***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: An interactive CD-ROM program design ed to reduce adolescent substance use was developed and evaluated . The program uses video vignettes to teach refusal skills and socially acceptable responses to substance use situations , specifically offers of marijuana . In a r and omized pretest-to-posttest experiment with 74 public school students from six classes in three high schools , significant changes were observed at posttest on ( 1 ) the adolescent 's personal efficacy to refuse the offer of marijuana , ( 2 ) the adolescent 's intention to refuse marijuana if offered , and ( 3 ) the adolescent 's perceptions of the social norms associated with substance use and the importance of respecting another 's decision to refuse a drug offer . In addition , adolescents in the treatment condition were able to recall approximately 50 % of the portrayed refusal strategies . Findings are discussed with regard to the potential benefits of an interactive multimedia approach for conducting substance use interventions This article review s major risk factors for cigarette smoking , alcohol , and other drug abuse and promising community-based approaches to primary prevention . In a longitudinal experimental study , 8 representative Kansas City communities were assigned r and omly to program ( school , parent , mass media , and community organization ) and control ( mass media and community organization only ) conditions . Programs were delivered at either 6th or 7th grade , and panels were followed through Grade 9 or 10 . The primary findings were ( a ) significant reductions at 3 years in tobacco and marijuana use and ( b ) equivalent reductions for youth at different levels of risk . This study provides evidence that a comprehensive community program-based approach can prevent the onset of substance abuse and that the benefits are experienced equally by youth at high and low risk The authors evaluated the efficacy of a brief image-based prevention intervention and assessed current drug use as a moderator of intervention effects . In a clinical trial , 416 high school-age adolescents were r and omized to either the brief intervention or usual care control , with data collected at baseline and 3-month follow-up . The brief intervention consisted of a tailored in-person communication and a series of parent/guardian print material s based on the behavior-image model .  Health behavior goal setting increased for participants receiving the brief intervention , with an effect size in the small range ( d = 0.33 ) . Overall effect sizes for cigarette smoking frequency and quantity and alcohol use frequency and quantity were small ( ds = 0.16 - 0.21 ) and in favor of the brief intervention . However , adolescents reporting current substance use who received the brief intervention reduced their frequency and heavy use of alcohol , frequency and quantity of cigarette smoking , and reported fewer alcohol/drug problems , with larger effects ranging from small to approaching medium in size ( ds = 0.32 - 0.43 , ps < .01 ) . This study suggests that brief image-based messages may increase health behavior goal setting and reduce substance use , particularly among drug-using older adolescents Effects of anti-tobacco and anti-marijuana TV advertisements on explicit ( i.e. , semantic differential ratings ) and implicit ( i.e. Implicit Association Test , IAT ) attitudes toward tobacco and marijuana were compared . Two hundred twenty nine , 18- to 19-year-old U.S. college students were r and omly assigned to anti-tobacco or anti-marijuana PSA viewing conditions .  Participants completed a short survey on attitudes  to tobacco and marijuana . Afterwards they watched 15 PSAs embedded in a 15-min science program . At the end , all participants completed IAT for marijuana , IAT for tobacco and the assessment of explicit attitudes . Results of ANCOVA revealed a significant interaction between type of TV PSAs watched and implicit attitudes , F(1,223)=7.12 , p<0.01 when controlling for preexisting attitudes to both substances ; the implicit attitudes were more negative toward the substance that corresponded to the content of advertisements watched ( i.e. , anti-tobacco or anti-marijuana ) . However , analogical analysis on explicit measures showed that attitudes to marijuana became less negative among students that watched anti-marijuana ads than the group with anti-tobacco ads , F(1,222)=5.79 , p<0.02 . The discussion focused on the practical and theoretical implication s of the observed dissociation between implicit and explicit attitudes to marijuana after the exposure to anti-marijuana PSAs OBJECTIVES This study examined the relative perceived effectiveness of 30  antidrug public service announcements ( PSAs )  and assessed the extent to which judgments of effectiveness are related to judgments of realism , amount learned , and positive and negative emotional responses . METHODS Data were obtained from 3608 students in grade s 5 through 12 in 10 schools . The ethnically diverse sample was 50.8 % male . Students in 5 experimental conditions viewed sets of 6 antidrug PSAs and filled out a brief evaluation question naire following each PSA . Those in the control condition viewed a non-drug-related television program . RESULTS The relative perceived effectiveness of the 30 PSAs varied considerably . Sixteen were rated as significantly more effective , and 6 as significantly less effective , than the control program .  