***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: The prevalence of systemic hypertension and its cardiovascular consequences is higher in African-Americans than in whites .  Low to moderate intensity aerobic exercise lowers blood pressure ( BP ) in African-American patients with severe hypertension . It is not known whether such exercise can improve lipid metabolism in these patients . Thirty-six African-American men with established essential hypertension , aged 35 to 76 years , were r and omly assigned to an exercise ( n = 17 ) or no exercise ( n = 19 ) group . The exercise group exercised for 16 weeks , 3 times/week , at 60 % to 80 % of maximum heart rate . After 16 weeks , peak oxygen uptake in the exercise group improved ( 21+/-4 vs 23+/-3 ml/kg/min ; p < 0.001 ) . Body weight did not change . Exercise intensity correlated with high-density lipoprotein ( HDL ) cholesterol changes from baseline to 16 weeks ( r = 0.65 ; p < 0.01 ) and was the strongest predictor of these changes ( R2 = 0.4 ; p = 0.009 ) . Lipoprotein-lipid changes in the 2 r and omized groups did not differ significantly . A 10 % increase in HDL cholesterol--42+/-19 versus 46+/-19 mg/dl ; p = 0.003 - -noted in 10 patients who exercised > or = 75 % of maximal heart rate suggested the existence of an exercise intensity threshold . Thus low to moderate intensity aerobic exercise may not be adequate to modify lipid profiles favorably in patients with severe hypertension . However , substantial changes in HDL cholesterol were noted in patients exercising at intensities > or = 75 % of age-predicted maximum heart rate , suggesting an exercise-intensity threshold Background Tailored health communications to date have been based on a rather narrow set of theoretical constructs . Purpose This study was design ed to test whether tailoring a print-based fruit and vegetable ( F & V ) intervention on relatively novel constructs from self-determination theory ( SDT ) and motivational interviewing ( MI ) increases intervention impact , perceived relevance , and program satisfaction . The study also aim ed to explore possible user characteristics that may moderate intervention response . Methods African American adults were recruited from two integrated health care delivery systems , one based in the Detroit Metro area and the other in the Atlanta Metro area , and then r and omized to receive three tailored  newsletters over 3 months . One set of newsletters was tailored only on demographic and social cognitive variables ( control condition ) , whereas the other ( experimental condition ) was tailored on SDT and MI principles and strategies . The primary focus of the newsletters and the primary outcome for the study was fruit and vegetable intake assessed with two brief self-report measures . Preference for autonomy support was assessed at baseline with a single item : “ In general , when it comes to my health I would rather an expert just tell me what I should do ” . Most between-group differences were examined using change scores . Results A total of 512 ( 31 % ) eligible participants , of 1,650 invited , were enrolled , of which 423 provided complete 3-month follow-up data . Considering the entire sample , there were no significant between-group differences in daily F & V intake at 3 month follow-up . Both groups showed similar increases of around one serving per day of F & V on the short form and half a serving per day on the long form . There were , however , significant interactions of intervention group with preference for autonomy-supportive communication as well as with age . Specifically , individuals in the experimental intervention who , at baseline , preferred an autonomy-supportive style of communication increased their F & V intake by 1.07 servings compared to 0.43 servings among controls . Among younger controls , there was a larger change in F & V intake , 0.59 servings , than their experimental group counterparts , 0.29 servings . Conversely , older experimental group participants showed a larger change in F & V , 1.09 servings , than older controls , 0.48 . Conclusion Our study confirms the importance of assessing individual differences as potential moderators of tailored health interventions . For those who prefer an autonomy-supportive style of communication , tailoring on values and other motivational constructs can enhance message impact and perceived relevance We examined race-specific weight-loss results from two r and omized , multicenter trials ; the Hypertension Prevention Trial ( HPT ) and the Trials of Hypertension Prevention ( TOHP ) . Mean weight change from baseline averaged 2.2 kg less in black women than in white women during 18 mo of follow-up in TOHP and 2.7 kg less during 36 mo of follow-up in HPT .  