***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 Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease . However , many times , such interventions are tested in r and omized trials , become evidence -based , and then fail to reach further use in the community . Project HEAL ( Health through Early Awareness and Learning ) is an implementation trial that aims to compare two strategies of implementing evidence -based cancer communication interventions in African American faith-based organizations . Method This article describes the community-engaged process of transforming three evidence -based cancer communication interventions into a coherent , br and ed strategy for training community health advisors with two delivery mechanisms . Peer community health advisors receive training through either a traditional classroom approach ( with high technical assistance/support ) or a web-based training portal ( with low technical assistance/support ) . Results We describe the process , outline the intervention components , report on the pilot test , and conclude with lessons learned from each of these phases . Though the pilot phase showed feasibility , it result ed in modifications to data collection protocol s and team and community member roles and expectations . Conclusions Project HEAL offers a promising strategy to implement evidence -based interventions in community setting s through the use of technology . There could be wider implication s for chronic disease prevention and control Colorectal cancer screening has clear benefits in terms of mortality reduction ; however , it is still underutilized and especially among medically underserved population s , including African Americans , who also suffer a disproportionate colorectal cancer burden . This study consisted of a theory-driven ( health belief model ) spiritually based intervention aim ed at increasing screening  among African Americans through a community health advisor-led educational series  in 16 churches . Using a r and omized design , churches were assigned to receive either the spiritually based intervention or a nonspiritual comparison , which was the same in every way except that it did not contain spiritual/religious content and themes . Trained and certified peer community health advisors in each church led a series of two group educational sessions on colorectal cancer and screening . Study enrollees completed a baseline , 1-month , and 12-month follow-up survey at their churches . The interventions had significant pre – post impact on awareness of all four screening modalities , and self-report receipt of fecal occult blood test , flexible sigmoidoscopy , and colonoscopy . There were no significant study group differences in study outcomes , with the exception of fecal occult blood test utilization , whereas those in the nonspiritual intervention reported significantly greater pre – post change . Both of these community-engaged , theory-driven , culturally relevant approaches to increasing colorectal cancer awareness and screening appeared to have an impact on study outcomes . Although adding spiritual/religious themes to the intervention was appealing to the audience , it may not result in increased intervention efficacy OBJECTIVES Body and Soul was a collaborative effort among two research universities , a national voluntary agency ( American Cancer Society ) , and the National Institutes of Health to disseminate and evaluate under real-world conditions the impact of previously developed dietary interventions for African Americans . METHODS Body and Soul was constructed from two successful research -based interventions conducted in African-American churches . Components deemed essential from the prior interventions were combined , and then tested in a cluster r and omized-effectiveness trial . The primary outcome was fruit and vegetable intake measured with two types of food frequency question naires  at baseline and 6-month follow-up . RESULTS At the 6-month follow-up , intervention participants showed significantly greater fruit and vegetable ( F&V ) intake relative to controls . Post-test differences were 0.7 and 1.4 servings for the 2-item and 17-item F&V frequency measures , respectively . Statistically significant positive changes in fat intake , motivation to eat F&V , social support , and efficacy to eat F&V were also observed . CONCLUSIONS The results suggest that research -based interventions , delivered collaboratively by community volunteers and a health-related voluntary agency , can be effectively implemented under real-world conditions BACKGROUND Using community-based participatory research ( CBPR ) as a guiding framework , a faith-based diet , nutrition and physical activity intervention for African Americans was implemented and evaluated as a small-scale r and omized trial . METHODS Five churches were recruited ( intervention=3 , control=2 ) , result ing in an enrolled sample of 106 adults ( intervention=74 , control=32 ) . The control group received a minimal intervention consisting of one educational workshop . The  Living Well By Faith intervention group received a more intensive 8-week program . Classes were held twice a week and included educational workshops and exercise sessions . Both