***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: OBJECTIVES The objectives of this pilot study were to compare the dietary , physiological and metabolic effects of 12-week modified carbohydrate nutrition intervention when disseminated in an individualized home-based format versus a group classroom-based format . METHODS Twenty-three overweight ( > /=85(th ) percentile BMI ) Latina adolescent females ( 12 - 17 years of age ) were r and omized to a 12-week modified carbohydrate dietary intervention delivered in either an individualized home-based format ( n = 11 ) or a group classroom-based format ( n = 12 ) . Anthropometrics , dietary intake by 3-day diet records , insulin dynamics by extended 3-hour Oral Glucose Tolerance test ( OGTT ) and body composition by Dual energy X-ray absorptiometry ( DXA ) were measured before and after intervention ; 24-hour diet recalls were collected once or twice per month throughout the program . RESULTS Mixed modeling showed no significant differences in changes in dietary intake between intervention groups , but both groups significantly reduced intake of added sugar , sugary beverages and refined carbohydrates by 33 % , 66 % , and 35 % , respectively , and dietary fiber significantly increased by 44 % ( p < 0.01 ) throughout the 12 weeks . There was a significant time effect for BMI z-scores within each intervention group ( p < 0.05 ) . There was no significant time*intervention group interaction for any of the physiological or metabolic variables , indicating that change over time was not significantly different between intervention groups . CONCLUSIONS Although a culturally tailored , modified carbohydrate dietary intervention led to significant improvements in dietary intake and BMI z-scores , the extremely intensive , individualized , home-based program was no more effective at improving diet , decreasing adiposity or reducing type 2 diabetes risk factors than the traditional classroom-based format PURPOSE The purpose of this study was to compare 2 culturally competent diabetes self-management interventions design ed for Mexican Americans : an original extended program ( 24 hours of education , 28 hours of support groups ) versus a shorter , more re source -efficient compressed strategy ( 16 hours of education , 6 hours of support groups ) . The effects of the interventions on health beliefs are compared . METHODS The authors recruited 216 persons between 35 and 70 years of age diagnosed with type 2 diabetes for at least 1 year . Intervention groups of 8 participants and 8 support persons were r and omly assigned to 1 of the interventions . RESULTS Mean health belief scores on each subscale improved for both intervention groups . Both intervention groups reported significant improvements in perceptions of control of their diabetes . Improvements in health beliefs were more sustained at 12 months for individuals in the longer , extended program . The health belief subscale control was the most significant predictor of HbA1c levels at 12 months . CONCLUSIONS Both culturally competent diabetes self-management education interventions were effective in promoting more positive health beliefs . These findings on health beliefs indicate a dosage effect of the intervention and support the importance of ongoing contact through support groups to attain more sustainable improvements in health beliefs Purpose The purpose of this pilot study was to evaluate a culturally tailored intervention for rural African Americans . Social Cognitive Theory provided the framework for the study . Methods Twenty-two participants were recruited and r and omly assigned to either Group or Individual diabetes self-management ( DSME ) . Group DSME included story-telling , h and s-on activities , and problem-solving exercises . Individual DSME sessions focused on goal - setting and problem-solving strategies . Sessions were offered in an accessible community center over a 10-week period . Results Outcomes included glycosylated hemoglobin ( A1C ) , self-care actions , self-efficacy level , goal attainment , and satisfaction with DSME . Participants in both Group and Individual DSME improved slightly over the 3-month period in self-care activities , A1C level , and goal attainment . Although differences were not statistically significant , trends indicate improved scores on dietary actions , foot care , goal attainment , and empowerment for those experiencing Group DSME . Conclusions The culturally tailored approach was well received by all participants . Improvements among those receiving Individual DSME may indicate that brief sessions using a culturally tailored approach could enhance self-care and glycemic