***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: Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design OBJECTIVE To determine whether a multicomponent health promotion intervention for Dutch adolescents ( defined as persons between 12 and 14 years of age ) would be successful in influencing body composition and dietary and physical activity behavior in both the short and long terms . DESIGN R and omized controlled trial . SETTING Ten intervention and 8 control prevocational secondary schools . PARTICIPANTS A total of 1108 adolescents ( mean age , 12.7 years ) . Intervention An interdisciplinary program with an adapted curriculum for 11 lessons in biology and physical education and environmental change options . MAIN OUTCOME MEASURES Body height and weight , waist circumference , 4 skinfold thickness measurements , and dietary and physical activity behavior data . RESULTS Multilevel analyses showed that the intervention remained effective in preventing unfavorable increases in important measures of body composition after 20-month follow-up in girls ( biceps skinfold and sum of 4 skinfolds ) and boys ( triceps , biceps , and subscapular skinfolds ) . Consumption of sugar-containing beverages was significantly lower in intervention schools both after intervention ( boys : -287 mL/d ; 95 % confidence interval [ CI ] , -527 to -47 ; girls : -249 ; -400 to -98 ) and at 12-month follow-up ( boys : -233 ; -371 to -95 ; girls : -271 ; -390 to -153 ) . For boys , screen-viewing behavior was significantly lower in the intervention group after 20 months ( -25 min/d ; 95 % CI , -50 to -0.3 ) . No significant intervention effects on consumption of snacks or active commuting to school were found . CONCLUSION The Dutch Obesity Intervention in Teenagers program result ed in beneficial effects on the sum of skinfold thickness measurements in girls and consumption of sugar-containing beverages in both boys and girls in both the short and long terms Background School-based interventions that target prevention of overweight and obesity in children have been tested with mixed results . Thus , successful interventions are still called for . The aim of the present study was to investigate effects of a multicomponent school-based intervention programme targeting physical activity , sedentary and dietary behaviours on anthropometric outcomes . Methods A 20-month intervention was evaluated in a cluster r and omised , controlled study of 1324 11-year-olds . Outcome variables were body mass index ( BMI ) , BMI -for-age z-score ( BMI z ) , waist circumference ( WC ) , waist-to-height ratio ( WTHR ) and weight status ( International Obesity Task Force 's cut-offs ) . Weight , height and WC were measured objective ly ; pubertal status was self-reported and parental education was self-reported by the parents . Intervention effects were determined by one-way analysis of covariance and logistic regression , after checking for clustering effects of school , and moderating effects of gender , pubertal status and parental education . Results Beneficial effects were found for BMI ( p=0.02 ) and BMI z ( p=0.003 ) in girls , but not in boys . While a beneficial effect was found for BMI ( p=0.03 ) in participants of parents reporting a high level of education , a negative effect was found for WTHR in participants with parents reporting a low level of education ( p=0.003 ) . There were no intervention effects for WC and weight status . Conclusions A multicomponent 20-month school-based intervention had a beneficial effect on BMI and BMI z in adolescent girls , but not in boys . Furthermore , children of higher educated parents seemed to benefit more from the intervention , and this needs attention in future interventions to avoid further increase in social inequalities in overweight and obesity Background Although school-based interventions to promote physical activity in adolescents have been suggested in several recent review s , questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective . The aim of the present study was to investigate effects of a school-based intervention program : the HEalth in Adolescents ( HEIA ) study , on change in physical activity , and furthermore , to explore whether potential effects varied by gender , weight status , initial physical activity level and parental education level . Methods This was a cluster r and omized controlled 20 month intervention study which included 700 11-year-olds . Main outcome -variable was mean count per minute ( cpm ) derived from ActiGraph accelerometers ( Model 7164/GT1 M ) . Weight and height were measured objective ly . Adolescents reported their pubertal status in a question naire and parents reported their education level on the consent form . Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school . Results The present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group ( 95 % CI −0.4 , 100 ) . Subgroup analyses showed that the effect appeared to be more profound among girls ( Est 65 cpm , CI 5 , 124 , p = 0.03 ) and among participants in the low-activity group ( Est 92 cpm , CI 41 , 142 , p < 0.001 ) , as compared to boys and participants in the high-activity group , respectively . Furthermore , the intervention affected physical activity among the normal weight group more positively than among the overweight , and participants with parents having 13–16 years of education more positively than participants with parents having either a lower or higher number of years of education . The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys . Conclusions A comprehensive but feasible , multi-component school-based intervention can affect physical activity patterns  in adolescents by increasing overall physical activity . This intervention effect seemed to be more profound in girls than boys , low-active adolescents compared to high-active adolescents , participants with normal weight compared to the overweight , and for participants with parents of middle education level as opposed to those with high and low education levels , respectively . An implementation of the HEIA intervention components in the school system may have a beneficial effect on public health by increasing overall physical activity among adolescents and possibly among girls and low-active adolescents in particular Background To improve effectiveness of future screen behaviour interventions , one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups . Parental regulation is identified as a consistent correlate of screen behaviours , but prospect i ve evidence as well as the mediation role of parental regulation is largely lacking . This study investigated post-intervention main effects on screen behaviours in the HEIA-intervention – a Norwegian school-based multiple-behaviour study , as well as mediation effects of parental regulation by adolescents ’ and parents ’ report . In addition , moderating effects of gender and weight status on the intervention and mediating effects were explored . Methods Participating schools were r and omized to control ( n = 25 ) or intervention ( n = 12 ) condition . Adolescents ( n = 908 Control ; 510 Intervention ) self-reported