interventions were delivered at participating churches . Assessment s for program evaluation occurred at baseline and 2-month follow-up . These included weight , blood pressure , percent body fat , and physical fitness using the step test . RESULTS The sample was predominantly African American , female and well educated . At baseline , no significant differences between intervention and control groups were found for any of the primary endpoints . At 2-months follow up , the intervention group , compared to the control group , showed significant decreases in weight ( P<.02 ) , BMI ( P<.05 ) , and % body fat ( P<.03 ) , with a significant increase in physical fitness ( P<.02 ) . Systolic blood pressure also showed group differences in the predicted direction ( P=.10 ) . CONCLUSION This study provides an exemplar of CBPR . The results obtained are sufficiently promising to support more research involving similar interventions of longer duration and with longer-term follow-up for evaluation Objective . The authors tested the impact on cardiovascular risk profiles of African American women ages 40 years and older after one year of participation in one of three church-based nutrition and physical activity strategies : a st and ard behavioral group intervention , the st and ard intervention supplemented with spiritual strategies , or self-help strategies . Methods . Women were screened at baseline and after one year of participation . The authors analyzed intention-to-treat within group and between groups using a generalized estimating equations adjustment for intra-church clustering . Because spiritual strategies were added to the st and ard intervention by participants themselves , the results from both active groups were similar and , thus , combined for comparisons with the self-help group . Results . A total of 529 women from 16 churches enrolled . Intervention participants exhibited significant improvements in body weight ( −1.1 lbs ) , waist circumference ( −0.66 inches ) , systolic blood pressure ( −1.6 mmHg ) , dietary energy ( −117 kcal ) , dietary total fat ( −8 g ) , and sodium intake ( −145 mg ) . The self-help group did not . In the active intervention group , women in the top decile for weight loss at one year had even larger , clinical ly meaningful changes in risk outcomes ( −19.8 lbs ) . Conclusions . Intervention participants achieved clinical ly important improvements in cardiovascular disease risk profiles one year after program initiation , which did not occur in the self-help group . Church-based interventions can significantly benefit the cardiovascular health of African American women Physical  activity ( PA )  is low among African American women despite awareness of its positive impact on health . Learning and Developing Individual Exercise Skills for a Better Life ( L.A.D.I.E.S. ) compares three strategies for increasing PA among African American women using a cluster r and omized , controlled trial . Underactive adult women from 30 churches ( n=15 participants /church ) were recruited . Churches were r and omized to a faith-based intervention , a non-faith based intervention , or an information only control group . Intervention groups will meet 25 times in group sessions with other women from their church over a 10-month period . Control group participants will receive st and ard educational material promoting PA . All participants will be followed for an additional 12 months to assess PA maintenance . Data will be collected at baseline , 10 , and 22 months . The primary outcome is PA ( steps/day , daily moderate-to-vigorous PA ) . We expect treatment effects indicating that assignment to either of the active interventions is associated with greater magnitude of change in PA compared to the control group . In exploratory analyses , we will test whether changes in the faith-based intervention group are greater than changes in the non-faith-based intervention group . L.A.D.I.E.S. focuses on a significant issue-increasing  PA levels-in a segment of the population most in need of successful strategies for improving health . If successful , L.A.D.I.E.S. will advance the field by providing an approach that is successful for initiating and sustaining change in physical activity , which has been shown to be a primary risk factor for a variety of health outcomes , using churches as the point of delivery BACKGROUND Faith-based interventions using a community-based participatory approach hold promise for eliminating ethnic health disparities . This study evaluated the effects of a volunteer-led statewide program to increase physical activity among members of African-American churches . METHODS African Method ist Episcopal churches within six regions ( Conferences ) were r and omly assigned to receive training in the program immediately or 1 year later . A cohort of 20 r and omly selected churches and 571 members within them took part in telephone surveys at baseline ( May-September 2003 ) and 1 year ( May-August 2004 ) and 2 years later ( June-September 2005 ) . Primary outcomes were physical activity participation , meeting physical activity recommendations , and stage of readiness for physical activity change . Statistical analyses were completed in April 2006 . RESULTS Volunteers ( N=889 ) from 303 churches were trained . Among survey respondents , physical activity did not increase significantly over time , although 67 % were aware of the program . Program awareness was significantly related to all three physical activity outcomes and to fruit and vegetable consumption . Pastoral support was significantly associated with physical activity . CONCLUSIONS Although this intervention reached a large number of churches and created awareness of intervention components , no effects on physical activity behaviors were found . Potential reasons for the lack of significant effects are discussed Despite multidisciplinary efforts to control the nation 's obesity epidemic , obesity has persisted as one of the U.S. 