***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: The unmet psychological needs of rural cancer patients are numerous . Telepsychology is a novel and feasible option that may provide cost-savings and help overcome inequalities in access to specialists . This is the first known study of psychological treatment for people with cancer delivered entirely via videoconferencing . We hypothesized that a telepsychology service would improve rural cancer patients ' anxiety and depression levels and quality of life , and would be an acceptable , satisfactory , and practical mode of service delivery . Twenty-five cancer patients attended an average of three sessions with a clinical psychologist providing brief cognitive-behavioral therapy . Question naires were completed at pre- , post- , and 1-month follow-up . Patients benefited in terms of anxiety ( P=0.01 ) and quality of life ( P=0.04 ) . The service was both practical and acceptable . These preliminary positive results provide a firm basis to conduct a r and omized controlled trial of face-to-face interaction vs. videoconferencing OBJECTIVE The objective of the current study was to examine the effectiveness of a multidisciplinary weekly family-based behavioral group delivered via telemedicine to rural areas , compared with a st and ard physician visit intervention . METHODS A r and omized controlled trial was conducted with 58 rural children and their families comparing a family-based behavioral intervention delivered via telemedicine to a structured physician visit condition . Outcome measures included child body mass index z-score ( BMI z ) , 24-hr dietary recalls , accelerometer data , Child Behavior Checklist , Behavioral Pediatrics Feeding Assessment Scale , and feasibility and fidelity . RESULTS Child BMI z outcomes were not statistically different between the 2 groups ( F = 0.023 , p = .881 ) . Improvements in BMI z , nutrition , and physical activity were seen for both groups . CONCLUSIONS Both telemedicine and structured physician visit may be feasible and acceptable methods of delivering pediatric obesity treatment to rural children To assess the feasibility of conducting empirically supported family-based paediatric obesity group treatment via TeleMedicine .  Seventeen families were r and omly assigned to one of two conditions ( physician visit , TeleMedicine ) . Measures included feasibility , satisfaction and intervention outcome measures such as BMI percentile , and nutrition and activity behaviours . Measures were completed at baseline , post-treatment and at 1-year follow-up . Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive . Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviours for either treatment group . A behavioural family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers . Due to the small sample size , null findings regarding intervention outcome should be interpreted with caution . Future research should focus on methods to increase the impact of this intervention on key outcome variables Objective The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family-based behavioural group intervention to treat paediatric obesity delivered to families living in rural areas using a r and omized controlled trial methodology . Methods 103 rural children and their families were recruited . Feasibility measures included participant satisfaction , session attendance and retention . Treatment outcome measures included child Body Mass Index z-score ( BMI z ) , parent BMI , 24-hour dietary recalls , accelerometer data , the child behavior checklist and the behavioral pediatrics feeding assessment scale . Results Participants were highly satisfied with the intervention both via telemedicine and via telephone .  Completion rates were much higher than for other paediatric obesity intervention programmes , and both method ologies were highly feasible . There were no differences in telemedicine and telephone groups on primary outcomes . Conclusion Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering paediatric obesity treatment to rural children Summary We conducted a pilot study to investigate the effectiveness of a home telehealth service for paediatric palliative care consultations . Over a 10 week period , 14 of the 17 caregivers approached to be part of the study agreed to participate . Families were allocated , non-r and omly , to a control group ( usual care ) or an intervention group ( usual care with the addition of home telehealth consultations ) . The primary outcome measure was quality -of-life score .  