***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: Objective : Workplace cancer prevention initiatives have been least successful with blue-collar workers . This study assesses whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables , compared to a st and ard health promotion intervention , for workers overall and for blue-collar workers in particular . Methods : A r and omized controlled design was used , with 15 manufacturing worksites assigned to a  health promotion ( HP )  or a health promotion plus occupational health and safety intervention ( HP/OHS ) , and compared from baseline ( 1997 ) to final ( 1999 ) . The response rates to the survey were 80 % at baseline ( n = 9019 ) and 65 % at final ( n = 7327 ) . Both groups targeted smoking and diet ; the HP/OHS condition additionally incorporated reduction of occupational exposures . Results : Smoking quit rates among  blue-collar  workers in the HP/OHS condition more than doubled relative to those in the HP condition ( OR = 2.13 , p = 0.04 ) , and were comparable to quit rates of white-collar workers . No statistically significant differences between groups were found for mean changes in fruits and vegetables . Conclusions : Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers Background : Studies testing Web-based computer-tailored education in real-life setting s are now needed . Purpose : The aim of this study is to examine the effectiveness and applicability of an  interactive computer-tailored fat reduction intervention  , which was previously tested as efficacious in a controlled setting , delivered to a broader population by local health promotion services . The impact of the computer-tailored intervention is compared with a generic intervention and with a no-intervention control group . Methods : A quasi-experimental design was used assigning 6 companies r and omly to ( a ) the computer-tailored intervention condition , ( b ) the generic intervention condition , and ( c ) the no-intervention control condition . Participants ( N=337 ) completed vali date d baseline and posttest question naires and received the personal feedback immediately through the company ’s intranet . A structured interview with the project coordinators assessed the process that the companies had passed through to disseminate the fat intake intervention . Results : Six months postbaseline , the results showed that the computer-tailored intervention to reduce fat intake implemented through worksites was more effective in decreasing employees ’ fat intake compared with a generic intervention , F=23.5 , p<.001 , or no intervention , F=28.1 , p<.001 . Moreover , the dissemination strategy used is feasible for local health promotion services . Conclusions : This study can be regarded as an effective “ real-life ” trial with an implementation strategy that can be used for large scale dissemination OBJECTIVES This study examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines . METHODS  Low-fat snacks were added to 55 vending machines in a convenience sample of 12 secondary schools and 12 worksites . Four pricing levels ( equal price , 10 % reduction , 25 % reduction , 50 % reduction ) and 3 promotional conditions ( none , low-fat label , low-fat label plus promotional sign ) were crossed in a Latin square design . Sales of low-fat vending snacks were measured continuously for the 12-month intervention . RESULTS Price reductions of 10 % , 25 % , and 50 % on low-fat snacks were associated with significant increases in low-fat snack sales ; percentages of low-fat snack sales increased by 9 % , 39 % , and 93 % , respectively . Promotional signage was independently but weakly associated with increases in low-fat snack sales . Average profits per machine were not affected by the vending interventions . CONCLUSIONS Reducing relative prices on low-fat snacks was effective in promoting lower-fat snack purchases from vending machines in both adult and adolescent population As part of the Harvard Cancer Prevention Program Project , we used a social context ual model of health behavior change to test an intervention targeting multiple risk-related behaviors in working-class , multiethnic population s. We examined the relationships between the social context ual factors in our conceptual model and changes in fruit and vegetable consumption from baseline to completion of intervention in health centers and small business studies . We analyzed change in fruit and vegetable consumption , measured at baseline and final assessment s by self-report , in 2 r and omized controlled prevention trials : 1 in small businesses ( n = 974 ) and 1 in health centers ( n = 1954 ) .  Stronger social networks , social norms that were more supportive , food sufficiency , and less household crowding were associated with greater change in fruit and vegetable intake . We also observed differences between our intervention sites . Social context can play an important role in promoting changes in fruit and vegetable consumption Introduction Dietary fat and low fruit and vegetable intake are linked to many chronic diseases , and U.S. population intake does not meet recommendations . Interventions are needed that incorporate effective behavior-change principles and that can be delivered inexpensively to large segments of the population . Methods Employees at a corporate worksite were invited to participate in a program , delivered entirely by e-mail , to reduce dietary fat and increase fruit and vegetable intake .  