's top public health problems , particularly among African Americans . Innovative approaches to address obesity that are sensitive to the unique issues of African Americans are needed . Thus , a faith-based weight-loss intervention using a community-based participatory research approach was developed , implemented , and evaluated with a rural African American faith community . A two-group , quasi-experimental , delayed intervention design was used , with church as the unit of assignment ( treatment n = 2 , control n = 2 ) and individual as the unit of observation ( treatment n = 36 , control n = 37 ) . Weekly small groups led by trained community members met for 8 weeks and emphasized healthy nutrition , physical activity , and faith 's connection with health . The mean weight loss of the treatment group was 3.60 ± 0.64 lbs . compared to the 0.59 ± 0.59-lb loss of the control group OBJECTIVE To examine the extent to which participants in a combined physical activity ( PA ) and dietary intervention  achieved changes in multiple health behaviors . DESIGN Group r and omized trial ; includes only participants assigned to the intervention group only . SETTING Thirty-six churches in South Carolina . PARTICIPANTS Three hundred sixty African American church members . INTERVENTION A 15-month PA and dietary intervention , guided by the structural ecological model , targeting environmental ( i.e. , social , cultural , physical ) and organizational ( ie , policies , practice s ) changes within the church . MAIN OUTCOME MEASURES Self-reported PA , fruit and vegetable consumption , fat- , and fiber-related behaviors . ANALYSIS Change in each behavior was defined as unadjusted pretest-posttest improvement ≥ 0.20 of the baseline st and ard deviation . The total number and each combination of behaviors changed were calculated . RESULTS Up to 19 % changed no health behaviors as defined above , 31 % changed 1 health behavior , 31 % changed 2 health behaviors , 13 % changed 3 health behaviors , and 5 % changed all 4 of the targeted health behaviors . Combinations of multiple behavior change included PA and dietary behaviors  , which suggests that both behaviors can be changed simultaneously . CONCLUSIONS AND IMPLICATION S Nearly half of participants changed at least 2 health behaviors . Faith-based interventions targeting environmental and organizational change can successfully change multiple behaviors , potentially leading to greater improvements in public health BACKGROUND African Americans are at increased risk for cardiovascular disease and cancer morbidity and mortality .  Physical activity and healthy dietary practice s can reduce this risk . The church is a promising setting to address health disparities , and community-based participatory research is a preferred approach . OBJECTIVES Using a community-based participatory approach and the social ecologic model , the FAN trial aims to increase self-reported moderate-intensity physical activity and fruit and vegetable consumption and reduce blood pressure in African American church members . Secondary aims are to increase objective ly measured moderate-intensity physical activity and fiber/whole grain consumption and reduce fat consumption . DESIGN FAN is a group r and omized trial ( GRT ) with two levels of clustering : participants ( N=1279 ; n=316 accelerometer subgroup ) within church and church within church cluster . In the first wave , seven clusters including 23 churches were r and omized to an immediate intervention or delayed intervention . In subsequent waves , 51 churches were r and omized to an immediate or delayed intervention . METHODS Church committee members , pastors , and cooks participate in full-day trainings to learn how to implement physical activity and dietary changes in the church . Monthly mailings and technical assistance calls are delivered over the 15-month intervention . Members complete measurements at baseline and 15 months . A detailed process evaluation is included . SUMMARY FAN focuses on modifying the social , cultural , and policy environment in a faith-based setting . The use of a community-based participatory research approach , engagement of church leaders , inclusion of a detailed process evaluation , and a formal plan for sustainability and dissemination make FAN unique BACKGROUND Faith-based interventions hold promise for 
    Output:
    
A systematic review of topic-specific faith-based health programs  determined that health outcomes can be improved though faith-based health interventions .