***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 assess the effects of a comprehensive , integrated community-based lifestyle intervention on diet , physical activity and smoking in two Iranian communities . METHODS Within the framework of the Isfahan Healthy Heart Program , a community trial was conducted in two intervention counties ( Isfahan and Najaf-Abad ) and a control area ( Arak ) .  Lifestyle interventions targeted the urban and rural population s in the intervention counties but were not implemented in Arak . In each community , a r and om sample of adults was selected yearly by multi-stage cluster sampling . Food consumption , physical exercise and smoking behaviours were quantified and scored as 1 ( low-risk ) or 0 ( other ) at baseline ( year 2000 ) and annually for 4 years in the intervention areas and for 3 years in the control area . The scores for all behaviours were then added to derive an overall lifestyle score . FINDINGS After 4 years , changes from baseline in mean dietary score differed significantly between the intervention and control areas ( + 2.1 points versus -1.2 points , respectively ; P < 0.01 ) , as did the change in the percentage of individuals following a healthy diet ( + 14.9 % versus -2.0 % , respectively ; P < 0.001 ) . Daily smoking had decreased by 0.9 % in the intervention areas and by 2.6 % in the control area at the end of the third year , but the difference was not significant . Analysis by gender revealed a significant decreasing trend in smoking among men ( P < 0.05 ) but not among women . Energy expenditure for total daily physical activities showed a decreasing trend in all areas , but the mean drop from baseline was significantly smaller in the intervention areas than in the control area ( -68 metabolic equivalent task ( MET ) minutes per week versus -114 MET minutes per week , respectively ; P < 0.05 ) . Leisure time devoted to physical activities showed an increasing trend in all areas . A significantly different change from baseline was found between the intervention areas and the control area in mean lifestyle score , even after controlling for age , sex and baseline values . CONCLUSION The results suggest that community-based lifestyle intervention programmes can be effective in a developing country setting OBJECTIVES This paper presents a prospect i ve examination of sociodemographic , psychosocial , and physiologic characteristics associated with positive change in cardiovascular disease risk factors during a 6-year multiple risk factor intervention study . METHODS Data are presented on 221 women and 190 men ( aged 25 through 74 years ) who participated in four cohort surveys ( 1979 through 1985 ) . A signal detection model was used to identify baseline variables that best divide the sample into subgroups on the basis of the probability of positive change in a composite risk factor score . RESULTS Sixty-nine percent of the respondents showed a positive change in risk factor score during the intervention . The subgroup with the highest proportion of positive changers ( 83 % ) was composed of older adults ( > 55 years ) with the highest perceived risk , highest health media use , and highest blood pressure and cholesterol levels . The subgroup with the lowest proportion of positive changers ( 42 % ) was the least educated , was the most likely to be Hispanic , and had the lowest health knowledge and self-efficacy scores . CONCLUSIONS The differing composition of subgroups who respond or do not respond to community cardiovascular disease interventions illustrates the need to develop specific interventions that target different age , socioeconomic , and cultural subgroups Purpose . To assess the effectiveness of a large-scale , national smoking cessation media campaign , the EX campaign , across racial/ethnic and educational subgroups . Design . A longitudinal r and om-digit-dial panel study conducted prior to and 6 months following the national launch of the campaign . Setting . The sample was drawn from eight design ated media markets in the United States . Subjects . The baseline survey was conducted on 5616 current smokers , aged 18 to 49 years , and 4067 ( 73 % follow-up response rate ) were resurveyed at the 6-month follow-up . Measures . The primary independent variable is confirmed awareness of the campaign advertising , and the outcome variables are follow-up cessation-related cognitions index score and quit attempts . Analysis . Multivariable logistic and linear regression analyses were conducted within racial/ethnic and educational strata to assess the strength of association between confirmed awareness of campaign advertising and cessation-related outcomes . Results . Confirmed awareness of campaign advertising increased favorable cessation-related cognitions among Hispanics and quit attempts among non-Hispanic blacks , and increased favorable cessation-related cognitions and quit