***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: OBJECTIVES Motivating adolescents to adopt proper nutrition and physical activity behaviors is important in this nation 's fight to prevent obesity and chronic diseases . This study was conducted to determine which health education delivery method would elicit a greater behavior change . METHOD The intervention was conducted in three schools ( control , computer-based , and traditional education ) .  RESULTS Students who received the computer-based intervention showed increased knowledge ( p<0.001 ) , physical activity ( p=0.001 ) , self-efficacy ( p<0.001 ) , and social support ( p<0.001 ) , and decreased meals skipped ( p<0.001 ) . CONCLUSION The computer-based group showed more positive behavior changes . However , future programs may be enhanced by including group discussion and individual feedback Computer-tailored printed education can be a promising way of promoting physical activity . The present study tested whether computer-tailored feedback on physical activity is effective and whether there are differences between respondents with low and high motivation to change . Respondents ( n = 487 ) were r and omly assigned to a tailored intervention group or a no information control group .  Physical activity and determinants were measured at baseline and after 3 months . At post-test , the motivated respondents in the control group were more likely not to meet the recommendation for physical activity than to meet it , and motivated respondents in the experimental group were more likely to engage in transport-related activities and showed more improvement over time for the total activity score than respondents in the control group ( beta = 0.24 , P = 0.02 ) . Both groups improved their behaviour over time . No group differences in physical activity were found for the unmotivated respondents . The results showed that the effects of the tailored feedback were restricted to respondents who had a positive motivation to change at baseline . Possible explanations could be that unmotivated respondents were unwilling to read and process the information because they felt ' no need to change ' . Alternatively , one tailored feedback letter may not have been sufficient for this unmotivated group Background : Because physical inactivity poses serious health risks , interventions are urgently needed to reverse the increasingly sedentary lifestyles of adolescent girls . Objective : The aim of this study was to determine the feasibility of " Girls on the Move , " an individually tailored computerized physical activity ( PA ) program plus nurse counseling intervention , in increasing PA . Methods : A pretest-posttest control group design was used with 77 racially diverse sedentary girls in Grade s 6 , 7 , and 8 from two middle schools . Each of the instructional grade s was r and omly assigned to either an intervention or control condition . After completing computerized question naires , each girl in the control group received a h and out listing the PA recommendations . To encourage PA , each girl in the intervention group received computerized , individually tailored feedback messages based on her responses to the question naires , individual counseling from the school 's pediatric nurse practitioner ( PNP ) , and telephone calls and mailings from a trained research assistant . At 12 weeks , girls in both groups responded to the question naires . Results : No differences in self-reported PA emerged between the intervention and control groups at Weeks 1 ( baseline ) and 12 ( postintervention ) . Repeated measures ANOVA showed a significant interaction between group and time for social support for PA , F(1 , 69 ) = 5.73 , p = .019 , indicating that the intervention group had significantly greater social support across time than did the control group . From baseline to postintervention , social support increased for the intervention group but decreased for the control group . Discussion : Reasons for the lack of significant differences between the groups on the PA measures were cited . Important information that could inform subsequent studies that test interventions to increase youth PA was acquired from conducting this study . Future efforts to increase PA participation might include this approach for enhancing social support for PA BACKGROUND The role of physical activity in preventing obesity during adolescence remains unknown . We examined changes in activity in relation to changes in body-mass index ( BMI ) and adiposity in a cohort of 1152 black and 1135 white girls from the USA , who were followed up prospect ively from ages 9 or 10 to 18 or 19 years . METHODS BMI and sum of skinfold thickness were assessed annually , whereas habitual activity was assessed at years 1 ( baseline ) , 3 , 5 , and 7 - 10 . Each girls ' overall activity status was categorised as active , moderately active , or inactive . Longitudinal regression models examined associations between