Caregivers were surveyed for up to 99 days following recruitment . A descriptive analysis of the quality -of-life data showed no differences between caregivers in the two groups . However , important lessons were learnt regarding factors which influence the success of studies in this population group , and the domains of caregiver quality -of-life that warrant intervention . Palliative care is complex , and multiple interventions and supports are required if care is to be managed at home . Home telehealth consultations are a feasible and acceptable means of facilitating a palliative care consultation which can reduce the burden on families at a distressing time BACKGROUND Telemedicine holds great potential to improve access to care and to reduce barriers to treatment for military population s with posttraumatic stress disorder ( PTSD ) . This study sought to integrate the use of telemedicine mental health treatment services by a community healthcare provider to military population s residing in a rural location and to compare the equivalency of cognitive behavioral therapy ( CBT ) administered via telemedicine and traditional face-to-face therapy . SUBJECTS AND METHODS Study subjects were men or women 18 years of age or older who had served in Operation Enduring Freedom ( OEF ) and /or Operation Iraqi Freedom ( OIF ) and were diagnosed with PTSD . The 18 study subjects were r and omized and provided 10 weekly therapy sessions of CBT . Pre- and post-intervention assessment s were conducted using the Clinician Administered PTSD Scale ( CAPS ) , Hamilton Anxiety Rating Scale ( HAM-A ) , Montgomery-Asberg Depression Rating Scale ( MADRS ) , Life Events Checklist , and SF-36v2 ® ( Quality Metric , Lincoln , RI ) Health Survey . RESULTS The CAPS , HAM-A , and MADRS each demonstrated lower scores , signifying improvement , and 69 % of subjects experienced a clinical ly significant change in the CAPS . Patient satisfaction results indicated greater satisfaction for telemedicine as opposed to traditional face-to-face treatment . CONCLUSIONS Findings reveal a trend expressing the equivalence of telemedicine and face-to-face therapy when treating OEF/OIF veterans with PTSD among rural population s by a community provider . It further demonstrates the successful collaboration between a community healthcare provider and the military healthcare system IMPORTANCE Posttraumatic stress disorder ( PTSD ) is prevalent , persistent , and disabling . Although psychotherapy and pharmacotherapy have proven efficacious in r and omized clinical trials , geographic barriers impede rural veterans from engaging in these evidence -based treatments . OBJECTIVE To test a telemedicine-based collaborative care model design ed to improve engagement in evidence -based treatment of PTSD . DESIGN , SETTING , AND PARTICIPANTS The Telemedicine Outreach for PTSD ( TOP ) study used a pragmatic r and omized effectiveness trial design with intention-to-treat analyses . Out patients were recruited from 11 Department of Veterans Affairs ( VA ) community-based outpatient clinics serving predominantly rural veterans . Inclusion required meeting diagnostic criteria for current PTSD according to the Clinician-Administered PTSD Scale . Exclusion criteria included receiving PTSD treatment at a VA medical center or a current diagnosis of schizophrenia , bipolar disorder , or substance dependence . Two hundred sixty-five veterans were enrolled from November 23 , 2009 , through September 28 , 2011 , r and omized to usual care ( UC ) or the TOP intervention , and followed up for 12 months . INTERVENTIONS Off-site PTSD care teams located at VA medical centers supported on-site community-based outpatient clinic providers . Off-site PTSD care teams included telephone nurse care managers , telephone pharmacists , telepsychologists , and telepsychiatrists . Nurses conducted care management activities . Pharmacists review ed medication histories . Psychologists delivered cognitive processing therapy via interactive video . Psychiatrists supervised the team and conducted interactive video psychiatric consultations . MAIN OUTCOMES AND MEASURES The primary outcome was PTSD severity as measured by the Posttraumatic Diagnostic Scale . Process-of-care outcomes included medication prescribing and regimen adherence and initiation of and adherence to cognitive processing therapy . RESULTS During the 12-month follow-up period , 73 of the 133 patients r and omized to TOP ( 54.9 % ) received cognitive processing therapy compared with 16 of 132 r and omized to UC ( 12.1 % ) ( odds ratio , 18.08 [ 95 % CI , 7.96 - 41.06 ] ; P < .001 ) . Patients in the TOP arm had significantly larger decreases in Posttraumatic Diagnostic Scale scores ( from 35.0 to 29.1 ) compared with those in the UC arm ( from 33.5 to 32.1 ) at 6 months ( β = -3.81 ; P = .002 ) . Patients in the TOP arm also had significantly larger decreases in Posttraumatic Diagnostic Scale scores ( from 35.0 to 30.1 ) compared with those in the UC arm ( from 33.5 to 31.7 ) at 12 months ( β = -2.49 ; P=.04 ) . There were no significant group differences in the number of PTSD medications prescribed and adherence to medication regimens were not significant . Attendance at 8 or more sessions of cognitive processing therapy significantly predicted improvement in Posttraumatic Diagnostic Scale scores ( β = -3.86 [ 95 % CI , -7.19 to -0.54 ] ; P = .02 ) and fully mediated the intervention effect at 12 months . CONCLUSIONS AND RELEVANCE Telemedicine-based collaborative care can successfully engage rural veterans in evidence -based psychotherapy to improve PTSD outcomes . