***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 Despite the increasing breast cancer incidence and mortality rates , Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States . Mobile health ( mHealth ) , defined as the delivery of health care information or services through mobile communication devices , has been utilized to successfully improve a variety of health outcomes . Objective This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women , an underserved community . Methods Using a r and omized controlled trial design , 120 Korean American women aged 40 to 77 years were recruited and r and omly assigned to either the mMammogram intervention group ( n=60 ) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group ( n=60 ) to receive a printed brochure . Outcome measures included knowledge , attitudes , and beliefs about breast cancer screening , readiness for mammography , and mammogram receipt . The feasibility and acceptability of the mMammogram intervention was also assessed . Results The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines ( P=.01 ) . The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group . A significantly higher proportion of women who received the mMammogram intervention ( 75 % , 45/60 ) completed mammograms by the 6-month follow-up compared with the control group ( 30 % , 18/60 ; P<.001 ) . In addition , the intervention group rated satisfaction with the intervention ( P=.003 ) , effectiveness of the intervention ( P<.001 ) , and increase of knowledge on breast cancer and screenings ( P=.001 ) significantly higher than the control group . Conclusions A mobile phone app – based intervention combined with health navigator service was a feasible , acceptable , and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women . A flexible , easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit population s that bear disproportionate cancer burdens . Trial Registration Clinical trials.gov NCT01972048 ; https:// clinical trials.gov/show/NCT01972048 ( Archived by WebCite at https:// clinical trials.gov/archive/NCT01972048/2013_10_29 The progressive nature of Parkinson ’s disease , its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge . Clinicians have limited face-to-face consultation time with Parkinson ’s disease patients , making it difficult to comprehensively address non-adherence . Here we share the results from a multi-centre ( seven centres ) r and omised controlled trial conducted in Engl and and Scotl and to assess the impact of using a smartphone-based Parkinson ’s tracker app to promote patient self-management , enhance treatment adherence and quality of clinical consultation . Eligible Parkinson ’s disease patients were r and omised using a 1:1 ratio according to a computer-generated r and om sequence , stratified by centre and using blocks of variable size , to intervention Parkinson ’s Tracker App or control ( Treatment as Usual ) . Primary outcome was the self-reported score of adherence to treatment ( Morisky medication adherence scale −8 ) at 16 weeks . Secondary outcomes were Quality of Life ( Parkinson ’s disease question naire −39 ) , quality of consultation for Parkinson ’s disease patients ( Patient-centred question naire for Parkinson ’s disease ) , impact on non-motor symptoms ( Non-motor symptoms question naire ) , depression and anxiety ( Hospital anxiety and depression scale ) and beliefs about medication ( Beliefs about Medication Question naire ) at 16 weeks . Primary and secondary endpoints were analysed using a generalised linear model with treatment as the fixed effect and baseline measurement as the covariate . 158 patients completed the study ( Parkinson ’s tracker app = 68 and TAU = 90 ) . At 16 weeks Parkinson ’s tracker app  significantly improved adherence , compared to treatment as usual ( mean difference : 0.39 , 95%CI 0.04–0.74 ; p = 0.0304 ) with no confounding effects of gender , number of comorbidities and age . Among secondary outcomes , Parkinson ’s tracker app  significantly improved patients ’ perception of quality of consultation ( 0.15 , 95 % CI 0.03 to 0.27 ; p = 0.0110 ) . The change in non-motor symptoms was −0.82 ( 95 % CI −1.75 to 0.10 ; p = 0.0822 ) . 