***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 Oral contraceptive ( OC ) knowledge deficits may contribute to OC discontinuation . We examined the effect of an innovative educational intervention on young women 's OC knowledge . STUDY DESIGN As part of a r and omized trial evaluating the impact of text message reminders on OC continuation , we assessed  OC knowledge in 659 women ages 13 - 25 years . Women received routine care or routine care plus 6 months of daily educational text messages . We administered a comprehensive 41-item OC knowledge survey at baseline and 6 months . RESULTS Mean OC knowledge scores improved over time for all women ( baseline 22.8 , 56 % correct versus 24.7 , 60 % at 6 months ) , including knowledge of OC 's mechanisms of action ( p=.004 ) , effectiveness ( p<.001 ) , side effects ( p=.03 ) and benefits ( p<.001 ) . Mean 6-month scores were greater in the intervention ( 25.5 ) than the control group (23.7)(p<.001 ) . In multivariable linear regression models , the text message intervention most strongly predicted OC knowledge ( β=1.6 , 95 % confidence interval 0.9 - 2.2 ) . CONCLUSION Daily educational text messages can modestly improve knowledge of OCs , which may promote successful contraceptive outcomes Objectives To compare two post-abortion family planning ( FP ) service packages on contraceptive use and repeat abortion rate  among young women in three cities in China . Methods In this cluster-r and omized trial , one FP service package included provision of limited information and referral to existing FP services , and the other , more comprehensive , package consisted – in addition to the above simple package – of individual counselling , free provision of contraceptive material s , and involvement of the male partner . Eight matched pairs of hospitals were certified by central ized r and omization . Women undergoing abortion were followed up for six months , and data were collected in two rounds , before and after the intervention . Results We followed a total of 2336 women younger than 25 years ( 555 before and 555 after the simple intervention package ; 634 before and 592 after the comprehensive intervention package ) . Both packages increased use of any contraceptive method , but the comprehensive approach also increased use of more effective methods . Odds ratios for consistent and correct use of condoms were 2.32 ( 95 % confidence interval 1.55–3.46 ) and 2.78 ( 1.81–4.26 ) , respectively , compared with the simple package . The rates of unwanted pregnancies and repeat abortions were somewhat reduced for both packages , with no significant statistical difference between them . Conclusion Couples who received the comprehensive post-abortion FP service appear to use more effective contraceptive methods and show better compliance OBJECTIVE To evaluate the success of efforts to educate youth not only to use prescription contraceptives to avoid pregnancy , but also to use condoms to avoid sexually transmitted diseases , including infection with the human immunodeficiency virus . METHODS Longitudinal study of 383 African-American youth aged 9 to 15 years enrolled in a r and omized , controlled trial of an acquired immunodeficiency syndrome ( AIDS ) risk reduction intervention .  Data about contraceptive practice s were obtained at baseline and 6 , 12 , and 18 months later using a culturally and developmentally appropriate risk assessment tool administered with " talking " computers ( Macintosh , Apple Computer Inc , Cupertino , Calif ) . RESULTS Approximately three fourths of sexually active youth used some form of contraception  in each 6-month round , with almost half of the youth using combinations of contraceptives . Among all youth at baseline and among control youth throughout the study , more than half used condoms and more than two thirds who used oral contraceptives also used condoms . Receipt of an AIDS education intervention was associated with use of more effective contraceptive practice s ( eg ,  condoms  and another prescription or nonprescription method of birth control )  . After receiving the intervention , more than 80 % of the youth who used oral contraceptives also used condoms . Contraceptive practice s showed considerable stability . Knowledge about AIDS was positively associated with use of more effective contraceptive methods . CONCLUSIONS Many youth are using condoms and prescription birth control simultaneously , and these use rates can be increased through AIDS education interventions OBJECTIVE : To estimate whether daily educational text messages affect oral contraceptive pill ( OCP ) continuation at 6 months . METHODS : We r and omized young women electing OCPs at an urban family planning health center to either routine care or routine care plus 180 days of daily educational text messages .  