***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: A continuing challenge in weight loss treatment is attaining maintenance of weight loss . The goal of this study was to develop a counseling method that would assist African American breast cancer survivors with weight loss maintenance . In this pilot study , 31 obese breast cancer survivors were recruited .  Individualized , dietitian-led counseling by telephone and free Weight Watchers coupons were provided to all participants for 18 months . At the 6-month time point , women were r and omized to receive spirituality counseling or not in addition to the st and ard program . The spirituality counseling was delivered via telephone using an 8-step framework . Subjects were asked to utilize  daily meditation or prayer , daily readings  , and the recording of thoughts in a journal . Mean weight loss from baseline to 6 months was a modest 2.0 % of baseline weight . From 6 to 18 months , there was no further weight change in the spirituality arm and a gain of 0.7 % in the dietitian-only arm . Despite little effect on weight loss , it did appear that spirituality counseling positively affected spiritual well-being ( FACIT-Sp ) scores and dietary quality . The spirituality counseling framework therefore may be further refined and useful for other health promotion studies with African American population This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer PURPOSE Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer . The Exercise and Nutrition to Enhance Recovery and Good Health for You ( ENERGY ) study is the largest weight loss intervention trial among survivors of breast cancer to date . METHODS In this multicenter trial , 692 overweight/obese women who were , on average , 2 years since primary treatment for early-stage breast cancer were r and omly assigned to either a group-based behavioral intervention , supplemented with telephone counseling and tailored newsletters , to support weight loss or a less intensive control intervention and observed for 2 years . Weight and blood pressure were measured at 6 , 12 , 18 , and 24 months . Longitudinal mixed models were used to analyze change over time . RESULTS At 12 months , mean weight loss was 6.0 % of initial weight in the intervention group and 1.5 % in the control group ( P<.001 ) . At 24 months , mean weight loss in the intervention and control groups was 3.7 % and 1.3 % , respectively ( P<.001 ) . Favorable effects of the intervention on physical activity and blood pressure were observed . The weight loss intervention was more effective among women older than 55 years than among younger women . CONCLUSION A behavioral weight loss intervention can lead to clinical ly meaningful weight loss in overweight/obese survivors of breast cancer . These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival The goal of evidence -based medicine is ultimately to improve patient outcomes and quality of care .  Systematic review s of the available published evidence are required to identify interventions that lead to improvements in behavior , health , and well-being . Authoritative literature review s depend on the quality of published research and research reports . The Consoli date d St and ards for Reporting Trials ( CONSORT ) Statement ( www.consort-statement.org ) was developed to improve the design and reporting of interventions involving r and omized clinical trials ( RCTs ) in medical journals . We describe the 22 CONSORT guidelines and explain their application to behavioral medicine research and to evidence -based practice . Additional behavioral medicine-specific guidelines ( e.g. , treatment adherence ) are also presented . Use of these guidelines by clinicians , educators , policymakers , and research ers who design , report , and evaluate or review RCTs will strengthen the research itself and accelerate efforts to apply behavioral medicine research to improve the processes and outcomes of behavioral medicine practice The purpose of the study is to evaluate the performance of theoretically-derived mediators of health behavior change .  Participants were university seniors ( 184 females ; 154 males ) r and omly assigned to an intervention course design ed to promote physical activity or to a control course . Five physical activity outcomes and nine psychosocial mediating variables were assessed at baseline and the end of the 16-week course . For women , the intervention had significant effects on five of the mediators , including self-efficacy for making time , self-efficacy for resisting relapse , social support from friends , and experiential and behavioral processes of change . Among men , the intervention improved use of behavioral processes of change but also had the unintended effect of increasing perceived barriers to activity . For women , significant contributors to regressions explaining physical activity change were social support from friends ( for total activity ) and change in self-efficacy for resisting relapse ( for vigorous exercise ) . For men , significant explanatory variables included change in enjoyment ( for total activity ) , change in self-efficacy for resisting relapse ( for strength exercise ) , and change in benefits ( for moderate intensity activity ) . For both sexes , there were significant findings in the unexpected direction . Across the five physical activity outcomes , hypothesized mediators were inconsistent and weak contributors to the models . Investigating mediators of behavior change has the potential to stimulate improvements in theories and interventions Obese breast cancer survivors have increased risk of recurrence and death compared to their normal weight counterparts . Rural women have significantly higher obesity rates , thus weight control intervention may be a key strategy for prevention of breast cancer recurrence in this population . This one-arm treatment study examined the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations . The intervention included a reduced calorie diet incorporating prepackaged entrees and shakes , physical activity gradually increased to 225 min/week of moderate intensity exercise , and weekly group phone sessions . Outcomes included anthropomorphic , diet , physical activity , serum biomarker , and quality of life changes .  