Behavior-change principles underlying the intervention included tailoring to the participant 's dietary lifestyle , baseline assessment and feedback about dietary intake , family participation , and goal setting . Assessment , tailoring , and delivery was fully automated . The program was delivered weekly to participants ' e-mail inboxes for 12 weeks . Each e-mail included information on nutrition or on the relationship between diet and health , dietary tips tailored to the individual , and small goals to try for the next week . In this nonr and omized pilot study , we assessed technical feasibility , acceptability to employees , improvement in Stage of Change , increase in fruit and vegetable consumption , and decrease in fat intake . Results Approximately one third ( n = 84 ) of employees who were offered the 12-week program signed up for it , and satisfaction was high . There was significant improvement in Stage of Change : 74 % of those not already at the top had forward movement ( P < .001 ) . In addition , results suggest significant increase in fruit and vegetable consumption ( 0.73 times/day , P < .001 ) and significant decrease in intake of fat sources ( -0.39 times/day , P < .001 ) . Conclusion This inexpensive program is feasible and appears to be effective . A r and omized controlled trial is needed Environmental interventions such as labeling and an increased availability of healthy foods may help consumers to meet guidelines for a healthy diet . This article describes a study into the effectiveness of two environmental programs to be used in worksite cafeterias along with an educational program . The aim of the interventions was to reduce fat intake , and to increase fruit and vegetable intake . In the labeling program , low-fat products were labeled . The food supply program comprised an increased availability of low-fat products and fruits and vegetables in worksite cafeterias . The educational program consisted of information about healthy nutrition through brochures , table tents , a self-help manual and posters . The design consisted of a pre-test-post-test experimental control group design , with four conditions : the educational program ; the food supply program plus educational program ; the labeling program plus educational program ; and a control group .  Seventeen worksites were r and omly assigned to one of the four research conditions . Total fat , fruit and vegetable intake was measured with a quantitative , self-administered food frequency question naire ( 35 questions ) . Intake during lunch was measured by asking respondents to write down which food items they had purchased during their last lunch in the cafeteria . Furthermore , sales data for some targeted product categories were collected ( milk , butter , cheese , meat products , desserts ) . For the whole study population , no significant effects on consumption data were found for any of the programs . The data showed a beneficial and significant treatment effect of the labeling program on total fat intake for respondents who believed they ate a high-fat diet . Sales data revealed a significant effect of the labeling program on desserts , but not for the other products Male employees from four local worksites were recruited to participate in a short-term and low-intensity nutrition intervention which focused on promoting low-fat dietary habits . The sites were r and omized to control conditions or to the intervention programme that consisted of an individualized health risk appraisal , group sessions , mass media activities and environmental changes . Participants were seen before and three months after intervention to measure blood lipids , nutrition knowledge and dietary changes .  Eighty-three per cent of all eligible subjects were screened ( n = 770 ) and follow-up measures were obtained for 82 % . The score for nutrition knowledge improved significantly in the intervention group . There was also a net reduction in the intake of total calories and in the percentage of energy from total fat . Reported intake of carbohydrates and proteins increased . For all employees assessed , there were no changes in mean total cholesterol level or fatty acid composition . Only among participants with hypercholesterolemia was a significant reduction in blood cholesterol observed . This low-intensity intervention programme achieved some self-reported dietary changes and was successful ( at least in part because statistical regression needs to be considered ) in obtaining a more short-term beneficial cholesterol level in employees at higher cardiovascular risk OBJECTIVE This study evaluated the Michigan Farmers ' Market Nutrition Program in one Michigan county to determine its effect on fruit and vegetable consumption behavior . SUBJECTS/ SETTING