changes in activity and in overall activity status with changes in BMI and in sum of skinfold thickness . FINDINGS Each decline in activity of 10 metabolic equivalent [MET]-times per week was associated with an increase in BMI of 0.14 kg/m2 ( SE 0.03 ) and in sum of skinfold thickness of 0.62 mm ( 0.17 ) for black girls , and of 0.09 kg/m2 ( 0.02 ) and 0.63 mm ( 0.13 ) for white girls . At ages 18 or 19 years , BMI differences between active and inactive girls were 2.98 kg/m2 ( p<0.0001 ) for black girls and 2.10 kg/m2 ( p<0.0001 ) for white girls . Similar results were apparent for sum of skinfold thickness . For moderately active girls , changes in BMI and sum of skinfold thickness were about midway between those for active and inactive girls . INTERPRETATION Changes in activity levels of US girls during adolescence significantly affected changes in BMI and adiposity . Thus , preventing the steep decline in activity during adolescence is an important method to reduce obesity OBJECTIVE The Girls health Enrichment Multisite Studies ( GEMS ) Fun , Food , and Fitness Project ( FFFP ) was design ed to prevent obesity among 8-year-old African-American girls . DESIGN Twelve-week , two-arm parallel group r and omized controlled pilot study . SETTING Summer day camp and homes in Houston , Texas . PARTICIPANTS Thirty-five girls and their parents or caregivers were r and omly assigned to treatment ( N=19 ) or control groups ( N=16 ) . INTERVENTION Girls in the intervention group attended a special 4-week summer day camp , followed by a special 8-week home Internet intervention for the girls and their parents . Control group girls attended a different 4-week summer day camp , followed by a monthly home Internet intervention , neither of which components included the GEMS-FFFP enhancements . MAIN OUTCOME MEASURES Body mass index ( BMI ) , consumption of fruit , 100 % fruit juice , and vegetables ( FJV ) , physical activity . RESULTS After adjusting for baseline BMI , there were no significant differences in BMI between treatment and control group girls , either at the end of the 4-week summer day camp , or after the full 12-week intervention . By the end of the summer camp , the subgroup of treatment group girls heavier at baseline exhibited a trend ( P<.08 ) toward lower BMI , compared to their heavier counterparts in the control group . Overall results at the end of the 12-week program demonstrated substantial , although not significant , differences between treatment and control groups in the hypothesized directions . On average , less than half the treatment sample logged onto the Website , which limited intervention dose . CONCLUSIONS Summer day camp appears to offer promise for initiating health behavior change . Effective methods must be developed and tested to enhance log-on rates among healthy children and their parents before Internet programs can achieve their potential PURPOSE To compare the effectiveness of a Web-based physical activity ( PA ) intervention with identical content delivered in a printed workbook among a sample of adolescent girls . METHODS Participants consisted of 319 girls with home Internet access enrolled in four middle schools within one school district . A r and omized trial design was used to compare changes in PA self-efficacy and intentions after two weeks of exposure to either a Web- or print-based intervention delivered to their home . Self-reported physical activity was assessed as a secondary outcome . Analysis of covariance was conducted to determine changes between the intervention groups while controlling for baseline levels of PA constructs . RESULTS Both Web and print groups had significant changes in physical activity self-efficacy ( Web : t[155 ] = 2.58 , p = .01 ; print : t[156 ] = 3.11 , p = .002 ) and intentions ( Web : t[157 ] = 2.27 , p = .02 ; print : t[159 ] = 6.32 , p < or = .001 ) . The print group demonstrated significantly greater increases in intentions compared with the Web group ( F [ 1,315 ] = 13.53 , p < or = .001 ) . Self-reported physical activity increased significantly in the print group only ( t[159 ] = 3.21 , p = .002 ) . CONCLUSIONS It can not be assumed that new media technologies are superior to traditional media such as print for health communication to adolescents . These results suggest that a printed workbook was more effective than an identical website for increasing physical activity intentions and behavior among a sample of middle school girls PURPOSE To evaluate the effects of a  middle school physical activity intervention , new in combining an environmental and computer tailored component ; and to evaluate the effects of parental involvement . METHODS A clustered r and omized controlled design was used . A r and om sample of 15 schools with 7th and 8th grade rs was r and omly assigned to one of three conditions : ( a ) intervention with parental support , ( b ) intervention alone , and ( c ) control group . The intervention was new in combining environmental strategies with computer-tailored feedback to increase levels of moderate to vigorous physical activity .  