Investigators masked to treatment allocation r and omized participants who were not masked to treatment . The primary outcome measure was self-reported OCP continuation through a telephone call at 6 months ( contacts between 5 and 8 months ) . RESULTS : We enrolled 962 participants ( 480 intervention and 482 routine care ) and obtained continuation data on 683 ( 346 and 337 , respectively ) . At the follow-up , 64 % of participants r and omized to the intervention were still OCP users compared with 54 % of the routine care group ( P=.005 ) . Continuation was highest in the intervention group if the interview took place while the intervention was ongoing ( 75 % compared with 54 % , P=.003 ) ; the effect of the intervention on continuation was less after the intervention ended ( 60 % compared with 54 % , P=.16 ) . Participants receiving the intervention were more likely to continue oral contraception than control participants at 6 months ( odds ratio 1.44 , 95 % confidence interval 1.03–2.00 ) in analyses adjusted for age , race or ethnicity , age at coitarche , pregnancy history , and OCP experience . CONCLUSION : The use of daily educational text messages improves OCP continuation at 6 months over routine care alone . Ten women would need to receive this simple intervention to improve continuation in one . This effect is strongest in the women whose follow-up took place while the text intervention was ongoing . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . Clinical Trials.gov , NCT00677703 . LEVEL OF EVIDENCE : CONTEXT Adolescent females often have questions or concerns about their contraceptive methods , and they may discontinue use if these questions are not answered . Little evidence exists on whether follow-up phone calls to address young women 's concerns can help sustain contraceptive use . METHODS Between 2005 and 2007 , a total of 805 females aged 14 - 18 attending a reproductive health clinic in San Francisco were r and omly assigned to receive either regular clinic services or regular clinic services plus nine follow-up phone calls over 12 months . The young women were surveyed at baseline and roughly six , 12 and 18 months later to measure condom and contraceptive use , rates of pregnancy and STDs , and other outcomes and mediators . Multiple linear and logistic regression repeated measures analyses were used to assess the program 's effects . RESULTS Clinic counselors completed only 2.7 calls per patient , and made 7.8 attempts for every completed call . Although contraceptive use increased from baseline to follow-up at six months in both groups , levels of condom and contraceptive use , and rates of pregnancy and STDs , did not differ between the intervention and control groups at any of the follow-up assessment s. Moreover , the intervention did not improve clinic utilization or satisfaction or have consistent positive effects on participants ' attitudes . CONCLUSIONS Reaching young women by phone after a clinic visit for contraception is challenging and does not appear to provide significant benefits beyond those provided by basic clinic services . More intensive interventions may be needed to markedly change adolescent sexual and contraceptive behavior OBJECTIVE To evaluate the impact of a preconception counseling program tailored for teens with type 1 diabetes on cognitive , psychosocial , and behavioral outcomes and to assess its cost-effectiveness . RESEARCH DESIGN AND METHODS A total of 88 teens with type 1 diabetes from two sites were r and omized into the READY-Girls ( Reproductive-health Education and Awareness of Diabetes in Youth for Girls ) intervention ( IG ) ( n = 43 ) or st and ard care ( SC ) ( n = 45 ) groups . During three diabetes clinic visits , IG subjects viewed a two-part CD-ROM , read a book , and met with a nurse .  Program effectiveness was measured by knowledge , attitudes , intentions , and behaviors regarding diabetes , pregnancy , sexuality , and preconception counseling . Assessment s occurred at baseline , before and after viewing program material s , and at 9 months . Economic analyses included an assessment of re source utilization , direct medical costs , and a break-even cost analysis .  