their weekday and weekend TV-viewing and computer/game-use . Change in adolescents ’ behaviours was targeted through school and parents . Adolescents , mothers ( n = 591 Control ; 244 Interventions ) and fathers ( n = 469 Control ; 199 Intervention ) reported  parental regulation of the screen behaviours  post-intervention ( at 20 month ) . The product-of-coefficient test using linear regression analysis was conducted to examine main and mediating effects . Results There was no intervention effect on the screen behaviours in the total sample . Gender moderated effect on weekend computer/game-use , while weight status moderated the effect on weekday TV-viewing and computer/game-use . Stratified analyses showed a small favourable intervention effect on weekday TV-viewing among the normal weight . Parental regulation did not mediate change in the screen behaviours . However , stronger parental regulation was associated with less TV-viewing and computer/game-use with effects being conditional on adolescents ’ versus parental reports . Parental regulation of the screen behaviours , primarily by the parental report , was associated with change in the respective behaviours . Conclusion Multiple behaviour intervention may not affect all equally well , and the effect may differ by weight status and gender . In future interventions parents should be encouraged to regulate their adolescents ’ TV-viewing and computer/game-use on both weekdays and weekends as parental regulation was identified as a determinant of these screen behaviours . However , future intervention studies may need to search for more effective intervention strategies targeting parental regulation . Trial registration Current Controlled Trials IS RCT Active commuting to school increases  children 's daily physical activity .  The built environment is associated with children 's physical activity levels in cross-sectional studies . This study examined the role of the built environment on the outcomes of a " walking school bus " study . Geographical information systems was used to map out and compare the built environments around schools participating in a pilot walking school bus r and omised controlled trial , as well as along school routes . Multi-level modelling was used to determine the built environment attributes associated with the outcomes of active commuting to school and accelerometer-determined moderate-to-vigorous physical activity ( MPVA ) . There were no differences in the surrounding built environments of  control ( n = 4 ) and intervention ( n = 4 ) schools participating in the walking school bus study . Among school walking routes , park space was inversely associated with active commuting to school ( β = -0.008 , SE = 0.004 , P = 0.03 ) , while mixed-l and use was positively associated with daily MPVA ( β = 60.0 , SE = 24.3 , P = 0.02 ) . There was effect modification such that high traffic volume and high street connectivity were associated with greater moderate-to-vigorous physical activity . The results of this study suggest that the built environment may play a role in active school commuting outcomes and daily physical activity Adequate reporting of r and omized , controlled trials ( RCTs ) is necessary to allow accurate critical appraisal of the validity and applicability of the results . The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , a 22-item checklist and flow diagram , is intended to address this problem by improving the reporting of RCTs . However , some specific issues that apply to trials of nonpharmacologic treatments ( for example , surgery , technical interventions , devices , rehabilitation , psychotherapy , and behavioral intervention ) are not specifically addressed in the CONSORT Statement . Furthermore , considerable evidence suggests that the reporting of nonpharmacologic trials still needs improvement . Therefore , the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments . A consensus meeting of 33 experts was organized in Paris , France , in February 2006 , to develop an extension of the CONSORT Statement for trials of nonpharmacologic treatments . The participants extended 11 items from the CONSORT Statement , added 1 item , and developed a modified flow diagram . To allow adequate underst and ing and implementation of the CONSORT extension , the CONSORT group developed this elaboration and explanation document from a review of the literature to provide examples of adequate reporting . This extension , in conjunction with the main CONSORT Statement and other CONSORT extensions , should help to improve the reporting of RCTs performed in this field Background and purpose : The lack of effective school-based interventions for preventing obesity in children has caused a call for longer duration of interventions and better reporting on design and evaluation methodology . The purpose of this paper is to present the development of the intervention , the design of the effectiveness study , and the test-retest reliability of the main outcome measures in the HEalth In Adolescents ( HEIA ) study . Methods / design : The HEIA intervention programme was developed based on literature review s , a social ecological framework , and focus groups . The intervention aim ed to increase total physical activity ( PA ) and consumption of fruit and vegetables and to decrease screen time and consumption of sugar-sweetened beverages . The intervention programme consisted of a classroom component , including dietary behaviour lessons , computer tailoring , fruit/vegetable and PA breaks , and posters , and an environmental component including active transport campaigns , equipment , suggestions for easy improvements of schoolyards , inspirational courses for teachers ( all with regards to PA ) , and fact sheets to parents . The effect of the intervention programme is evaluated in a cluster r and omised controlled trial design ( intervention = 12 schools , control = 25 schools ) including process evaluation . Main outcomes include anthropometry , PA , screen time , and consumption of fruit , vegetables , and sugar-sweetened beverages . A 2-week test— retest study was conducted among 114 pupils . Determinants of the behaviours were assessed . Similar data were collected from parents . Children ’s PA was measured objective ly by accelerometers . Conclusions : The HEIA study represents a theoretically informed r and omised trial comprising a comprehensive set of multilevel intervention components with a thorough evaluation using reliable outcome measures . The study will contribute to a better underst and ing of determinants of healthy weight development among young people and how such determinants can be modified The annual distance walked by children  has fallen 28 % since 1972 , partly because 
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The analysis of the interventions using the ALBD Community Action Model showed that Preparation and Promotion were used much more frequently than Policy and Physical projects .
Conclusion Noted improvements were an increase in use of objective measures .
Lack of theory , weak method ological design and a lack of reliable and valid measurement were observed .