Relative rated effectiveness was highly related to realism ( r = .87 ) , amount learned ( r = .88 ) , negative emotion ( r = .87 ) , and positive emotion ( r = -.35 ) . CONCLUSIONS Evaluative research is necessary to prevent broadcast of PSAs that could have a negative impact . PSAs should point out the negative consequences of drug use behavior rather than telling adolescents to " just say no. BACKGROUND Despite the availability of an increasing array of empirically vali date d adolescent drug abuse prevention programs , program material s and evaluation findings are poorly disseminated . CD-ROM and the Internet hold promise for disseminating this information to schools and agencies that directly serve youth , and to policy-making bodies that exercise control over funds to support adolescent drug abuse prevention programming . However , data on the relative efficacy of these newer technologies over conventional print means of dissemination are lacking . METHODS Recruited through schools , community agencies , and policy-making bodies , 188 professionals were r and omized to receive prevention program material s via  pamphlets  ( 55 participants ) , CD-ROM ( 64 participants ) , and the Internet ( 69 participants ) . Participants completed pretest , posttest , and 6-month follow-up measures that assessed their access to prevention program material s ; self-efficacy for identifying , obtaining , and recommending these programs ; and their likelihood of requesting , implementing , and recommending prevention programs to their constituents . RESULTS Participants exposed to dissemination via CD-ROM and the Internet evidence d the greatest short- and long-term gains on accessibility , self-efficacy , and behavioral intention variables . CONCLUSIONS CD-ROM and the Internet are viable means for disseminating adolescent drug abuse prevention programs to schools , community agencies , and policy-making bodies , and should be increasingly used for dissemination purpose Despite clear need , brief web-based interventions for marijuana-using college students have not been evaluated in the literature . The current study was design ed to evaluate a brief , web-based personalized feedback intervention for at-risk marijuana users transitioning to college . All entering first-year students were invited to complete a brief question naire . Participants meeting criteria completed a baseline assessment ( N = 341 ) and were r and omly assigned to web-based personalized feedback or assessment -only control conditions . Participants completed 3-month ( 95.0 % ) and 6-month ( 94.4 % ) follow-up assessment s. Results indicated that although there was no overall intervention effect , moderator analyses found promising effects for those with a family history of drug problems and , to a smaller extent , students who were higher in contemplation of changing marijuana use at baseline . Implication s of these findings for selective intervention of college marijuana use and web-based interventions in general are discussed Two media-based interventions design ed to reduce  adolescent marijuana use ran concurrently from 2005 to 2009 . Both interventions used similar message strategies , emphasizing marijuana ’s inconsistency with personal aspirations and autonomy . “ Be Under Your Own Influence ” was a r and omized community and school trial replicating and extending a successful earlier intervention of the same name ( Slater et al. Health Education Research 21:157–167 , 2006 ) . “ Above the Influence ” is a continuing national television , radio , and print campaign sponsored by the Office of National Drug Control Policy ( ONDCP ) . This study assessed the simultaneous impact of the interventions in the 20 U.S. communities . Results indicate that earlier effects of the “ Be Under Your Own Influence ” intervention replicated only in part and that the most plausible explanation of the weaker effects is high exposure to the similar but more extensive ONDCP “ Above the Influence ” national campaign . Self-reported exposure to the ONDCP campaign predicted reduced marijuana use , and analyses partially support indirect effects of the two campaigns via aspirations and autonomy Successful anti-marijuana messages can be hypothesized to have two types of effects , namely persuasion effects , that is , a change in people 's beliefs about using marijuana , and priming effects , that is , a strengthened correlation between beliefs and associated variables such as attitude and intention . This study examined different sets of anti-drug advertisements for persuasion and priming effects . The ads targeted the belief that marijuana is a gateway to stronger drugs , a belief that is often endorsed by campaign planning officials and health