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00821678 OBJECTIVE Practice -based collaborative care is a complex evidence -based practice that is difficult to implement in smaller primary care practice s that lack on-site mental health staff . Telemedicine-based collaborative care virtually co-locates and integrates mental health providers into primary care setting s. The objective of this multisite r and omized pragmatic comparative effectiveness trial was to compare the outcomes of patients assigned to practice -based and telemedicine-based collaborative care . METHOD From 2007 to 2009 , patients at federally qualified health centers serving medically underserved population s were screened for depression , and 364 patients who screened positive were enrolled and followed for 18 months . Those assigned to practice -based collaborative care received evidence -based care from an on-site primary care provider and a nurse care manager . Those assigned to telemedicine-based collaborative care received evidence -based care from an on-site primary care provider and an off-site team : a nurse care manager and a pharmacist by telephone , and a psychologist and a psychiatrist via videoconferencing . The primary clinical outcome measures were treatment response , remission , and change in depression severity . RESULTS Significant group main effects were observed for both response ( odds ratio=7.74 , 95 % CI=3.94 - 15.20 ) and remission ( odds ratio=12.69 , 95 % CI=4.81 - 33.46 ) , and a significant overall group-by-time interaction effect was observed for depression severity on the Hopkins Symptom Checklist , with greater reductions in severity over time for patients in the telemedicine-based group . Improvements in outcomes appeared to be attributable to higher fidelity to the collaborative care evidence base in the telemedicine-based group . CONCLUSIONS Contracting with an off-site telemedicine-based collaborative care team can yield better outcomes than implementing practice -based collaborative care with locally available staff INTRODUCTION Exp and ed access to efficacious interventions is needed for women living with human immunodeficiency virus ( WLH ) in the United States . Availability of " prevention with ( human immunodeficiency virus [ HIV ) ] positives " interventions in rural/remote and low HIV prevalence areas remains limited , leaving WLH in these communities few options for receiving effective behavioral interventions such as Healthy Relationships ( HR ) . Offering such programs via videoconferencing groups ( VGs ) may exp and access . This analysis tests the effectiveness of HR-VG ( versus wait-list control ) for reducing sexual risk behavior among WLH and explores intervention satisfaction . SUBJECTS AND METHODS In this r and omized controlled trial unprotected vaginal/anal sex occasions over the prior 3 months reported at the 6-month follow-up were compared across r and omization groups through zero-inflated Poisson regression modeling , controlling for unprotected sex at baseline . Seventy-one WLH were r and omized and completed the baseline assessment ( n=36 intervention and n=35 control ) ; 59 ( 83 % in each group ) had follow-up data . RESULTS Among those who engaged in unprotected sex at 6-month follow-up , intervention participants had approximately seven fewer unprotected occasions than control participants ( 95 % confidence interval 5.43 - 7.43 ) . Intervention participants reported high levels of satisfaction with HR-VG ;  84 % reported being " very satisfied " overall . CONCLUSIONS This study found promising evidence for effective dissemination of HIV risk reduction interventions via VGs . Important next steps will be to determine whether V 
    Output:
    
The disciplines of psychology and nursing were represented most frequently , as were studies using a cognitive intervention approach .
Meta- analysis results slightly favoured telehealth interventions compared with face-to-face interventions , but did not show significant differences .
Interventions using a combined physical and cognitive approach appeared to be more effective .
CONCLUSION Telehealth services may be as effective as face-to-face interventions , which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings