***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: Background Positive self-esteem , emotional well-being , school achievements and family connectedness are considered protective factors against health-compromising behaviors . This study examined the effect of an interactive , community-based , media literacy and dissonance wellness program , In Favor of Myself , on the self-image , body image , eating attitudes and behavior of young adolescents . A preliminary cohort study was conducted among 972 program participants who did not take part in the controlled trial . Over 75 % of participants said they would recommend the program to their friends . Methods A controlled trial was conducted to evaluate program acceptability , efficacy and effectiveness among 259 participants ( 210 in the intervention group and 49 in the control group ) , aged 12–14 years , who completed question naires during at least two assessment times . Program material s were provided , along with leaders ' training , in order to ensure quality program delivery and creation of a wide network of committed program leaders . Results The program significantly reduced drive for thinness and self-worth contingent upon others ' approval , the gap between current body figure and ideal figure , and the impact of mood on girls ' self-image . Superiority was found among those participating in the intervention group with respect to recognizing media strategies , the influence of media on desire to change , and the influence of appearance on self-confidence and drive for thinness . Conclusions In Favor of Myself shows promising results for strengthening adolescents ' ability to cope with the challenges of their life stage . Suggestions for improving In Favor of Myself are presented The Media Ready Program was design ed as a middle school , media literacy education , preventive intervention program to improve adolescents '  media literacy skills and reduce their intention to use alcohol or tobacco products . In a short-term efficacy trial , schools in North Carolina were r and omly assigned to conditions ( Media Ready : n = 214 ; control : n = 198 ) . Boys in the Media Ready group reported significantly less intention to use alcohol in the future than did boys in the control group . Also , students in the Media Ready group who had used tobacco in the past reported significantly less intention to use tobacco in the future than did students in the control group who had previously used tobacco . Multilevel multiple mediation analyses suggest that the set of logical analysis Message Interpretation Processing variables mediated the program 's effect on students ' intentions to use alcohol or tobacco in the future Background / Objectives : This longitudinal study describes the relationship between young children ’s screen time , dietary habits  and anthropometric measures . The hypothesis was that television viewing and other screen activities at baseline result in increased consumption of sugar-sweetened beverages ( SSB ) and increased BMI , BMI z-score and waist to height ratio ( WHtR ) two years later . A second hypothesis was that SSB consumption mediates the association between the screen activities and changes in the anthropometric measures .Subjects/ Methods : The study is a part of the prospect i ve cohort study IDEFICS ( “ Identification and prevention of dietary and lifestyle-induced health effects in children and infants ” ) , investigating diet , lifestyle and social determinants of obesity in 2 to 9-year-olds in eight European countries ( baseline n=16 225 , two-year follow-up ; n=11 038 ) .  Anthropometry was objective ly measured , and behaviours were parent-reported . Results : The main hypothesis was supported , but the second hypothesis was not confirmed . The odds ratio of being in the highest quintile of % change in WHtR was 1.26 ( 95 % CI : 1.17–1.36 ) and in BMI 1.22 ( 95 % CI : 1.13–1.31 ) , for each hour per day watching television . The odds ratio of having  increased SSB consumption was 1.19 ( 95 % CI : 1.09–1.29 ) for each hour per day watching TV . The associations for total screen time were slightly weaker . Conclusions : The results indicate substantial effects of TV viewing and other screen activities for young children , both on their consumption of sugary drinks and on an increase in BMI and central obesity . Our findings suggest that television viewing seems to have a stronger effect on food habits and anthropometry than other screen activities in this age group BACKGROUND A r and omized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing  eating disorder and obesity risk factors .  METHOD A total of 1316 grade 7 and 8 girls and boys ( mean age = 13.21 years ) across three Australian states were r and omly allocated to : Media Smart ; Life Smart ; the Helping , Encouraging , Listening and Protecting Peers ( HELPP ) initiative ; or control ( usual school class ) . Risk factors were measured at baseline , post-program ( 5 weeks later ) , and at the 6- and 12-month follow-ups . RESULTS Media Smart girls had half the rate of onset of clinical ly significant concerns about shape and weight than control girls at the 12-month follow-up . Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up . Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up . Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys . A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up , while a main effect for group found Media Smart participants reported less screen time than controls . CONCLUSIONS Media Smart was the only program to show benefit on both disordered eating and obesity risk factors . Whilst further investigations are indicated , this study suggests that this program is a promising approach to reducing risk factors for both problems This study aim ed to evaluate the efficacy of BodyThink , a widely disseminated body image and self-esteem program . Participants were 277 , grade 7 students from 4 secondary schools in Australia . The intervention group ( 62 girls , 85 boys ) participated in BodyThink during four 50-min lessons , while the control group ( 65 girls , 65 boys ) received their usual classes . All participants completed baseline , postintervention and 3-month follow-up question naires . For girls , the intervention group reported higher media literacy and lower internalization of the thin ideal compared to the control group . For boys , the intervention group reported higher media literacy and body satisfaction than the control group . Although some positive outcomes were observed , it would be valuable to find ways to enhance the impact of BodyThink , especially in light of its wide dissemination . Suggestions for improving BodyThink are presented OBJECTIVE To evaluate a community-based intervention aim ed at the primary prevention of disordered eating among preadolescent girls . DESIGN Girl Scout troop members were r and omized into control and intervention groups . Program feasibility and effect at postintervention and 3-month follow-up were evaluated . SUBJECTS/ SETTING 226 girls ( mean age = 10.6 years , st and ard deviation = 0.7 ) from 24 Girl Scout troops . INTERVENTION Six 90-minute sessions focusing on media literacy and advocacy skills . MAIN OUTCOME MEASURES Evaluation focused on program satisfaction and short-term effect on dieting behaviors , body image attitudes , and media knowledge , attitudes , and habits . STATISTICAL ANALYSES Performed t tests , chi 2 tests , and analyses of covariance including troop as a r and om source of variation . RESULTS At baseline , 29 % of the girls were trying to lose weight . The program had a notable positive influence on media-related attitudes and behaviors including internalization of sociocultural ideals , self-efficacy to impact weight-related social norms , and print media habits . A modest program effect on body-related knowledge and attitudes was apparent at post-intervention ( i.e. , on body size acceptance , puberty knowledge , and perceived weight status ) but not at follow-up . Significant changes were not noted for dieting behaviors , but they were in the hypothesized direction . Satisfaction with the program was high among girls , parents , and leaders . APPLICATIONS/ CONCLUSIONS It is feasible to use community youth setting s , such as the Girl Scouts , to implement interventions to prevent disordered eating behaviors . The program led to positive trends in outcome variables ; however , longer and more intensive interventions are needed for lasting changes in body image and dieting behaviors Research ers used a quasi-experiment ( N = 723 ) conducted in the field and using both pretests and posttests to carry out a theory-based evaluation of the effectiveness of a media literacy curriculum implemented in Washington state . Results showed that reflective thinking concerning media message about tobacco increased for all media literacy participants , whether or not they had used tobacco previously . Changes in reflective thinking affected a range of decision-making indicators . Lesson participants who had not used tobacco demonstrated greater change at earlier stages of decision making in ways that suggested a greater underst and ing of the persuasive techniques used by tobacco manufacturers , on indicators such as perceived realism , desirability , and similarity . Lesson participants who had tried tobacco demonstrated greater change at later stages of decision making on indicators such as perceived peer norms for tobacco use , identification with tobacco-related portrayals , and expectancies for tobacco use . All participants also showed increases in their ability and motivations to resist smoking-related influences . Overall , the results suggest that media literacy has important and somewhat different effects on those who have and those who have not experimented with tobacco use . The results also show the importance of measuring cognitive and affective indicators of decision making that may change gradually as participants gain experience putting lessons learned into action OBJECTIVES Body image and eating disturbances have become global phenomena , yet prospect i ve design s have rarely been employed in research on non-Western sample s. This study tested the extent to which select features of the dual-pathway account of bulimic disturbances contributed to changes in eating disorder symptoms reported among adolescents from China . METHODS A sample of 593 Chinese middle school and high school students ( 217 boys , 376 girls ) completed measures of eating disorder symptoms , body image concerns , internalized physical appearance ideals , negative affect , and appearance-based social pressure , teasing  , and  comparison  and returned 9 months later to complete the same measures . RESULTS For both girls and boys , increases in eating disorder symptoms between Times 1 and 2 were predicted by higher baseline levels of fatness concern and perceived social pressure . Among the girls , negative affect also contributed marginally to changes in eating disorder symptoms . CONCLUSIONS Findings suggest specific risk factors including personal concerns about being fat and negative social feedback about physical appearance , may help to explain changes in eating disturbances of adolescents over time and across specific cultures 
    Output:
    
Some relationships between high scores on measures consistent with media literacy constructs and low scores on body dissatisfaction and related attitudes were found .
Media literacy-based interventions revealed improvements in media literacy constructs realism scepticism , influence of media , and awareness of media motives for profit , and improvements in body-related variables , but not disordered eating .