***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 To test the feasibility , acceptability , and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , among African-American girls . DESIGN Twelve-week , 2-arm parallel group , r and omized controlled trial . SETTING Low-income neighborhoods . PARTICIPANTS Sixty-one 8 - 10-year-old African-American girls and their parents/guardians . INTERVENTIONS The treatment intervention consisted of after-school dance classes at 3 community centers , and a 5-lesson intervention , delivered in participants ' homes , and design ed to reduce television , videotape , and video game use . The active control intervention consisted of disseminating newsletters and delivering health education lectures . MAIN OUTCOME MEASURES Implementation and process measures , body mass index , waist circumference , physical activity measured by accelerometry , self-reported media use , and meals eaten with TV . RESULTS Recruitment and retention goals were exceeded . High rates of participation were achieved for assessment s and intervention activities , except where transportation was lacking . All interventions received high satisfaction ratings . At follow up , girls in the treatment group , as compared to the control group , exhibited trends toward lower body mass index ( adjusted difference = -.32 kg/m2 , 95 % confidence interval [ CI ] -.77 , .12 ; Cohen 's d = .38 st and ard deviation units ) and waist circumference ( adjusted difference = -.63 cm , 95 % CI -1.92 , .67 ; d = .25 ) ; increased after-school physical activity ( adjusted difference = 55.1 counts/minute , 95 % CI -115.6 , 225.8 ; d = .21 ) ; and reduced television , videotape , and video game use ( adjusted difference = -4.96 hours/week , 95 % CI -11.41 , 1.49 ; d = .40 ) . The treatment group reported significantly reduced household television viewing ( d = .73 , P = .007 ) and fewer dinners eaten while watching TV ( adjusted difference = -1.60 meals/week , 95 % CI -2.99 , -.21 ; d = .59 ; P = .03 ) . Treatment group girls also reported less concern about weight ( d = .60 ; P = .03 ) , and a trend toward improved school grade s ( d = .51 ; P = .07 ) . CONCLUSIONS This study confirmed the feasibility , acceptability , and potential efficacy of using dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , in African-American girls OBJECTIVE This study tested the efficacy of an 8-week culturally targeted nutrition and physical activity intervention on body composition . METHODS A r and omized , attention-controlled , two-group trial was conducted in a blackowned commercial gym with a sample of 366 predominantly healthy , obese African American women . A free 1-year membership to the study site gym was provided to participants in both groups . Data were collected at baseline , 2 , 6 , and 12 months . RESULTS Sample retention at 1 year was 71 % . Between-group longitudinal analysis including only participants with complete data revealed a trend toward weight stability in the intervention group at 2 months compared with controls ( + 0.05 kg/m(2 ) , p = 0.75 ; + 0.32 kg/m(2 ) , p = 0.08 , respectively ) , disappearing at 12 months ( + 1.37 kg/m(2 ) , p = 0.0001 ; + 1.02 kg/m(2 ) , p = 0.001 , respectively ) . Within-group analysis demonstrated that intervention and control participants ' fitness ( 1-mile run-walk ) improved by 1.9 minutes ( p = 0.0001 ) and 2.3 minutes ( p = 0.0001 ) , respectively , at 12 months . Mixed model regression analyses demonstrated a significant main effect of the intervention on fitness ( p = 0.0185 ) and a marginally significant effect on body mass index ( BMI ) ( p = 0.057 ) , at 2 months , disappearing by 6 months . By 12 months , however , the controls exhibited a significant advantage in waist circumference stability compared with intervention participants ( + 1.1 cm , p = 0.2763 ; + 2.1 cm , p = 0.0002 , respectively ) . CONCLUSIONS The intervention produced modest short-term improvements in body composition , but the economic incentive of a free 1-year gym membership provided to all participants was a more potent intervention than the education and social support intervention tested . However , longer-term fitness enhancement remains elusive and dem and s research and policy attention . These findings have policy implication s in that employer-/insurer-subsidized gym memberships may require interventions targeting other levels of change ( e.g. , physical or social/environmental ) to foster sustainable fitness improvements The goal of evidence -based medicine is ultimately to improve patient outcomes and quality of care .  