72 % of participants in the Parkinson ’s tracker app group continued to use and engage with the application throughout the 16-week trial period . The Parkinson ’s tracker app can be an effective and novel way of enhancing self-reported medication adherence and quality of clinical consultation by supporting self-management in Parkinson ’s disease in patients owning smartphones . Further work is recommended to determine whether the benefits of the intervention are maintained beyond the 16 week study period . Digital healthcare : App helps patients stick to planA smartphone-based application improves treatment adherence of patients with Parkinson ’s disease ( PD ) . Rashmi Lakshminarayana , from uMotif Ltd , and research ers from the UK and The Netherl and s describe the results of a 16 week trial of a Parkinson ’s tracker app ( PTA ) that r and omised 215 patients from seven different health centres . Patients using the app reported significantly better adherence to their medication plan compared with control patients who continued their treatment as usual . Interestingly , using the PTA also improved the patients ’ perception of the quality of their clinical care , possibly as a result of feeling more involved and in control of their care . These findings suggest that by sending medication reminders and tracking symptoms , the app can help patients with Parkinson ’s self-manage their increasingly complex treatment regimen as the disease progresses Background : Little is known about the benefits of social networks in the management of patients . Objective : The aim of this study was to compare the effects of self-management ( SM ) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension . Methods : This r and omized clinical trial was conducted with 100 patients . They were r and omly allocated to four groups : ( i ) control , ( ii ) SM training without follow-up , ( iii ) telephone follow-up and ( iv ) smartphone-based social networking follow-up . The hypertension SM behavior question naire was used for data collection before and six weeks after the study . Results : Those patients who underwent SM education training ( with and without follow-up ) had statistically significant differences from those in the control group in terms of SM behaviors ( p < .001 ) . There was no statistically significant difference between different types of follow-up . Conclusion : SM education using telephone follow-up and /or smartphone-based social networking follow-up influenced SM behaviors among patients with hypertension Background Many preventable behaviors contribute to adolescent mortality and morbidity . Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population . The widespread use of electronic communication technologies by adolescents , particularly the use of text messaging ( short message service , SMS ) and mobile phones , presents new opportunities to intervene on risk and preventive risk behavior , but little is known about their efficacy . Objective This study aim ed to systematic ally evaluate evidence for the efficacy of text messaging and mobile phone app interventions to improve adherence to preventive behavior among adolescents and describe intervention approaches to inform intervention development . Methods This review covers literature published between 1995 and 2015 . Search es included PubMed , Embase , CENTRAL , PsycINFO , CINAHL , INSPEC , Web of Science , Google Scholar , and additional data bases . The search strategy sought articles on text messaging and mobile phone apps combined with adherence or compliance , and adolescents and youth . An additional h and search of related themes in the Journal of Medical Internet Research was also conducted . Two review ers independently screened titles and abstract s , assessed full-text articles , and extracted data from articles that met inclusion criteria . Included studies reflect original research —experimental or preexperimental design s with text messaging or mobile phone app interventions —targeting adherence to preventive behavior among adolescents ( 12 - 24 years old ) . The preferred reporting items of systematic review s and meta-analyses ( PRISMA ) guidelines were followed for reporting results , and findings were critically appraised against the Oxford Centre for Evidence -based Medicine criteria . Results Of 1454 records , 19 met inclusion criteria , including text messaging ( n=15 ) and mobile phone apps ( n=4 ) . Studies targeted clinic attendance , contraceptive use , oral health , physical activity and weight management , sun protection , human papillomavirus ( HPV ) vaccination , smoking cessation , and sexual health .  Most studies were performed in the United States ( 47 % , 9/19 ) , included younger adolescents ( 63 % , 12/19 ) , and had sample size < 100 ( 63 % , 12/19 ) . Although most studies were r and omized controlled trials ( RCTs ; 58 % , 11/19 ) , only 5 followed an intent-to-treat analysis . Only 6 of 19 studies ( 32 % ) incorporated a theoretical framework in their design . Most studies reported good feasibility with high acceptability and satisfaction . About half of the included studies ( 42 % , 8/19 ) demonstrated significant improvement in preventive behavior with moderate st and ardized mean differences . As early efforts in this field to establish feasibility and initial efficacy , most studies were low to moderate in quality . Studies varied in sample size and methods of preventive behavior adherence or outcome assessment , which prohibited performing a meta- analysis . Conclusions Despite