control . Additional testing among more participants over a longer time period is recommended PURPOSE The purpose of this r and omized controlled trial is to determine the effectiveness of an intervention led by promotoras ( community lay workers ) on the glycemic control , diabetes knowledge , and diabetes health beliefs of Mexican Americans with type 2 diabetes living in a major city on the Texas-Mexico border . METHODS One hundred fifty Mexican American participants were recruited at a Catholic faith-based clinic and r and omized into 2 groups . Personal characteristics , acculturation , baseline A1C level , diabetes knowledge , and diabetes health beliefs were measured . The intervention was culturally specific and consisted of participative group education , telephone contact , and follow-up using inspirational faith-based health behavior change postcards . The A1C levels , diabetes knowledge , and diabetes health beliefs were measured 3 and 6 months postbaseline , and the mean change between the groups was analyzed . RESULTS The 80 % female sample , with a mean age of 58 years , demonstrated low acculturation , income , education , health insurance coverage , and strong Catholicism . No significant changes were noted at the 3-month assessment , but the mean change of the A1C levels , F(1 , 148 ) = 10.28 , P < .001 , and the diabetes knowledge scores , F(1 , 148 ) = 9.0 , P < .002 , of the intervention group improved significantly at 6 months , adjusting for health insurance coverage . The health belief scores decreased in both groups . CONCLUSIONS The intervention result ed in decreased A1C levels and increased diabetes knowledge , suggesting that using promotoras as part of an interdisciplinary team can result in positive outcomes for Mexican Americans who have type 2 diabetes . Clinical implication s and recommendations for future research are suggested Background Epidemiologic data have shown that the prevalence of Type 2 diabetes varies with ethnic origin . Type 2 diabetes is up to four times more common in British South Asians than in the indigenous white population . The aim of this study was to develop a culturally appropriate educational intervention programme for South Asians with Type 2 diabetes . We then investigated whether this intervention could produce an improvement , and finally whether any improvement was greater than background changes in knowledge in comparison groups . Methods A multi-site prospect i ve , r and omised controlled study was conducted in all day care centres and three general practice registers with high proportion patients from different ethnic minority groups in Glasgow , Scotl and . The intervention consisted of 18 educational sessions in 6 separate programmes . A modified question naire was used to measure the knowledge , attitudes , and practice of diabetes before and after intervention . Results Baseline assessment showed that Indian and Pakistani subjects had less knowledge about diabetes , regarded the disease less seriously , and had a lesser underst and ing of the relationship between control and complications than the white population . No differences in initial responses were found between those who completed the second assessment and those who did not . The intervention group showed significant improvements in scores for Knowledge ( + 12.5 % ) ; Attitudes toward seriousness ( + 13.5 % ) , complications ( + 8.1 % ) , Practice ( + 20.0 % ) . However there were also changes in the ethnic control group scores ; respectively + 5.0 % , + 16.3 % ( significant P < 0.001 ) , + 1.5 % , + 1.7 % . The single white control group also showed some improvements ; respectively + 12.2 % , + 12.4 % ( P = 0.04 ) , + 6.0 % , + 25.0 % ( P = 0.007 ) , but the differences in improvement between these two control groups were not significant . Overall , the improvement seen was similar in both intervention and ethnic control groups and there was no significant difference in the amount of change ( P = 0.36 CI -0.9 to + 2.6 ) . Conclusion This study has shown that conducting a culturally-competent educational intervention in patients with Type 2 diabetes from ethnic minority groups is feasible and can improve their knowledge and attitudes and practice . However there was no net benefit compared with the control group AIMS To compare the impact on weight and exercise of a 2-year church-based diabetes risk reduction programme in four churches in South Auckl and , New Zeal and . METHODS A prospect i ve non-r and omized controlled study of a modular lifestyle and diabetes awareness intervention programme applying community development principles . The study involved four complete church congregations , two