population can be enhanced using additional pre-intervention instructions and alternative formats ; namely , an ‘ if-then ’ implementation intention versus a more general , ‘ global ’ plan that does not explicitly link a situational cue with a goal -directed response . Participants ( N = 557 ) completed pre-test measures of planning , motivation and behaviour with respect to increasing their fruit and vegetable intake before being r and omised to a 3 ( intervention format : control vs. ‘ if-then ’ vs. ‘ global ’ implementation intentions ) × 2 ( pre-intervention instruction vs. no pre-intervention instruction )  between- participants design . Results revealed a significant intervention format by time interaction , such that intake significantly increased by 0.50 portions in the if-then format condition compared with 0.31 in the global format and 0.01 in the control condition . These results suggest that ‘ if-then ’ manipulations are superior in promoting behaviour change in an applied setting . The use of pre-intervention instructions had no additional effect on behaviour , providing evidence for the efficacy of implementation intentions even when experimenter dem and is reduced . Evidence is also presented to suggest that reported increases in intake are not related to dem and characteristics Background Fatigue is a common and troubling symptom for people with multiple sclerosis ( MS ) . Aim To evaluate the effectiveness and cost-effectiveness of a six-session group-based programme for managing MS-fatigue ( Fatigue : Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ( FACETS ) ) . Methods Three-centre parallel arm r and omised controlled trial with economic evaluation . Patients with MS and significant fatigue were r and omised to FACETS plus current local practice ( FACETS ) or current local practice alone ( CLP ) , using concealed computer-generated r and omisation . Participant blinding was not possible . Primary outcomes were fatigue severity ( Fatigue Assessment Instrument ) , self-efficacy ( Multiple Sclerosis-Fatigue Self-Efficacy ) and disease-specific quality of life ( Multiple Sclerosis Impact Scale ( MSIS-29 ) ) at 1 and 4 months postintervention ( follow-up 1 and 2 ) . Quality adjusted life years ( QALYs ) were calculated ( EuroQoL 5-Dimensions question naire and the Short-form 6-Dimensions question naire ) . Results Between May 2008 and November 2009 , 164 patients were r and omised ; primary outcome data were available for 146 ( 89 % ) . Statistically significant differences favour the intervention group on fatigue self-efficacy at follow-up 1 ( mean difference ( MD ) 9 , 95 % CI ( 4 to 14 ) , st and ardised effect size ( SES ) 0.54 , p=0.001 ) and follow-up 2 ( MD 6 , 95 % CI ( 0 to 12 ) , SES 0.36 , p=0.05 ) and fatigue severity at follow-up 2 ( MD −0.36 , 95 % CI ( −0.63 to −0.08 ) , SES −0.35 , p=0.01 ) but no differences for MSIS-29 or QALYs . No adverse events reported . Estimated cost per person for FACETS is £ 453 ; findings suggest an incremental cost-effectiveness ratio of £ 2157 per additional person with a clinical ly significant improvement in fatigue . Conclusions FACETS is effective in reducing fatigue severity and increasing fatigue self-efficacy . However , it is difficult to assess the additional cost in terms of cost-effectiveness ( ie , cost per QALY ) as improvements in fatigue are not reflected in the QALY outcomes , with no significant differences between FACETS and CLP . The strengths of this trial are its pragmatic nature and high external validity . Trial registration : Current Controlled Trials IS RCT N76517470 OBJECTIVE This study tested whether an intervention that combined information with self-regulation strategies had a better effect on eating fruits and vegetables than an information-only intervention . DESIGN Women between age 30 and 50 ( N = 255 ) participated in a 24-month r and omized controlled trial comparing two brief interventions : All participants received the same information intervention ; participants in the information plus self-regulation group additionally learned a self-regulation technique that integrates mental contrasting with implementation intentions . MAIN OUTCOME MEASURES Participants reported in daily diaries how many servings of fruits and vegetables they ate per day during 1 week at baseline , and in the first week , 1 , 2 , 4 , and 24 months after intervention . RESULTS Participants in both groups ate more fruits and vegetables ( 0.47 to 1.00 daily servings ) than at baseline during the first 4 months after intervention . Two years later , participants in the information plus self-regulation group maintained the higher intake , whereas participants in the information group returned to baseline levels . CONCLUSION Adding self-regulation training to an information intervention increased its effectiveness for long-term behavior change OBJECTIVE To test the efficacy in promoting brisk walking of two theory-based interventions that incorporate implementation intentions and text message ( Short Message Service ; SMS ) reminders directed at one 's walking-related plans or goals . DESIGN Participants ( N = 149 ) were r and omized to one of three conditions ( implementation intention + SMS plan reminder , implementation intention + SMS goal reminder , control ) before completing measures at baseline and follow-up 4 weeks later . At follow-up , the experimental groups were given a surprise recall task concerning their plans . All participants completed an equivalent goal recall task . MAIN OUTCOME MEASURES Vali date d self-report measures of physical activity and measures of implementation intention and goal recall , weight , and waist-to-hip ratio . RESULTS Both intervention groups increased their brisk walking relative to the control group , without reducing other physical activity . The goal reminder group lost the most weight . The SMS plan reminder group recalled more of their plans than the SMS goal reminder group , but the latter were more successful in goal recall . CONCLUSION Both interventions can promote brisk walking in sedentary population s. Text messages aid the recall of , and could enhance interventions that target , implementation intentions and goals The combination of low physical activity rates and increased cardiovascular deaths indicate the overwhelming need for behaviour change interventions that can effectively promote physical activity among sedentary women . This 11-week r and omised controlled trial examined the effects of an implementation intentions intervention on sedentary women 's walking behaviour . Seventy-five women ( M age = 48.17 ) were r and omly assigned to either a control group where they were required to self-monitor their daily pedometer-determined step count or to an experimental group where they were asked to form specific walking plans ( i.e. implementation intentions ) every 6 weeks and to self-monitor their daily pedometer-determined step count .  Measures of  exercise intentions , perceived behavioural control , scheduling and barrier self-efficacy were administered at baseline , week 6 and week 11 . Analyses indicated higher step counts over the first 6 weeks for women in the experimental condition ( p < 0.02 ) . Furthermore , higher self-efficacy to schedule ( p < 0.01 ) and overcome walking barriers ( p < 0.03 ) , as well as higher perceptions of behavioural control ( p < 0.02 ) were found at week 11 for women in the experimental versus control condition . However , none of the control beliefs were found to mediate the effects of the intervention on the women 's walking behaviour . Furthermore , the intervention did not have any effect on the strength of the goal intention – behaviour relationship . The findings suggest implementation intentions are an effective strategy for initiating leisure-time walking within sedentary women Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to  
    Output:
    
Implication s for Rehabilitation Steps involved in achieving goals , such as doing exercises or completing other goal related tasks , can be compromised for people with chronic health conditions particularly result ing from difficulties in self-regulating behaviour .
If-then plans are implementation intention tools aim ed at supporting people to deal more effectively with self-regulatory problems that might undermine goal striving and goal attainment , and have been found to be effective in health promotion and health behaviour change .
If-then plans provide an opportunity for clinicians to develop better ways of implementing rehabilitation