attempts among smokers with less than a high school education . Conclusions . These results suggest that the EX campaign may be effective in promoting cessation-related cognitions and behaviors among minority and disadvantaged smokers who experience a disproportionate burden of tobacco-related illness and mortality . ( Am J Health Promot 2011;25[5 Supplement]:S38–S50 . Abstract Objective : To evaluate the effectiveness of an antismoking campaign conducted by the Health Education Board for Scotl and . Design : Descriptive survey of adult callers to a telephone helpline ( Smokeline ) for stopping smoking ; panel study of a r and om sample of adult callers ; assessment of changes in prevalence of smoking in Scotl and before and after introduction of the helpline Setting : Telephone helpline . Subjects : Callers to Smokeline over the initial one year period . Detailed information was collected on a 10 % sample ( n=8547 ) . A cohort of adult smokers who called Smokeline ( total n=848 ) was followed up by telephone interview three weeks , six months , and one year after the initial call . Main outcome measures : Numbers of adult smokers calling helpline ; changes in smoking behaviour , especially stopping smoking among cohort members ; and changes in prevalence of smoking in the general population . Results : An estimated 82 782 regular adult smokers made genuine contact with Smokeline over the year , representing about 5.9 % of all adult smokers in Scotl and . At one year 143 of the cohort of 848 callers ( 23.6 % ; 95 % confidence interval 20.2 % to 27.0 % ) reported that they had stopped smoking , and 534 ( 88.0 % ; 85.4 % to 90.6 % ) reported having made some change . About 19 500 ( 16 700 to 22 350 ) adult smokers , equivalent to 1.4 % ( 1.2 % to 1.6 % ) of the mean adult smoking population , stopped smoking with direct help from Smokeline . During the second year of the campaign ( 1994 ) smoking prevalence among 25 - 65 year olds in Scotl and was 6 % ( 2.0 % to 10.0 % ) lower than it had been before the start of the campaign . Conclusion : The Health Education Board for Scotl and 's antismoking campaign reached a high number of adult smokers , was associated with a highly acceptable quit rate among adults given direct help through Smokeline , and contributed considerably to an accelerated decline in smoking prevalence in Scotl and . Key messages There was an unprecedented response to the antismoking campaign of the Health Education Board for Scotl and , with an estimated 5.9 % of adult smokers in Scotl and responding to the invitation to call Smokeline , a free telephone helpline , in its first year of operation A panel study of callers to Smokeline , with telephone interviewing , obtained an acceptable response rate of 71.6 % at one year follow up Nearly a quarter ( 23.6 % ) of smokers who called the helpline were not smoking at the one year follow up , a success rate that exceeds a proposed st and ard for comparable health education and promotion interventions The Smokeline campaign contributed considerably to an accelerated ( 6 % ) reduction in smoking among people aged 25 - 65 in Scotl and during 1992 - 4 The study findings provide further evidence of the efficacy of mass media antismoking initiatives with a social support The effectiveness of a smoking cessation campaign that included both printed and televised material s was evaluated in registrant and r and omly acquired sample s of smokers during the first month postcampaign and again at 3 months . Registrant and r and om sample s differed on several sociodemographic variables .  Registrants had much higher rates of abstinence at both times compared to the r and omly acquired group .  Nicotine gum replacement  was used more frequently among the registrant group . Fifteen percent of registrants who had not attempted to quit at Time 1 were abstinent 3 months postcampaign . Registering to participate in print and televised cessation programs may be related to a change in smoking behavior This paper reports a controlled evaluation of the six-part BBC TV series " So You Want To Stop Smoking ? " which aim ed to give advice and encouragement to smokers who wanted to stop . In an experimental design , 134 cigarette smokers in two firms were shown either the first two programs in the series or a control film of the same length .  