Ninety-one percent of participants ( 31 of 34 ) attended > 75 % of intervention sessions and completed post-treatment data collection visits . At 6 months , significant changes were observed for weight ( −12.5 ± 5.8 kg , 13.9 % of baseline weight ) , waist circumference ( −9.4 ± 6.3 cm ) , daily energy intake ( −349 ± 550 kcal/day ) , fruits , and vegetables ( + 3.7 ± 4.3 servings/day ) , percent kcal from fat ( −12.6 ± 8.6 % ) , physical activity ( + 1235 ± 832 kcal/week ; all P values < 0.001 ) , as well as significant reductions in fasting insulin ( 16.7 % reduction , P = 0.006 ) , and leptin ( 37.1 % reduction , P < 0.001 ) . Significant improvements were also seen for quality of life domains including mood , body image , and sexuality . In conclusion , the intervention produced > 10 % weight loss as well as significant improvements across multiple endpoints . The group phone-based treatment delivery approach may help disseminate effective weight control intervention to hard-to-reach breast cancer survivors OBJECTIVE Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival . As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage , and have higher rates of obesity , effective weight loss strategies are needed . We piloted a r and omized , waitlist-controlled , crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic , African American and Afro-Caribbean breast cancer survivors . DESIGN AND METHODS Women with stage 0-IIIa breast cancer ≥ 6 months posttreatment , sedentary , and BMI ≥ 25 kg/m(2 ) were r and omized to the immediate arm ( IA ) : 6 months of the Curves program followed by 6 months of observation ; or the waitlist control arm ( WCA ) : 6 months of observation followed by 6 months of the Curves program . The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet . RESULTS A total of 42 women enrolled ( 79 % Hispanic , 21 % black ) , mean age 51 ( range 32 - 69 ) and mean BMI 33.2(± 5.9 ) kg/m(2 ) ; 91 % were retained at month 12 . At month 6 , women in the IA lost an average 3.3 % ( ± 3.5 % ) of body weight ( range : 1.7 % gain to 10.6 % loss ) , as compared with 1.8 % ( ± 2.9 % ) weight loss in the WCA ( P = 0.04 ) . At month 12 , on average women in the IA regained some but not all of the weight lost during the first 6 months ( P = 0.02 ) . CONCLUSIONS Minority breast cancer survivors were recruited and retained in a weight loss study . Six months of the Curves program result ed in moderate weight loss , but weight loss was not maintained postintervention . Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors OBJECTIVE The majority of endometrial cancer survivors ( ECS ) are obese and at risk for premature death . The purpose of this study was to evaluate an intervention for ECS to promote weight loss and a healthy lifestyle . METHODS Early stage overweight and obese ( body mass index ≥ 25 ) ECS ( N=75 ) were r and omized to a  6-month lifestyle intervention ( LI ) or usual care ( UC ) . The LI group received education and counseling for six months ( 10 weekly followed by 6 bi-weekly sessions ) . Weight change at 12 months was the primary endpoint . Secondary outcomes included fruit/vegetable servings/day and physical activity ( PA ) . Multiple imputations were used for missing data and mixed models were used to analyze changes from baseline . RESULTS Adherence was 84 % and follow-up data were available from 92 % of participants at 6 months and 79 % at 12 months . Mean [ 95 % CI ] difference in weight change between LI and UC groups at 6 months was -4.4 kg [ -5.3 , -3.5 ] , p<0.001 and at 12 months was -4.6 kg [ -5.8 , -3.5 ] , p<0.001 . Mean [ 95 % CI ] difference in PA minutes between groups at 6 months was 100 [ 6 , 194 ] , p=0.038 and at 12 months was 89 [ 14 , 163 ] , p=0.020 . Mean difference in kilocalories consumed was -217.8 ( p<0.001 ) at 6 months and -187.2 ( p<0.001 ) at 12 months . Mean [ 95 % CI ] difference in fruit and vegetable servings was 0.91 servings/day at 6 months and 0.92 at 12 months ( p<0.001 ) . CONCLUSIONS Behavior change and weight loss are achievable in overweight and obese ECS , however , the clinical implication s of these changes are unknown and require a larger trial with longer follow-up PURPOSE Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity , but few have assessed adherence and health outcomes long term . METHODS Between July 2005 and May 2007 , the Reach Out to Enhance Wellness ( RENEW ) trial accrued 641 locoregionally staged , long-term ( ≥ 5 years from diagnosis ) colorectal , breast , and prostate cancer survivors in the United States ( 21 states ) , Canada , and the United Kingdom . All participants were sedentary ( < 150 minutes of physical activity [ PA ] a week ) , overweight or obese ( body mass index , 25 to 40 kg/m(2 ) ) , and over age 65 years . The trial tested a diet-exercise intervention delivered via mailed print material s and telephone counseling . RENEW used a wait-list control , cross-over design ( ie , participants received the year-long intervention immediately or after a 1-year delay ) , which allowed the opportunity to assess program efficacy ( previously reported primary outcome ) , durability , and reproducibility ( reported herein ) . Measures included diet quality ( DQ ) , PA , BMI , and physical function ( PF ) . RESULTS No significant relapse was observed in the immediate-intervention arm for DQ , PA , and BMI ; however , rates of functional decline increased when the intervention ceased . From year 1 to year 2 , significant improvements were observed in the delayed-intervention arm ; mean change scores in behaviors and BMI and PF slopes were as follows : DQ score , 5.2 ( 95 % CI , 3.4 to 7.0 ) ; PA , 45.8 min/wk ( 9 
    Output:
    
Implication s for cancer survivorsThis study contributed to increasing knowledge on the optimal strategy to achieve weight loss , which is recommended for overweight cancer survivors to improve health outcomes