RESULTS Age range was 13.2–19.7 years ( mean ± SD 16.7 ± 1.7 years ) ; 6 % ( n = 5 ) were African American , and 24 % ( n = 21 ) were sexually active . Compared with baseline and SC subjects , IG subjects demonstrated a significant group-by-time interaction for benefit and knowledge of preconception counseling and reproductive health : increasing immediately after the first visit ( P < 0.001 ) and being sustained for 9 months ( P < 0.05 benefits ; P < 0.001 knowledge ) . For IG subjects , preconception counseling barriers decreased over time ( P < 0.001 ) , and intention and initiation of preconception counseling and reproductive health discussion s increased ( P < 0.001 ) . Costs of adverse reproductive outcomes are high . Direct medical costs of READY-Girls were low . CONCLUSIONS READY-Girls was beneficial and effects were sustained for at least 9 months . This low-cost self-instructional program can potentially empower young women with type 1 diabetes to make well-informed reproductive health choices , adding little time burden or cost to their diabetes management Recent efforts to involve patients more actively in therapeutic decisions have suggested the relevance of computer-based interventions at clinic visits . This paper presents a longitudinal , experimental study evaluating a computer-based contraceptive decision aid in Chicago and Madison family planning clinic visits . Patient interviews at three time points evaluated patient acceptance by  and  program impact on 949 young women . Both Chicago and Madison patients reported high acceptance . The program result ed in improved short-term knowledge and confidence in oral contraceptive ( OC ) efficacy for Chicago and Madison patients . In addition , compared to their control group , Madison experimental group patients had higher OC knowledge 1 year after the initial visit and a trend for fewer pregnancies ( P < 0.074 ) . Compared to their control group , a higher percent of the Chicago experimental group patients adopted OC 's after stating their intention to do so at the initial visit . Exposure to the computer program had no observable impact on the number of months on the oral contraceptive for Chicago or Madison patients . Overall findings suggest the usefulness of informatics tools as a supplement to patient-provider interactions Many college women are at risk for pregnancy , and binge drinking college women are often at risk for alcohol-exposed pregnancy . Brief interventions with sustainable outcomes are needed , particularly for college women who are binge drinking , at risk for pregnancy , and at increased risk of alcohol-exposed pregnancy . Two-hundred-twenty-eight women at a Mid-Atlantic urban university at risk for alcohol-exposed pregnancy enrolled in the r and omized clinical trial , and 207 completed the 4 month follow-up . The BALANCE intervention used Motivational Interviewing plus feedback to target drinking and contraception behaviors . Main outcome measures included ( 1 ) the rate of risk for alcohol-exposed pregnancy , ( 2 ) the rate of risk drinking , and ( 3 ) the rate of pregnancy risk . At 4-month follow-up , the rate of alcohol-exposed pregnancy risk was significantly lower in the intervention ( 20.2 % ) than the control condition ( 34.9 % ) , ( P < .02 ) . Assignment to the intervention condition halved the odds of women remaining at risk for alcohol-exposed pregnancy , while not receiving the intervention doubled the odds of continued alcohol-exposed pregnancy risk ( OR = 2.18 ; 95 % CI = 1.16–4.09 ) . A baseline history of blackouts , continued high blood alcohol drinking days at 1 month , and continued risk for pregnancy at 1 month independently contributed to a multivariate model of continued alcohol-exposed pregnancy risk at 4 month follow-up . BALANCE reduced alcohol-exposed pregnancy risk , with similar outcomes to longer interventions . Because early response predicted sustained alcohol-exposed pregnancy risk reduction , those who fail to achieve initial change could be identified for further intervention . The BALANCE intervention could be adopted into existing student health or university alcohol programs . The risks of unintended pregnancy and alcohol-exposed pregnancy among binge drinking women in college merit greater prevention efforts A significant number of college women are at risk for alcohol-exposed pregnancy ( AEP ) owing to binge drinking paired with using contraception ineffectively . This article describes a r and omized controlled trial of a one-session motivational interviewing-based intervention to reduce AEP risk among college women and presents 1-month outcomes demonstrating the early impact of this intervention . There were 228 female students from a mid-Atlantic urban university enrolled in the trial . Eligibility criteria were being in the age range of 18 - 24 years and being at risk for AEP .  Risk for AEP was defined as having sexual intercourse with a man in the past 90 days while using contraception ineffectively ( no 
    Output:
    
Few studies tested brief strategies for young people .
More intensive strategies could be more effective , but would also be challenging for many clinics to implement