the promising feasibility and acceptability of text messaging and mobile phone apps in improving preventive behavior among adolescents , overall findings were modest in terms of efficacy . Further research evaluating the efficacy , effectiveness , and cost-effectiveness of these intervention approaches in promoting preventive behavior among adolescents is needed Purpose The purpose of this prospect i ve r and omized-controlled trial ( RCT ) was to evaluate if an app-based feedback-controlled active muscle training programme can be used to improve the outcome in the immediate postoperative period after total knee arthroplasty ( TKA ) . Methods Sixty patients , with a median age of 65.9 years ( range 45–84 ) , awaiting primary TKA were r and omized into a control and training group . Both groups followed an identical postoperative protocol . In addition , the training group postoperatively performed an app-based feedback-controlled active muscle training programme multiple times daily . Outcome measures were active and passive range of motion ( ROM ) , pain at rest and in motion , knee extension strength , the timed “ Up and Go ” , 10-m Walk Test , 30-s Chair St and Test , Knee Injury and Osteoarthritis Outcome Score ( KOOS ) , Knee Society Score ( KSS ) , and clinical data . Results The training group performed an average of 18.4 training sessions , which led to significantly higher ROM , less pain at rest and in motion , higher strength , and significantly higher functional scores . More training correlated with a better outcome . Conclusions The use of an app-based feedback-controlled active muscle training programme can improve the clinical outcome after TKA , especially ROM and reduce pain . Clinical ly relevant is that the training programme could be considered an alternative to continuous passive motion after total knee arthroplasty . Level of evidence II Background Modern health care focuses on shared decision making ( SDM ) because of its positive effects on patient satisfaction , therapy compliance , and outcomes . Patients ’ knowledge about their illness and available treatment options , gained through medical education , is one of the key drivers for SDM . Current patient education relies heavily on medical consultation and is known to be ineffective . Objective This study aim ed to determine whether providing patients with information in a subdivided , categorized , and interactive manner via an educational app for smartphone or tablet might increase the knowledge of their illness . Methods A surgeon-blinded r and omized controlled trial was conducted with 213 patients who were referred to 1 of the 6 Dutch hospitals by their general practitioner owing to knee complaints that were indicative of knee osteoarthritis . An interactive app that , in addition to st and ard care , actively sends informative and pertinent content to patients about their illness on a daily basis by means of push notifications in the week before their consultation . The primary outcome was the level of perceived and actual knowledge that patients had about their knee complaints and the relevant treatment options after the intervention . Results In total , 122 patients were enrolled in the control group and 91 in the intervention group . After the intervention , the level of actual knowledge ( measured on a 0 - 36 scale ) was 52 % higher in the app group ( 26.4 vs 17.4 , P<.001 ) . Moreover , within the app group , the level of perceived knowledge ( measured on a 0 - 25 scale ) increased by 22 % during the week within the app group ( from 13.5 to 16.5 , P<.001 ) , compared with no gain in the control group . Conclusions Actively offering patients information in a subdivided ( per day ) , categorized ( per theme ) , and interactive ( video and quiz questions ) manner significantly increases the level of perceived knowledge and demonstrates a higher level of actual knowledge , compared with st and ard care educational practice s. Trial Registration International St and ard R and omized Controlled Trial Number IS RCT N98629372 ; http://www.is rct n.com/IS RCT N98629372 ( Archived by WebCite at http://www.webcitation.org/73F5trZbb BACKGROUND AND AIM Getting ready for a colonos 
    Output:
    
The interventions showed the highest effects on satisfaction with information , adherence to treatment instructions and to medication usage , clinical outcomes , and knowledge .
Conclusions This review demonstrates that educating patients with timely medical information through their smartphones or tablets improves their levels of knowledge , medication or treatment adherence , satisfaction , and clinical outcomes , as well as having a positive effect on health care economics .
These effects are most pronounced in interventions with a short duration ( ie , less than a month ) and with a high frequency of messages to patients ( ie , once per week or more ) .