Smokers in the former group were asked to watch the remaining four programs at home on their own television sets . Question naires were sent to participants four months and one year later , and cl aims of abstinence were vali date d biochemically . The results did not provide clear evidence that the BBC series was more effective in encouraging smokers to try to stop and helping them to succeed than the control film . For comparison with our own results , we also abstract some findings from an uncontrolled but larger-scale evaluation conducted by the BBC 's research department A televised , self-help cigarette smoking  cessation intervention was conducted and evaluated . During the 20-day program , reports were broadcast daily on the evening news programs of the local affiliate station of a national television network . Two sample s of smokers who requested self-help manuals  were interviewed by telephone immediately following the conclusion of the program and again 3 months later concerning their demographic characteristics , participation in the program , and smoking and quitting experiences . In one sample heavier smokers who expressed a greater desire to quit were more likely to participate in the program and , at the three-month followup , 21 % reported being abstinent compared to 10 % of those who did not participate . Smokers in the other sample were invited to attend three weekly support meetings during the program . More of those who attended meetings ( 35 % ) reported quitting during the program than those who did not attend ( 23 % ) , but this difference did not persist for 3 months . A greater percentage of the meeting sample ( 27 % ) than the other sample ( 21 % ) reported abstinence initially , but this difference did not persist for three months either . Intervention outcomes are compared with several st and ards OBJECTIVE The present study was conducted to determine the impact of a community-based intervention on the nutritional behaviour of a representative sample of Iranian adults . DESIGN The Isfahan Healthy Heart Programme ( IHHP ) , a six-year , action-oriented , integrated community-based study aim ed at health promotion through the reduction of CVD risk factors , targeted the whole population living in two intervention cities , and compared outcomes with the population of a non-intervention city considered as reference . Dietary interventions were performed as educational , environmental and /or legislative strategies . A global dietary index ( GDI ) was calculated representing the general dietary behaviour . In addition , two consumption indices were calculated for specific food groups , i.e. meat products and major sources of fat . Univariate AVOVA was conducted to evaluate the impact of the intervention on dietary behaviours . SETTING Isfahan and Najaf-Abad ( intervention cities ) and Arak ( reference city ) , central Iran . SUBJECTS The baseline survey was conducted among 12514 r and omly selected adults aged > or = 19 years in both intervention and reference areas . The survey was repeated annually among about 5000 persons ( 2002 - 2005 ) in the intervention and reference communities . RESULTS According to significant year x group interactions in mean fat consumption index ( FCI ) and meat consumption index ( MCI ) in the total population , a significant improvement in FCI and MCI was found in the intervention areas v. the reference area ( P < 0.001 ) . In addition , the GDI improved significantly in the intervention areas v. the reference area ( P < 0.001 ) . CONCLUSIONS The IHHP interventions were effective in improving dietary behaviours at the population level . The highest effectiveness was documented in the change in the type of fat consumed . Such simple and integrated interventions can be adopted in other developing countries with limited financial re sources OBJECTIVES This study examined the reach , effectiveness , and cost-effectiveness of a mass media-led smoking cessation campaign including television shows , a television clinic , a quit line , local group programs , and a comprehensive publicity campaign . METHODS A r and om sample of baseline smokers ( n = 1338 ) was interviewed before and after the campaign and at a 10-month follow-up . A nonpretested control  group ( n = 508 ) of baseline smokers was incorporated to control for test effects . RESULTS Most smokers were aware of the campaign , although active participation rates were low . Dose-response relations between exposure and quitting were found . The follow-up point prevalence abstinence rate attributable to the campaign was estimated to be 4.5 % after control for test effects and secular trends . The cost per long-term quitter was about $ 12 . CONCLUSIONS In spite of a massive rise in tobacco promotion expenditures prior to the campaign and the absence of governmental control over the media , the campaign under study may have increased normal cessation rates substantially OBJECTIVE To assess adults ' receptivity to the Massachusetts television anti-tobacco campaign .  Reactions were examined as a function of respondents ' demographics , baseline tobacco control attitudes , changes in smoking status during the campaign , and advertisements ' affective qualities . DESIGN A r and om digit dial telephone survey in 1993 at 
    Output:
    
The purpose of the mass media campaign must be primarily to encourage smokers to quit .
No consistent relationship was observed between campaign effectiveness and age , education , ethnicity or gender