Mean weight loss averaged 2.0 kg less in black than in white men in TOHP and 1.4 kg less in HPT . Because of greater weight gain in black control subjects , a comparison of net weight loss ( change in intervention minus change in control participants , within-race ) showed a less marked difference than did black-white differences in weight loss within the actively treated group . Thus , relative to weight that would have been gained without the intervention , the experience of blacks and whites was more similar . Racial differences in weight loss may result from a combination of behavioral , sociocultural , biological , and programmatic factors OBJECTIVE To identify African American cultural characteristics that may be used to modify clinical trial design s and behavioral programs aim ed at losing weight and maintaining weight loss . DESIGN Focus group discussion s. SETTING University-affiliated biomedical research center . PARTICIPANTS Thirty-one African American men and women who completed the screening process , but were ineligible for the Weight Loss Maintenance ( WLM ) trial , participated in one of five focus group sessions . WLM is a r and omized controlled trial that compares two lifestyle interventions for preventing weight regain in individuals who have successfully lost weight in a group-based behavioral weight loss program .  RESULTS Nine themes emerged as cultural characteristics specific to African Americans seeking participation in a lifestyle change program : ( 1 ) religion is a powerful force ; ( 2 ) family structure ; ( 3 ) integration dismantled the African American family ; ( 4 ) general mistrust of Caucasians ; ( 5 ) African Americans are undervalued and not respected as a people ; ( 6 ) limited re sources equal limited ability to make lifestyle changes ; ( 7 ) preservation of an explicit ethnic identity ; ( 8) education is the key to success as an African American ; and ( 9 ) communication skills are vital . CONCLUSIONS Identifying cultural characteristics specific to African Americans may help investigators design clinical trials that will enhance outcomes and improve the generalizability of results in ethnic minority population PURPOSE Communities That Care ( CTC ) is a prevention system design ed to reduce levels of adolescent delinquency and substance use through the selection and use of effective preventive interventions tailored to a community 's specific profile of risk and protection . This article describes early findings from the first group-r and omized trial of CTC . METHODS A panel of 4407 fifth- grade students was surveyed annually through seventh grade . Analyses were conducted to assess the effects of CTC on reducing levels of targeted risk factors and reducing initiation of delinquent behavior and substance use in seventh grade , 1.67 years after implementing preventive interventions selected through the CTC process . RESULTS Mean levels of targeted risks for students in seventh grade were significantly lower in CTC communities compared with controls . Significantly fewer students in CTC communities than in control communities initiated delinquent behavior between grade s 5 and 7 . No significant intervention effect on substance use initiation by spring of seventh grade was observed . CONCLUSIONS CTC 's theory of change hypothesizes that it takes from 2 to 5 years to observe community-level effects on risk factors and 5 or more years to observe effects on adolescent delinquency or substance use . The early findings indicating hypothesized effects of CTC on targeted risk factors and initiation of delinquent behavior are promising Disengagement beliefs function to reduce cognitive dissonance and a number of predictions with regard to disengagement beliefs have been tested and verified . However , the influence of disengagement beliefs on persuasion has not been studied yet . In a field-experiment , 254 smokers were r and omly assigned to a persuasive message condition or a no-information control condition . First , it was assessed to what extent disengagement beliefs influenced  persuasion .  In smokers with low adherence to disengagement beliefs , quitting activity ( attempting to quit ) in the control condition was high , but this was not further increased by persuasive information on the negative outcomes of smoking . In contrast , smokers who strongly adhered to disengagement beliefs showed low quitting activity in the control condition , but significantly more quitting activity when they received the persuasive message . Second , it was studied what smokers do when they experience negative affect caused by the persuasive message . The results show that in smokers who strongly adhered to disengagement beliefs , negative affect was associated with less quitting activity . Although these results show that quitting activity as assessed at 2 and 8 months follow-ups was influenced by disengagement beliefs , point prevalence seven-day quitting was not . This study shows that