***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: PURPOSE We test the efficacy of an intervention based on the transtheoretical model to increase the intake of fruits and vegetables and to describe differences in psychosocial variables based on the achievement of the 5 A Day Program target . DESIGN AND METHODS This study is a r and omized controlled trial comparing a 12-month fruit and vegetable intervention to a control condition with a 12-month follow-up . Participants included 1,277 community-residing persons who were 60 years of age or older ; 834 provided dietary data at all three time points and are included in our outcome analyses . RESULTS The intervention group increased intake by 0.5 to 1.0 serving more than the control group over 24 months as measured by the NCI Fruit and Vegetable Screener and the 5 A Day Program screener . The majority of the participants ( 58 % ) perceived that they maintained 5 or more servings per day for 24 months . These maintainers had a higher intake at each time point for all dietary measures and differed from those who failed to progress ( 11 % ) for most transtheoretical model variables . IMPLICATION S The intervention was effective in increasing the intake of fruits and vegetables in older adults . Those who maintained their level of perceived intake as 5 or more servings per day consumed 2 - 4 servings per day more than those who failed to progress OBJECTIVE To increase fruit , vegetable , and calcium-rich food consumption in community-dwelling , functionally impaired elderly . DESIGN Six-month , home-based nutrition intervention study . SUBJECTS Seventy men and women older than age 69 years were r and omized to either a nutrition education intervention ( n = 38 ) or a control group that received an exercise intervention ( n = 32 ) . INTERVENTION Nutrition education was design ed to increase fruit , vegetable , and calcium-rich food consumption .  MAIN OUTCOME MEASURES Food intake was assessed by a food frequency question naire . Fasting blood measures of nutrients and carotenoids were performed . Statistical Analysis Two-group r and omized controlled trial with pre-test and post-test design and intention-to-treat analysis . Analysis of covariance to was used to assess differences between the two groups . Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels . Paired t tests were conducted to test within-group changes . RESULTS Compared with the exercise group , subjects in nutrition group increased their self-reported intake of fruits by 1.1 + /- 0.2 ( mean + /- SEM ) servings per day ( 2.8 to 3.9 , P = .01 ) , vegetables 1.1 + /- 0.2 servings per day ( 2.3 to 3.4 , P = .001 ) , and milk/dairy 0.9 + /- 0.2 servings per day ( 3.0 to 3.9 , P = .001 ) . There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene ( P < or = .02 ; r = 0.33 and r = 0.33 , respectively ) . CONCLUSION The results of this study suggest that it is possible to improve the dietary intake of community dwelling elders to include more fruits , vegetables , and calcium-rich foods . Recommendations for increasing consumption of fruits , vegetables , and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual . Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement OBJECTIVE To evaluate the effect of a theory-based newsletter on knowledge , attitude , and behavior change in older adults . DESIGN Pretest-posttest , r and om assignment , and treatment-control design with 2 treatment groups : 1 that received newsletters only and 1 that received newsletters with follow-up telephone interviews . Control group completed pretest-posttest surveys only . SUBJECTS/ SETTING Four hundred eighty men and women , aged 60 to 74 years , were recruited to participate in a home-based educational intervention using a patient list generated from a rural tertiary care hospital data base , Geisinger Medical Center in Danville , Pa. INTERVENTION Five nutrition newsletters design ed using the nutrition communication model and adult learning theory principles were mailed biweekly . Telephone interviews followed each of the 5 newsletters 10 to 14 days after distribution . OUTCOME MEASURES Nutrition knowledge and interest , food behavior related to dietary fat , and stages of change for dietary fat and fiber . STATISTICAL ANALYSES PERFORMED Analysis of covariance was used to determine group differences in posttest outcome measures using pretest as covariate . RESULTS In addition to achieving higher scores than the control group , the treatment groups were significantly different from each other in correct and perceived nutrition knowledge at posttest . Those in the treatment group receiving telephone calls scored higher ( mean change = 19.0 % for correct and 20.3 % for perceived ) than those who received the newsletters only ( mean change = 12.5 % for correct and 14.3 % for perceived ; P < .05 ) . Treatment groups also rated their interest in nutrition higher than the control group did ; there was no between-treatment difference . Treatment groups performed significantly better than the control group for dietary fiber stage of change ( P < .05 ) . Those receiving only newsletters scored significantly better than the control for the " avoid fat " food behavior ( P < .05 ) . APPLICATIONS/ CONCLUSIONS This study provides an example of the incorporation of a theoretical model in development and evaluation of newsletters . Home-delivered nutrition newsletters based on this model can communicate health and nutrition information to older adults . Consumers today have more opportunities than ever before to access nutrition information quickly and inexpensively . Newsletters can help dietetics professionals filter and limit what consumers must process , saving clients time and improving the accuracy of information obtained . Dietetics professionals in both clinical and community practice are uniquely positioned to provide highly focused and underst and able information to consumers via a newsletter format OBJECTIVE The rising health care costs and increasing older adult population in the United States make preventive medicine for this age group especially crucial . Regular physical activity and fruit and vegetable consumption may prevent or delay the onset of many chronic conditions that are common among older adults . The decisional balance sheet is a promotional tool targeting the perceived pros and cons of behavior adoption . The current study tested the efficiency and effectiveness of a single-day decisional balance sheet program , targeting increased physical activity and fruit and vegetable intake among older adults . DESIGN AND SAMPLE Participating adults ( N = 21 , age = 72.2 ) who represented a diverse population in Hawaii ( Japanese = 5 , Filipino = 4 , Caucasian = 4 , Native American = 1 , Native Hawaiian = 1 , Hispanic = 1 , and Others = 5 ) were recruited from housing communities and r and omized to a decisional balance sheet program adapted for physical activity or fruit and vegetable consumption . MEASURES Physical activity was assessed using the International Physical Activity Question naire ( IPAQ ) short form , and daily fruit and vegetable intake with the National Health and Nutrition Examination Survey single item instrument . Baseline and follow-up data were collected . RESULTS Both programs were implemented efficiently , and participants in both groups improved their daily physical activity . The decisional balance sheet for fruit and vegetable consumption appeared less effective . CONCLUSIONS Specific suggestions for similar programs are reported 
    Output:
    
Nutritional programs varied in terms of contents , outcomes , lengths of interventions and follow-up .