Samoan and two Tongan , with 516 participants at commencement . Risk of Type 2 diabetes is high among both ethnic groups . RESULTS Overall , 285 subjects were available for their second assessment . In one intervention church , weight gain was controlled ( vs. control 0 + /- 4.8 vs. + 3.1 + /- 9.8 kg , respectively ; P=0.05 ) , diabetes knowledge ( + 46 + /- 26 % vs. + 4 + /- 17 % ; P<0.001 ) and regular exercise ( at least 3 days per week : + 22 % vs. -8 % ; P=0.032 ) increased and readiness to change weight ( P=0.007 ) shifted towards maintenance ( e.g. maintenance + 41 % vs. + 8 % , respectively ) . The other intervention church increased diabetes knowledge ( + 19 + /- 24 vs. + 8 + /- 25 ; P<0.024 ) , but no other significant personal changes occurred . Attendance and perceived utility of the programme were greater in the first intervention church . CONCLUSIONS A moderate intensity , community-based , structured diabetes awareness and lifestyle programme can reduce diabetes risk , but increasing diabetes knowledge alone is not necessarily associated with healthier lifestyle choices . Continuous and detailed monitoring of penetration of interventions may be essential to help guide the timing of interventions and identify the need for additional strategies to increase participation and motivation BACKGROUND In Turkish immigrant diabetics , problems with communication and cultural differences may hinder delivery of diabetes care . METHODS In a prospect i ve controlled study , the effect of an ethnic-specific diabetes education programme on glycaemic control and cardiovascular risk factors in Turkish type 2 diabetes patients was assessed , by comparing  Turkish diabetics who were offered the education programme with Turkish diabetics offered routine care only ( control group ) .  From 16 general practice s ( 31 GPs ) in Rotterdam , 104 Turkish type 2 diabetes patients were recruited , 85 of whom could be assessed at one-year follow-up .  Glycaemic control , lipid concentrations , blood pressure and body mass index were measured . RESULTS Compared with the control group , mean HbA(1C ) in the intervention group decreased by 0.3 % ( 95 % CI -0.8 to 0.2 ) . A significant decrease in HbA(1C ) was observed in women with HbA(1C ) > 7 % at baseline ( -0.9 % ; 95 % CI -1.73 to -0.09 ) but not in the other subgroups studied . serum lipid concentrations , blood pressure and body mass index remained unchanged in the intervention group . CONCLUSION Ethnic-specific diabetes education by Turkish female educators has no obvious beneficial effect on glycaemic control or cardiovascular risk profile . More focus on specific patient selection and gender e quality between educators/ patients may prove worthwhile OBJECTIVE : To promote weight loss in Samoan church communities through an exercise program and nutrition education . METHODS : A quasi-experimental design was used to assess weight change , over 1 y , in cohorts of people aged 20–77 y from three non-r and omised Samoan church communities ( two intervention , n=365 and one control , n=106 ) in Auckl and , New Zeal and . The intervention churches received aerobics sessions and nutrition education about dietary fat . RESULTS : Baseline body mass index for the intervention and control churches was ( mean±s.e . ) 34.8±0.4 and 34.3±0.9 kg/m2 , respectively . The intervention churches lost an average of 0.4±0.3 kg compared to a 1.3±0.6 kg weight gain in the control church ( P=0.039 , adjusted for confounders ) . The number of people who were vigorously active increased by 10 % in the intervention churches compared to a 5 % decline in the control church ( P=0.007 ) . Nutrition education had little apparent impact on knowledge or behaviour . CONCLUSION : Samoan communities in New Zeal and are very obese and have high rates of annual weight gain . A community-based intervention program arrested this weight gain in the short term We have assessed the impact of a 2-year pilot church-base diabetes risk reduction programme on major lifestyle predictors of future Type 2 diabetes mellitus : exercise and weight control in a prospect i ve non-r and omized controlled study of a modular lifestyle and diabetes awareness intervention programme using a community development model . The study involved two complete church congregations from an ethnic group at high risk of diabetes ( Western Samoans ) ( intervention church n = 78 ; control church n = 144 ) .  Weight remained stable ( 0+/-4.8 kg ) in the intervention church but increased by 3.1+/-9.8 kg in the control 
    Output:
    
The effect on diabetes was greater in culturally tailored and facilitated interventions that encompassed multiple strategies .