adherence to disengagement beliefs is a relevant individual difference in underst and ing effects of smoking cessation interventions OBJECTIVE To evaluate a weight loss and exercise program design ed to improve diabetes management in older African-Americans . RESEARCH DESIGN AND METHODS Overweight African-Americans ( n = 64 ) ages 55–79 years with NIDDM were r and omized to either an intervention ( 12 weekly group sessions , 1 individual session , and 6 biweekly group sessions ) or usual care ( 1 class and 2 informational mailings ) . Clinical and behavioral variables were assessed at 0 , 3 , and 6 months of treatment . RESULTS Significant net differences in the intervention versus usual care were observed for weight ( −2.0 kg , P = 0.006 ) , physical activity , and dietary intake of fat , saturated fat , cholesterol , and nutrition knowledge at 3 months ( all P < 0.05 ) and for weight at 6 months ( −2.4 kg ; P = 0.006 ) and mean HbA1c values at 3 and 6 months ( respectively , −1.6 and −2.4 % , both P < 0.01 ) . After the adjustment for changes in weight and activity , the intervention participants were ∼ twice as likely to have a one unit decrease in HbA1c value as those in usual care . Blood pressure increase sin usual care participants result ed in net differences ( intervention minus control ) at 3 and 6 months of −3.3 ( P = 0.09 ) and −4.0 ( P = 0.05 ) mmHg diastolic , respectively , and −8.4 ( P = 0.06 ) and −5.9 ( P > 0.10 ) mmHg systolic , respectively . Blood lipid profiles improved more in intervention than usual care participants , but not significantly . CONCLUSIONS The intervention program was effective in improving glycemic and blood pressure control . The decrease in HbA1c values was generally independent of the relatively modest changes in dietary intake , weight , and activity and may reflect indirect program effects on other aspects of self-care BACKGROUND African Americans have lower rates of  physical activity ( PA ) than Caucasians . Although correlates of PA have been studied in many population s , little is known about the influences on physical activity for African Americans , particularly African-American men . METHODS Individuals were r and omly selected from 20 church rosters and participated in a telephone survey ( 165 men , 407 women ) in May to September 2003 . Participants were classified according to whether they were meeting recommendations for moderate to vigorous physical activity , walking , and strength training . Sociodemographic , health , psychosocial , and physical environment correlates were also assessed . Mixed-model logistic regression analyses were conducted . RESULTS For men , explained variance ranged from 20.8 % to 33.3 % . For women , the independent variables explained 10.8 % to 23.2 % of the variance in physical activity behavior . Significant positive correlates among men were employment , income , self-rating of health , PA self-efficacy , and PA enjoyment , and fruit and vegetable intake , with age as a negative correlate . Significant positive correlates among women were employment , education , income , self-rating of health , PA self-efficacy , PA enjoyment , fruit and vegetable intake , reporting PA programs at their church , and attempting weight loss . Negative correlates included age , number of chronic health conditions , and body mass index . CONCLUSIONS Various factors influenced  PA in men and women , suggesting a need for gender targeting in addition to cultural adaptations in PA interventions for African Americans Sodium reduction is efficacious for primary prevention of hypertension , but the feasibility of achieving this effect is unclear . The objective of the paper is detailed analyses of adherence to and effects of the sodium reduction intervention among overweight adults in the Trials of Hypertension Prevention , Phase II . Sodium reduction ( comprehensive education and counselling about how to reduce sodium intake ) was tested vs no dietary intervention ( usual care ) for 36–48 months . A total of 956 white and 203 black adults , ages 30–54 years , with diastolic blood pressure 83–89 mmHg , systolic blood pressure ( SBP ) < 140 mmHg , and body weight 110–165 % of gender-specific st and ard weight were included in the study . At 36 months , urinary sodium excretion was 40.4 mmol/24 h ( 24.4 % ) lower in sodium reduction compared to usual care participants ( P<0.0001 ) , but only 21 % of sodium reduction participants achieved the targeted level of sodium excretion below 80 mmol/24 h. Adherence was positively related to attendance at face-to-face contacts . Net decreases in SBP at 6 , 1 
    Output:
    
Although the available evidence appears to show that these interventions produce positive results , the relative and the long-term effectiveness of weight loss , dietary and /or physical activity interventions for this population are unknown