Systematic review s of the available published evidence are required to identify interventions that lead to improvements in behavior , health , and well-being . Authoritative literature review s depend on the quality of published research and research reports . The Consoli date d St and ards for Reporting Trials ( CONSORT ) Statement ( www.consort-statement.org ) was developed to improve the design and reporting of interventions involving r and omized clinical trials ( RCTs ) in medical journals . We describe the 22 CONSORT guidelines and explain their application to behavioral medicine research and to evidence -based practice . Additional behavioral medicine-specific guidelines ( e.g. , treatment adherence ) are also presented . Use of these guidelines by clinicians , educators , policymakers , and research ers who design , report , and evaluate or review RCTs will strengthen the research itself and accelerate efforts to apply behavioral medicine research to improve the processes and outcomes of behavioral medicine practice Background Latinos comprise the largest racial/ethnic group in the United States and have 2–3 times the prevalence of type 2 diabetes mellitus as Caucasians . Methods and design The Lawrence Latino Diabetes Prevention Project ( LLDPP ) is a community-based translational research study which aims to reduce the risk of diabetes among Latinos who have a ≥ 30 % probability of developing diabetes in the next 7.5 years per a predictive equation . The project was conducted in Lawrence , Massachusetts , a predominantly Caribbean-origin urban Latino community . Individuals were identified primarily from a community health center 's patient panel , screened for study eligibility , r and omized to either a usual care or a lifestyle intervention condition , and followed for one year . Like the efficacious Diabetes Prevention Program ( DPP ) , the LLDPP intervention targeted weight loss through dietary change and increased physical activity . However , unlike the DPP , the LLDPP intervention was less intensive , tailored to literacy needs and cultural preferences , and delivered in Spanish . The group format of the intervention ( 13 group sessions over 1 year ) was complemented by 3 individual home visits and was implemented by individuals from the community with training and supervision by a clinical research nutritionist and a behavioral psychologist . Study measures included demographics , Stern predictive equation components ( age , gender , ethnicity , fasting glucose , systolic blood pressure , HDL-cholesterol , body mass index , and family history of diabetes ) , glycosylated hemoglobin , dietary intake , physical activity , depressive symptoms , social support , quality of life , and medication use . Body weight was measured at baseline , 6-months , and one-year ; all other measures were assessed at baseline and one-year . All surveys were orally administered in Spanish . Results A community-academic partnership enabled the successful recruitment , intervention , and assessment of Latinos at risk of diabetes with a one-year study retention rate of 93%.Trial registration BACKGROUND Many patients in primary care setting s present with multiple behavioral risk factors for cardiovascular disease . Research has provided little information on the most effective ways to approach multiple behavior change counseling in clinical setting s. METHODS We implemented a r and omized trial in a publicly funded primary care setting to test whether a sequential presentation of stage of change-based counseling to stop smoking , reduce dietary sodium level to less than 100 mEq/L per day , and increase physical activity by at least 10,000 pedometer steps per week would be more effective than simultaneous counseling .  African Americans with hypertension , aged 45 to 64 years , initially nonadherent to the 3 behavioral goals , were r and omized to the following conditions : ( 1 ) 1 in-clinic counseling session on all 3 behaviors every 6 months , supplemented by motivational interviewing by telephone for 18 months ; ( 2 ) a similar protocol that addressed a new behavior every 6 months ; or ( 3 ) 1-time referral to existing group classes ( " usual care " ) . The primary end point was the proportion in each arm that met at least 2 behavioral criteria after 18 months . RESULTS A total of 289 individuals ( 67.3 % female ) were r and omized , and 230 ( 79.6 % ) completed the study . At 18 months , only 6.5 % in the simultaneous arm , 5.2 % in the sequential arm , and 6.5 % in the usual-care arm met the primary end point . However , results for single behavioral goals consistently favored the simultaneous group . At 6 months , 29.6 % in the simultaneous , 16.5 % in the sequential , and 13.4 % in the usual-care arms had reached the urine sodium goal ( P = .01 ) . At 18 months , 20.3 % in the simultaneous , 16.9 % in the sequential , and 10.1 % in