***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 measure the change in cardiovascular risk factors achievable in families over one year by a cardiovascular screening and lifestyle intervention in general practice . DESIGN R and omised controlled trial in 26 general practice s in 13 towns in Britain . SUBJECTS 12,472 men aged 40 - 59 and their partners ( 7460 men and 5012 women ) identified by household . INTERVENTION Nurse led programme using a family centred approach with follow up according to degree of risk . MAIN OUTCOME MEASURES After one year the pairs of practice s were compared for differences in ( a ) total coronary ( Dundee ) risk score and ( b ) cigarette smoking , weight , blood pressure , and r and om blood cholesterol and glucose concentrations . RESULTS In men the overall reduction in coronary risk score was 16 % ( 95 % confidence interval 11 % to 21 % ) in the intervention practice s at one year . This was partitioned between systolic pressure ( 7 % ) , smoking ( 5 % ) , and cholesterol concentration ( 4 % ) . The reduction for women was similar . For both sexes reported cigarette smoking at one year was lower by about 4 % , systolic pressure by 7 mm Hg , diastolic pressure by 3 mm Hg , weight by 1 kg , and cholesterol concentration by 0.1 mmol/l , but there was no shift in glucose concentration . Weight , blood pressure , and cholesterol concentration showed the greatest difference at the top of the distribution . If maintained long term the differences in risk factors achieved would mean only a 12 % reduction in risk of coronary events . CONCLUSIONS As most general practice s are not using such an intensive programme the changes in coronary risk factors achieved by the voluntary health promotion package for primary care are likely to be even smaller . The government 's screening policy can not be justified by these results Purpose . To present an evaluation of a 5-year , community-based , chronic disease prevention project managed by a state health department to determine whether the department could replicate similar previous projects that had received more funding and other re sources . Design . The evaluation used a matched comparison design and a review of archive and interview data . Setting . Florence , South Carolina ( population : 56,240 ) . Subjects . A r and om sample of 1642 persons in Florence ( and 1551 in the comparison ) who responded to a risk factor question naire and underwent a physical assessment ; 70 . 7 % of baseline subjects participated in the postintervention . Forty key persons were interviewed concerning project effectiveness . Interventions by Project . Walk-a-thons , a speakers ' bureau , media messages , restaurant food labeling , and cooking seminars .  More than 31,000 participants were involved in 585 activities . Measures . Question naires focused on hypertension , obesity , high cholesterol , smoking , and exercise . Physical assessment s determined lipid , lipoprotein , apolipoprotein , and blood pressure levels . Analysis of covariance was used for baseline and postintervention comparisons . Content analysis was used on archive and interview data . Results . The project had a slightly favorable intervention effect on cholesterol and smoking , but failed to have an effect on other risk factors for cardiovascular disease . The project influenced community awareness , enlisted influential community members , and fostered linkages among local health services . Conclusions . Health departments can be instrumental in community risk reduction programming ; however , they may not replicate projects having greater re sources Background . Worksite wellness programs vary considerably in their design . This study tested four models to compare effectiveness at controlling  high blood pressure , obesity , and cigarette smoking .  Methods . Baseline screening was conducted in four manufacturing plants . Site 1 offered screening only , with referral recommendations for those found to have CVD risks . Site 2 also provided health education information and classes . Site 3 added routine follow-up counseling and a menu of intervention types , and Site 4 added social organization within the plant . R and om sample s of 400 to 500 employees were rescreened at the end of three years . Results . Major improvements in risk levels were found with the addition of routine follow-up counseling and a menu of interventions ( Sites 3 and 4 , compared with Sites 1 and 2 ) . More hypertensives entered treatment and showed greater reductions in blood pressure . Participation in worksite weight loss and smoking cessation programs was significantly increased , and those who participated showed significantly better maintenance of improvements where follow-up was provided . Discussion . The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk , a variety of health improvement intervention modalities , and ongoing follow-up counseling to help people make decisions and sustain health improvements Background The prevalence of overweight and elevated cardiovascular disease ( CVD ) risk among workers in the construction industry is relatively high . Improving lifestyle lowers CVD risk and may have work-related benefits . The purpose of the study was to evaluate the effects on physical activity ( PA ) , diet , and smoking  of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease ( CVD ) . Methods In a r and omized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD , usual care was compared to a 6-month lifestyle intervention . The intervention consisted of individual counseling using motivational interviewing techniques , and was delivered by an occupational physician or occupational nurse . In three face to face and four telephone contacts , the participant 's risk profile , personal determinants , and barriers for behavior change were discussed , and personal goals were set . Participants chose to aim at either  diet and PA  , or smoking . Data were collected at baseline and after six and 12 months , by means of a question naire . To analyse the data , linear and logistic regression analyses were performed . Results The intervention had a statistically significant beneficial effect on snack intake ( β-1.9 , 95%CI -3.7 ; -0.02 ) and fruit intake ( β 1.7 , 95%CI 0.6 ; 2.9 ) at 6 months . The effect on snack intake was sustained until 12 months ; 6 months after the intervention had ended ( β -1.9 , 95%CI -3.6 ; -0.2 ) . The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant . The beneficial effect on smoking was statistically significant at 6 ( OR smoking 0.3 , 95%CI 0.1;0.7 ) , but not at 12 months ( OR 0.8 , 95%CI 0.4 ; 1.6 ) . Conclusions Beneficial effects on smoking , fruit , and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD . Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior . Considering the rising prevalence of unhealthy lifestyle and CVD , especially in the aging population , implementation of this intervention in the occupational health care setting is recommended . Trial registration Current Controlled Trials IS RCT OBJECTIVES To compare the effects of a worksite intervention by the occupational physician  offering simple advice of smoking cessation with a more active strategy of advice including a “ quit date ” and extra support . POPULATION Employees of an electrical and gas company seen at the annual visit by their occupational physicians . CRITERIA END POINTS Smoking point prevalence defined as the percentage of smokers who were non-smokers at one year . Secondary criteria were the percentage of smokers who stopped smoking for more than six months and the difference in prevalence of smoking in both groups . METHODS R and omised controlled trial . The unit of r and omisation was the work site physician and a r and om sample of the employees of whom he or she was in charge . The length of the follow up was one year . Each of 30 work site physicians included in the study 100 to 150 employees . RESULTS Among 504 subjects classified as smokers at baseline receiving simple advice ( group A ) and 591 the more active programme ( group B ) , 68 ( 13.5 % ) in group A and 109 ( 18.4 % ) were non-smokers one year later ( p=0.03 ; p=0.01 taking the occupational physician as the statistical unit and using a non-parametric test ) . Twenty three subjects ( 4.6 % ) in group A and 36 ( 6.1 % ) in group B ( p=0.26 ) declared abstinence of six months or more . Among non-smokers at baseline , 3.4 % in both groups were smokers after one year follow up . The prevalence of smokers did not differ significantly at baseline ( 32.9 % and 32.4 % , p=0.75 ) . After the intervention the prevalence of smoking was 30.8 % in group A and 28.7 % in group B ( p=0.19 ) . An increase of the mean symptoms score for depression in those who quit was observed during this period . CONCLUSIONS A simple cessation intervention strategy during a m and atory annual examination , targeting a population of smokers independently of their motivation to stop smoking or their health status , showed a 36 % relative increase of the proportion of smokers who quit smoking as compared with what can be achieved through simple advice The study describes changes in cardiovascular risk factors during 10 years of a  community intervention program  conducted in a rural area in Central Italy . Two areas were involved , one for treatment and one for reference . In 1983 - 84 , 739 men and 859 women in the treatment area and 942 men and 1045 women in the control area , aged 20 - 69 years , were screened ; total and HDL cholesterol , systolic and diastolic blood pressure , fasting blood glucose , smoking habit , weight and height were measured . Between 1983 and 1993 several intervention activities based on community medicine were carried out in the treatment area . They were based on interaction with the local socio-sanitary institutions and school system in order to influence individual persons , small groups and entire community . Major effort was addressed to mass health education , nutrition education , antismoking-propag and a and detection and treatment of hypertension , diabetes and hyperlipidemia In Japan , the prevalence of smoking among males and females was 56.1 % and 14.2 % , respectively , in 1997 . Male smoking prevalence was exceedingly high as compared to those in other industrialized countries . We conducted a r and omized controlled intervention study on smoking cessation for all smokers in a worksite regardless of their willingness to quit smoking . All of the male smokers in a radiator manufacturing factory ( n=263 ) were r and omly allocated to an intervention group ( n=132 ) or a control group ( n=131 ) . Subjects in the intervention group received individual counseling by a doctor , and those who signed a Smoking Cessation Declaration underwent a five-month intervention . Subjects in the control group received equivalent delayed intervention for four months . The cessation rate after the original intervention was 12.9 % ( 17/132 ) and 3.1 % ( 4/131 ) in the intervention and control groups , respectively ( p=0.003 ) . Among those who once succeeded in quitting , 48.6 % ( 18/37 ) maintained cessation at the long-term survey . Overall , the cessation rate was 8.4 % ( 22/263 ) and the prevalence of smoking among males significantly decreased from 62.9 to 56.7 % ( p=0.038 ) . As a conclusion , intervention in all smokers at a worksite regardless of their willingness to quit is effective and impacts the overall smoking rate Objectives : State and national tobacco quitlines have exp and ed rapidly and offer a range of services . We examined the effectiveness and cost effectiveness of offering callers single session versus multisession counselling , with or without free nicotine patches . Methods : This 3 × 2 r and omised trial included 4614 Oregon tobacco quitline callers and compared brief ( one 15-minute call ) , moderate ( one 30-minute call and a follow-up call ) and intensive ( five proactive calls ) intervention protocol s , with or without offers of free nicotine patches ( nicotine replacement therapy , NRT ) . Blinded staff assessed tobacco use by phone at 12 months . Results : Abstinence odds ratios were significant for moderate ( OR = 1.22 , CI = 1.01 to 1.48 ) and intensive ( OR = 1.29 , CI = 1.07 to 1.56 ) intervention , and for NRT ( OR = 1.58 , CI = 1.35 to 1.85 ) . Intent to treat quit rates were as follows : brief no NRT ( 12 % ) ; brief NRT ( 17 % ) ; moderate no NRT ( 14 % ) ; moderate NRT ( 20 % ) ; intensive no NRT ( 14 % ) ; and intensive NRT ( 21 % ) . Relative to brief no NRT  , the added costs for each additional quit was $ 2467 for brief NRT , $ 1912 for moderate no NRT , $ 2109 for moderate NRT , $ 2641 for intensive no NRT , and $ 2112 for intensive NRT . Conclusion : Offering free NRT and multisession telephone support within a state tobacco quitline led to higher quit rates , and similar costs per incremental quit , than less intensive protocol Background Tobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to or 
    Output:
    
These interventions used Prochaska theory , motivational interviewing or cognitive-behavioral therapies .
Self-help documentation alone was less effective than face-to-face counseling .
Community-based or workplace public interventions alone did not seem effective .
Discussion Behavioral change strategies were effective in helping patients to give up smoking .
BA alone was less effective than multiple session strategies although it required fewer re sources .