The intervention was implemented by the school staff . Physical activity was measured through a question naire in the total sample and with accelerometers in a sub sample of adolescents . RESULTS The intervention with parental support led to an increase in self-reported school-related physical activity of , on average , 6.4 minutes per day ( p < or = .05 , d = .40 ) . Physical activity of light intensity measured with accelerometers decreased with , on average , 36 minutes per day as a result of the intervention with parental support ( p < or = .05 , d = .54 ) . Physical activity of moderate to vigorous intensity measured with accelerometers significantly increased with on average 4 minutes per day in the intervention group with parental support , while it decreased with almost 7 minutes per day in the control group ( p < or = .05 , d = .46 ) . CONCLUSIONS The physical activity intervention , implemented by the school staff , result ed in enhanced physical activity behaviors in both middle school boys and girls . The combination of environmental approaches with computer-tailored interventions seemed promising OBJECTIVE To evaluate acceptability , feasibility and effectiveness of computer-tailored physical activity education among adolescents . METHODS Two classes of 7th grade rs from 10 r and omly selected schools were assigned to the intervention ( computer-tailored intervention , n=139 ) or control ( no-intervention , n=142 ) condition . Question naires were completed 1 week before and 3 months after the intervention . The computer-tailored intervention was completed during classes . RESULTS Students had few problems with the diagnostic questions and with the use of a computer . About half of the students evaluated the advice as interesting and easy to underst and and about 40 % as personally relevant , easy to use and credible . Half of students evaluated the advice as too long and only 33 % reported to have used the advice . The computer-tailored intervention was effective for increasing school related physical activity levels with on average 25 min per week ( F=3.4 , P < or = .05 ) , but not for increasing total physical activity or leisure time physical activity . CONCLUSIONS A 1-h computer-tailored intervention offered during class-time has the potential to increase school related physical activity . PRACTICE IMPLICATION S Although favourable effects of large scale implementation may be expected , some adaptations that might increase effectiveness should be investigated in the future The rising tide of obesity erodes the health of youths and many times results in adult obesity . The purpose of this investigation was to examine the effectiveness of an eight-session health promotion/transtheoretical model Internet/video-delivered intervention to increase physical activity and reduce dietary fat  among low-income , culturally diverse , seventh- grade students . Those who completed more than half the sessions increased exercise , t ( 103 ) = -1.99 , p = .05 , and decreased the percentage of dietary fat , t ( 87 ) = 2.73 , p = .008 . Responses to the intervention by stage of change , race , and income are examined There is ample evidence that printed , computer-tailored nutrition education is a more effective tool for motivating people to change to healthier diets than general nutrition education . New technology is now providing more advanced ways of delivering tailored messages , e.g. via the World Wide Web ( WWW ) . Before disseminating a tailored intervention via the web , it is important to investigate the potential of web-based tailored nutrition education . The present study investigated the immediate impact of web-based computer-tailored nutrition education on personal awareness and intentions related to intake of fat , fruit and vegetables . A r and omized controlled trial , with a pre-test-post-test control group design was conducted . Significant differences in awareness and intention to change were found between the intervention and control group at post-test . The tailored intervention was appreciated better , was rated as more personally relevant , and had more subjective impact on opinion and intentions to change than the general nutrition information . Computer literacy had no effect on these ratings . The results indicate that interactive , web-based computer-tailored nutrition education can lead to changes in determinants of behavior . Future research should be aim ed at longer-term ( behavioral ) effects and the practicability of distributing tailored interventions via the WWW BACKGROUND This study reports the results of a 9-week intervention on the physical activity levels of adolescent males . METHODS Participants were  
    Output:
    
Computer- and web-based interventions can promote physical activity  among preadolescents and adolescents , particularly in schools .