***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: Mobile devices are a promising channel for delivering just-in-time guidance and support for improving key daily health behaviors . Despite an explosion of mobile phone applications aim ed at physical activity and other health behaviors , few have been based on theoretically derived constructs and empirical evidence . Eighty adults ages 45 years and older who were insufficiently physically active , engaged in prolonged daily sitting , and were new to smartphone technology , participated in iterative design development and feasibility testing of three daily activity smartphone applications based on motivational frames drawn from behavioral science theory and evidence . An “ analytically ” framed custom application focused on personalized goal setting , self-monitoring , and active problem solving around barriers to behavior change . A “ socially ” framed custom application focused on social comparisons , norms , and support . An “ affectively ” framed custom application focused on operant conditioning principles of reinforcement scheduling and emotional transference to an avatar , whose movements and behaviors reflected the physical activity and sedentary levels of the user . To explore the applications ' initial efficacy in changing regular physical activity and leisure-time sitting , behavioral changes were assessed across eight weeks in 68 participants using the CHAMPS physical activity question naire and the Australian sedentary behavior question naire . User acceptability of and satisfaction with the applications was explored via a post-intervention user survey . The results indicated that the three applications were sufficiently robust to significantly improve regular moderate-to-vigorous intensity physical activity and decrease leisure-time sitting during the 8-week behavioral adoption period . Acceptability of the applications was confirmed in the post-intervention surveys for this sample of midlife and older adults new to smartphone technology . Preliminary data exploring sustained use of the applications across a longer time period yielded promising results . The results support further systematic investigation of the efficacy of the applications for changing these key health-promoting behaviors Background Reaction time , coordination , and cognition performance typically diminish in older adults , which may lead to gait impairments , falls , and injuries . Regular strength – balance exercises are highly recommended to reduce this problem and to improve health , well-being , and independence in old age . However , many older people face a lack of motivation in addition to other strong barriers to exercise . We developed ActiveLifestyle , an information technology (IT)-based system for active and healthy aging aim ing at improving balance and strength . ActiveLifestyle is a training app that runs on a tablet and assists , monitors , and motivates older people to follow personalized training plans autonomously at home . Objective The objectives were to ( 1 ) investigate which IT-mediated motivation strategies increase adherence to physical exercise training plans in older people , ( 2 ) assess the impact of ActiveLifestyle on physical activity behavior change , and ( 3 ) demonstrate the effectiveness of the ActiveLifestyle training to improve gait speed . Methods A total of 44 older adults followed personalized , 12-week strength and balance training plans . All participants performed the exercises autonomously at home . Question naires were used to assess the technological familiarity and stage of behavior change , as well as the effectiveness of the motivation instruments adopted by ActiveLifestyle . Adherence to the exercise plan was evaluated using performance data collected by the app and through information given by the participants during the study . Pretests and posttests were performed to evaluate gait speed of the participants before and after the study . Results Participants were 75 years ( SD 6 ) , predominantly female ( 64 % ) , held a trade or professional diploma ( 54 % ) , and their past profession was in a sitting position ( 43 % ) . Of the 44 participants who enrolled , 33 ( 75 % ) completed the study . The app proved to assist and motivate independently living and healthy older adults to autonomously perform strength – balance exercises ( median 6 on a 7-point Likert scale ) . Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan , as well as to change their behavior permanently toward a more physically active lifestyle . The exercises were effective to improve preferred and fast gait speed . Conclusions ActiveLifestyle assisted and motivated independently living and healthy older people to autonomously perform strength – balance exercises over 12 weeks and had low dropout rates . The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention . The adoption of assistive technology devices for physical intervention tends to motivate and retain older people exercising for longer periods of time Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background This study provides insight into the long-term efficacy ( i.e. 12 month results ) of the Web-based or print-delivered tailored Active Plus intervention ( with and without environmental approach ) to promote physical activity ( PA ) among the over-fifties . Differences in effect among subgroups are studied as well . Methods Intervention groups ( i.e. print-delivered basic ( PB ; N = 439 ) , print-delivered environmental ( PE ; N = 435 ) , Web-based basic ( WB ; N = 423 ) , Web-based environmental ( WE ; N = 432 ) ) and a waiting list control group ( N = 411 ) were studied in a clustered r and omized controlled trial . Intervention participants received tailored advice three times within 4 months . Long-term effects ( 12 months after the intervention has started , i.e. 8 months after the intervention was completed ) on PA ( i.e. self-reported weekly minutes and days of sufficient PA ) were tested using multilevel linear regression analyses . Participants ’ age , gender , BMI , educational level , PA intention and the presence of a chronic physical limitation were considered to be potential moderators of the effect . Results Overall , the Active Plus intervention was effective in increasing weekly days of sufficient PA ( B=0.49 ; p=.005 ) , but ineffective in increasing weekly minutes of PA ( B=84.59 ; p=.071 ) . Per intervention condition analysis showed that the PB-intervention ( Bdays=0.64 ; p=.002 ; Bmi n=111.36 ; p=.017 ) and the PE-intervention ( Bdays=0.70 ; p=.001 ; Bmi n=157.41 ; p=.001 ) were effective in increasing days and minutes of PA . Neither Web-based conditions significantly increased PA , while the control group decreased their PA . In contrast to the intervention effect on minutes of PA , the effect on weekly days of PA was significantly moderated by the participants ’ baseline intention to be sufficiently physically active . Conclusions In general , after 12 months the print-delivered interventions result ed in stronger effects than the Web-based interventions . The participants ’ baseline intention was the only significant moderator of the intervention effect . All other assessed user characteristics did not significantly moderate the effect of the intervention , which might indicate that the intervention is sufficiently tailored to the different participant characteristics . Additional efforts should be taken to increase the sustainability of Web-based interventions .Trial registration Dutch Trial Register : NTR2297 With more social support and environment-centered interventions being recommended in web-based interventions , this study examined the efficacy of three intervention conditions aim ed at promoting physical activity ( PA ) in older adults . The efficacy analyses included the self-reported PA level , stage of change for PA and awareness about PA among participants . Eligible participants ( N = 149 ; M = 65 years old , SD = 6 ) , recruited in a unique Belgian French-speaking municipality , were r and omized in four research arms for a 3-month intervention : ( i ) web-based ; ( ii ) center-based ; ( iii ) mixed ( combination of web- and center-based ) ; and ( iv ) control ( no intervention ) . Web-based condition included a PA website and monthly tailored emails whereas center-based condition comprised 12 sessions ( 1 per week ) of group exercising . With a significant increase in PA , the PA stage of change and the PA awareness at 12 months , the mixed intervention condition seemed to include the key social and motivating elements for sustainable behavior change . Center-based intervention was more likely to produce significant improvements of the PA level and the stage of change for PA change whereas web-based intervention was more likely to extend the awareness about PA BACKGROUND Remote and web 2.0 interventions for promoting physical activity ( PA ) are becoming increasingly popular but their ability to achieve long term changes are unknown . OBJECTIVES To compare the effectiveness of remote and web 2.0 interventions for PA promotion in community dwelling adults ( aged 16 years and above ) with a control group exposed to placebo or no or minimal intervention . SEARCH METHODS We search ed CENTRAL , MEDLINE , EMBASE , CINAHL , and some other data bases ( from earliest date s available to October 2012 ) . Reference lists of relevant articles were checked . No language restrictions were applied . SELECTION CRITERIA R and omised controlled trials ( RCTs ) that compared remote and web 2.0 PA interventions for community dwelling adults with a placebo or no or minimal intervention control group .  We included studies if the principal component of the intervention was delivered using remote or web 2.0 technologies ( for example the internet , smart phones ) or more traditional methods ( for example telephone , mail-outs ) , or both . To assess behavioural change over time , the included studies had a minimum of 12 months follow-up from the start of the intervention to the final results . We excluded studies that had more than a 20 % loss to follow-up if they did not apply an intention-to-treat analysis . DATA COLLECTION AND ANALYSIS At least two authors independently assessed the quality of each study and extracted the data . Non-English language papers were review ed with the assistance of an interpreter who was an epidemiologist . Study authors were contacted for additional information where necessary . St and ardised mean differences ( SMDs ) and 95 % confidence intervals ( CIs ) were calculated for the continuous measures of self-reported PA and cardio-respiratory fitness . For studies with dichotomous outcomes , odds ratios and 95 % CIs were calculated . MAIN RESULTS A total of 11 studies recruiting 5862 apparently healthy adults met the inclusion criteria . All of the studies took place in high-income countries . The effect of the interventions on cardiovascular fitness at one year ( two studies ; 444 participants ) was positive and moderate with significant heterogeneity of the observed effects ( SMD 0.40 ; 95 % CI 0.04 to 0.76 ; high quality evidence ) . The effect of the interventions on self-reported PA at one year ( nine studies ; 4547 participants ) was positive and moderate ( SMD 0.20 ; 95 % CI 0.11 to 0.28 ; moderate quality evidence ) with heterogeneity ( I2 = 37 % ) in the observed effects . One study reported positive results at two years ( SMD 0.20 ; 95 % CI 0.08 to 0.32 ; moderate quality evidence ) . When studies were stratified by risk of bias , the studies at low risk of bias ( eight studies ; 3403 participants ) had an increased effect ( SMD 0.28 ; 95 % CI 0.16 to 0.40 ; moderate quality evidence ) . The most effective interventions applied a tailored approach to the type of PA and used telephone contact to provide feedback and to support changes in PA levels . There was no evidence of an increased risk of adverse events ( seven studies ; 2892 participants ) . Risk of bias was assessed as low ( eight studies ; 3060 participants ) or moderate ( three studies ; 2677 participants ) . There were no differences in effectiveness between studies using different types of professionals delivering the intervention ( for example health professional , exercise specialist ) . There was no difference in pooled estimates between studies that generated the prescribed PA using an automated computer programme versus a human , nor between studies that used pedometers as part of their intervention compared to studies that did not . AUTHORS ' CONCLUSIONS We found consistent evidence to support the effectiveness of remote and web 2.0 interventions for promoting PA . These interventions have positive , moderate sized effects on increasing self-reported PA and measured cardio-respiratory fitness , at least at 12 months . The effectiveness of these interventions was supported by moderate and high quality studies . However , there continues to be a paucity of cost effectiveness data and studies that include participants from varying socioeconomic or ethnic groups . To better underst and the independent effect of individual programme components , longer term studies , with at least one year follow-up , are required 
    Output:
    
The results of this review will provide new information regarding the question whether eHealth interventions are an effective intervention vehicle for PA promotion in this population .