educators . A sample of 418 middle and high school students was r and omly assigned to a control video or one of three series of ads , two of which included the gateway message in either an explicit or implicit way . Results did not support the use of the gateway belief in anti-marijuana interventions . Whereas no clear persuasion or priming effects were found for any of the ad sequences , there is some possibility that an explicit gateway argument may actually boomerang . In comparison to the control condition , adolescents in the explicit gateway condition tended to agree less with the gateway message and displayed weaker correlations between anti-marijuana beliefs and their attitude toward marijuana use . The results suggest that the gateway message should not be used in anti-drug interventions OBJECTIVES The authors describe computer services design ed to make patients better informed and more motivated to participate in treatment . Patients use these services through their touch-tone telephone ; access to a home computer or a modem is not needed . METHODS The authors tested the impact of these computer services on the management of 179 pregnant women who had used cocaine during pregnancy or 1 month before pregnancy ( as reported by the woman ) . Patients were r and omly assigned to control and experimental groups ; only the experimental group had access to the computer services .  Patients were enrolled during the prenatal period and followed for 6 months after the birth of a live child . Self-reported data on the subjects ' participation in drug treatment programs , health status ( using the SF-36 ) , and addiction severity ( using the addiction severity index ) were collected . The computer collected data on the frequency of the use of the service . The dependent variables were participation in formal treatment during the course of the project , and drug and alcohol use at exit interview . Multiple and logistic regressions were used to identify the effects of the intervention after controlling for demographic and baseline variables . RESULTS Data showed that poor , pregnant , undereducated clients who use drugs and lived in multiple residences could use the services ; about one-third of clients used the services more than three times a week . Access to the service did not lead to significant change in patients ' health status , drug use , or utilization of services . Use of the services did lead to significant changes in participation in drug treatment : subjects who used the service more than three times a week were 1.5 times more likely to participate in formal drug treatment than subjects who used the service less often . Participation in formal drug treatment , however , was not effective in reducing the drug or the alcohol use . CONCLUSIONS Almost all patients used the  computer services  to some extent , but there seems to be a threshold after which the use of the services had a more positive impact This study investigates an approach for reducing inhalant initiation among younger adolescents :  altering Socio-Personal Expectations ( SPEs ) , a term referring to perceived linkages between behavior and personally relevant social outcomes . The study focuses specifically on SPEs regarding outcomes associated with increased social status and popularity . An anti-inhalant message was embedded within a short anti-bullying education video .  Young adolescents ( N = 893 ) were assigned r and omly to receive a message focused on the physical or the social harms of inhalant use . The objectives of this study were to test : ( 1 ) the malleability of SPEs , ( 2 ) SPEs ’ predictive validity for future inhalant use , and ( 3 ) whether being exposed to a socio-personal threat , rather than a physical threat , led to different variables affecting drug-relevant decision-making processes . Analysis of variance suggested the malleability of SPEs ( p < .001 ) . Multiple regression analysis revealed that SPEs were predictive of future inhalant use . SPEs accounted for a significant portion of variance in future intentions over and above demographic variables , prior use , psychosocial variables , and perceived physical harm ( R2 = .26 , p < .01 ) . Moreover , being exposed to a social , rather than a physical threat , message result ed in different variables being predictive of future intentions to use inhalants AIMS Continued progress in etiological research and prevention science requires more precise information concerning the specific stages at which socio-demographic variables are implicated most strongly in transition from initial substance use to dependence . The present study examines prospect i ve associations between socio-demographic variables and the subsequent onset of alcohol and drug dependence using data from the National Comorbidity Survey ( NCS ) and the NCS Follow-up survey ( NCS-2 ) . DESIGN The NCS was a nationally representative survey of the prevalence and correlates of DSM-III-R mental and substance disorders in the United States carried out in 1990 - 2002 . The 
    Output:
    
Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people .