Subjects were selected from WIC and Community Action Agency population s : 564 low income women completed the pretest ; 455 completed the posttest . Attrition rate was 19.3 % . INTERVENTION Subjects were assigned to one of 4 interventions : education about the use , storage and nutritional value of fruits and vegetables , distribution of farmers ' market coupons , both education and coupons , or no intervention . DESIGN Education-only and coupon and education groups were r and omly assigned ; clinic appointment timing determined assignment to no-intervention and coupon-only groups . MAIN OUTCOME MEASURES A self-administered question naire before and after intervention measured attitudes about fruit and vegetable consumption and intake of fruits and vegetables . WIC records documented redemption of coupons . STATISTICAL ANALYSES Data analysis included 2-way multivariate analysis of covariance , univariate analysis of covariance , logistic regression , and covariance structure modeling . RESULTS Both the education interventions and the coupon interventions had positive effects . Coupons had a direct effect on increasing fruit and vegetable consumption behavior but no effect on attitudes . Education had a direct effect on attitudes and seemed to exert an effect on consumption behavior through attitudes . The maximum impact of the intervention was achieved through a combination of education and coupons . APPLICATIONS This study demonstrated that a low-income population may be more likely to increase its fruit and vegetable consumption behavior when incentives such as coupons improve affordability Objective : This study determined the behavioral and clinical impact of a worksite chronic disease prevention program . Methods : Working adults participated in r and omized clinical trial of an intensive lifestyle intervention . Nutrition and physical activity behavior and several chronic disease risk factors were assessed at baseline , 6 weeks , and 6 months . Results : Cognitive underst and ing of the requirements for a healthy lifestyle increased at the end of the program . Program participants significantly improved their cognitive underst and ing of good nutrition and physical activity and had significantly better nutrition and physical activity behavior at both 6 weeks and 6 months . Participants had significantly lower body fat , blood pressure , and cholesterol . Conclusions : This worksite chronic disease prevention program can significantly increase health knowledge , can improve nutrition and physical activity , and can improve many employee health risks in the short term BACKGROUND This study assessed the effects of the Health Works for Women ( HWW ) intervention on improving multiple behaviors including nutrition and physical activity among rural female blue-collar employees in North Carolina . METHODS Nine small to mid-size workplaces were r and omly assigned to either intervention or delayed intervention conditions . After a baseline survey , an intervention consisting of two computer-tailored magazines and a natural helpers program was conducted over 18 months . Delayed worksites received one tailored magazine . Approximately 77 and 76 % of baseline respondents completed follow-up surveys at 6 and 18 months , respectively , and 538 women ( 63 % ) completed all three surveys . RESULTS At the 18-month follow-up , the intervention group had increased fruit and vegetable consumption by 0.7 daily servings compared to no change in the delayed group ( P < 0.05 ) . Significant differences in fat intake were observed at 6 months ( P < 0.05 ) but not at 18 months . The intervention group also demonstrated improvements in strengthening and flexibility exercise compared to the delayed group . The rates of smoking cessation and cancer screening did not differ between study groups . CONCLUSIONS The HWW project was a successful model for achieving certain health behavior changes among blue-collar women Worksites are a key channel for delivery of interventions design ed to reduce chronic disease among adult population s. Although some evaluations of worksite physical-activity interventions have been conducted , to date very few r and omized trials of worksite health promotion have included the goal of increasing physical-activity levels as part of a comprehensive multiple risk factor approach to worksite health promotion . This article presents the results regarding behavior change found among the cohort of 2055 individuals who completed three health-behavior assessment s as part of their worksites ' participation in The Working Healthy Project ( WHP ) , a multiple risk factor intervention implemented in 26 manufacturing worksites . In this study , a r and omized matched-pair design was used . Fifty-one percent ( n = 2,761 ) of the employees who completed the baseline assessment also completed the interim survey . E 
    Output:
    
In general , worksite interventions led to positive changes in fruit , vegetable and total fat intake .
Conclusions The findings of this review suggest that worksite health promotion programmes are associated with moderate improvement in dietary intake .