the usual-care arms were urine cotinine negative ( P = .08 ) . CONCLUSIONS Long-term multiple behavior change is difficult in primary care . This study provides strong evidence that addressing multiple behaviors sequentially is not superior to , and may be inferior to , a simultaneous approach Background The purpose of this study was to demonstrate how formative program process evaluation was used to improve dose and fidelity of implementation , as well as reach of the intervention into the target population , in the " Active by Choice Today " ( ACT ) r and omized school-based trial from years 1 to 3 of implementation . Methods The intervention integrated constructs from Self-Determination Theory and Social Cognitive Theory to enhance intrinsic motivation and behavioral skills for increasing long-term physical activity ( PA ) behavior in underserved adolescents ( low income , minorities ) .  ACT formative process data were examined at the end of each year to provide timely , corrective feedback to keep the intervention " on track " . Results Between years 1 and 2 and years 2 and 3 , three significant changes were made to attempt to increase dose and fidelity rates in the program delivery and participant attendance ( reach ) . These changes included exp and ing the staff training , reformatting the intervention manual , and developing a tracking system for contacting parents of students who were not attending the after-school programs regularly . Process outcomes suggest that these efforts result ed in notable improvements in attendance , dose , and fidelity of intervention implementation from years 1 to 2 and 2 to 3 of the ACT trial . Conclusion Process evaluation methods , particularly implementation monitoring , are useful tools to ensure fidelity in intervention trials and for identifying key best practice s for intervention delivery OBJECTIVE To assess the feasibility , acceptability , and outcomes of 2 versions of a culturally relevant , family-based intervention to prevent excess weight gain in pre-adolescent African-American girls . DESIGN Three-arm , 12-week parallel group r and omized controlled pilot trial . SETTING Community centers in Memphis , Tennessee . PARTICIPANTS Sixty African-American girls , aged 8 to 10 years , with a body mass index ( BMI ) > or = 25th percentile of the CDC growth charts , along with their parents/caregivers . INTERVENTIONS The active interventions involved highly interactive weekly group sessions with either girls ( child-targeted program ) or parents/caregivers ( parent-targeted program ) . Content focused on knowledge and behavior change skills to promote healthy eating and increased physical activity . The comparison intervention focused on global self-esteem . MAIN OUTCOME MEASURES Given the lack of power and the limited time frame of the pilot study , outcomes were evaluated on the basis of implementation measures and changes in physical activity ( accelerometer data ) , and in consumption of sweetened beverages and water , as estimated from question naires . Changes in body mass index , waist circumference , and body composition were also examined . RESULTS The Memphis GEMS pilot intervention met all recruitment , retention , implementation , and participation goals , and was given high rating by both participants and interventionists . With respect to the comparison intervention , girls in both the child-targeted and parent-targeted interventions demonstrated a trend toward reduced body mass index and waist circumference . In addition , girls in the active intervention groups reduced their consumption of sweetened beverages by 34 % , increased their level of moderate-to-vigorous activity by 12 % , and increased their serving ; of water by 1.5 % . CONCLUSIONS The findings from this pilot study demonstrated the feasibility , perceived acceptability , and efficacy of culturally relevant , obesity prevention interventions for pre-adolescent African-American girls and their parents/caregivers BACKGROUND Prevention efforts to reduce the morbidity and mortality disparity between blacks and whites in the United States present a national health priority . However , participation of blacks in prevention trials has been low . The present study reports successful recruitment processes from two economically diverse black population s. METHODS The two studies were independent projects , but both were part of a nationally funded collaboration on cardiovascular health . " Hip Hop to Health " is a 4-year r and omized controlled trial aim ed at di 
    Output:
    
Successful retention strategies included efficient administrative tracking of participants , persistence , skillful teamwork , and demonstrating a positive , caring attitude towards participants .