***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: Relationships among risky sexual behaviors , other problem behaviors , and the family and peer context were examined for two sample s of adolescents . Many adolescents reported behaviors ( e.g. , promiscuity or nonuse of condoms ) which risked HIV or other sexually transmitted disease infection . Such risky behaviors were significantly intercorrelated . Consistent condom use was rare among those whose behavior otherwise entailed the greatest risk of infection . In both sample s , an index of high-risk sexual behavior was significantly related to antisocial behavior , cigarette smoking , and illicit drug or alcohol use . Social context variables , including  family structure , parenting practice s , and friends ' engagement in problem behaviors , were associated with high-risk sexual behavior . Finally , for sexually active adolescents , problem behaviors and social context variables were predictive of nonuse of condoms .  Results were consistent across the two studies and regression weights held up well under cross-validation This study tested the effectiveness of a prevention curriculum , All Stars , as implemented in a year-long school-based after school program and provides an independent replication of the effects of All Stars on targeted mediators and problem behaviors using an experimental methodology . Middle school students ( N = 447 ) who registered for the after school program were r and omly assigned to the experimental or control condition . The sample included approximately equal proportions of males and females , was 70 % African American , and 59 % of the students received subsidized meals at school . All Stars was delivered with reasonable integrity to the program design , although with lower quality than reported in earlier efficacy trials . However , actual student exposure to the program was lower than expected due to low levels of attendance in the after school program . Students who ever attended received an average of 16 h of All Stars instruction . Results showed no differences between the treatment and control students at post-test on any of the outcomes or mediators . Further , no positive effects were found for youths receiving higher dosage , higher quality program delivery , or both . Insufficient time to achieve high quality implementation in the after school context and potential deviancy training are suggested as reasons for the failure to replicate positive program effects Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more We developed a 9-week after-school , small group , activities-based intervention focused on enhancing youth 's abilities to imagine themselves as successful adults and connecting these future imagines to current school involvement . We describe and evaluate this programme comparing three cohorts of urban African American middle school students ( n=62 experimental , n=146 control ) , controlling for sex and previous school involvement . By the end of the school year , intervention youth reported more bonding to school , concern about doing well in school , " balanced " possible selves , plausible strategies to attain these possible selves , better school attendance , and for boys , less trouble at school Experiences that are deeply engaging and enjoyable , engender full concentration , and present a balance between challenge and skill promote children 's development . This chapter describes a study that sought to identify the kinds of setting s and activities that foster engagement and , by extension , positive youth development . The after-school experiences of 191 ethnically diverse youth living in three states , some of whom participated in after-school programs and some of whom did not , were studied .  Youth were equipped with logbooks and watches that were programmed to signal at r and om times . When signaled , youth recorded their location , social partners , activity , and feelings . The study found pervasive differences in the experiences at programs and elsewhere . Youth spent more time in academic and arts enrichment , organized sports and physical activities , community service , and homework at programs versus elsewhere , and they spent less time eating and watching TV at programs . They also reported higher levels of motivation , engagement , and positive affect at programs . At the same time , there were few differences in activities , emotions , effort , or motivation of program participants and non participants when both groups were elsewhere . The similarities in these experiences while elsewhere suggest that the program context , not differences in youth characteristics or interests , was responsible for the feelings of engagement that were reported at programs After school programs ( ASPs ) are popular and receive substantial public funding . Aside from their child-care and supervision value , ASPs often provide youth development and skill-building activities that might reduce delinquent behavior . These possibilities and the observation that arrests for juvenile crime peak between 2 p.m. and 6 p.m. on school days have increased interest in the delinquency prevention potential of ASPs . This study examined effects of participation in ASPs conducted in Maryl and during the 1999 - 2000 school year and the mechanism through which such programs may affect  delinquent behavior .  Results imply that participation reduced delinquent behavior for middle-school but not for elementary-school-aged youths . This reduction was not achieved by decreasing time spent unsupervised or by increasing involvement in constructive activities , but by increasing intentions not to use drugs and positive peer associations . Effects on these outcomes were strongest in programs that incorporated a high emphasis on social skills and character development Objective : This pilot study tests the feasibility and preliminary efficacy of an after-school treatment program for middle schoolers with ADHD using a r and omized clinical trial design . Method : A total of 23 students with ADHD ( 25 % female , 48 % African American ) from a large public middle school were r and omly assigned to a 10-week program or to community comparison . Manualized treatment targeted educational , social , and recreational skills , homework completion , and school and home behavior . Parents participated . Results : Recruitment and r and omization targets were easily met ( 87 % completion ) . Parent and teacher satisfaction was positive . Small to medium treatment effects result ed despite greater medication use in the control group , with improvements in functioning for the program-treated youth or absence of deterioration relative to the comparison group . Conclusion : Despite testing an abbreviated version of the after-school program ( < 5 months ) , this study reveals feasibility and palatability for this intervention and modest beneficial effects on behavioral and academic outcomes . ( J. of Att . Dis . 2008 ; 12(3 ) 207 - 217 BACKGROUND AND OBJECTIVE To conduct a pilot study to compare the frequency of errors that accompany single vs. double data extraction , compare the estimate of treatment effect derived from these methods , and compare the time requirements for these methods . METHODS Review ers were r and omized to the role of data extractor or data verifier , and were blind to the study hypothesis . The frequency of errors associated with each method of data extraction was compared using the McNemar test . The data set for each method was used to calculate an efficacy estimate by each method , using st and ard meta-analytic techniques . The time requirement for each method was compared using a paired t-test . RESULTS Single data extraction result ed in more errors than double data extraction ( relative difference : 21.7 % , P = .019 ) . There was no substantial difference between methods in effect estimates for most outcomes . The average time spent for single data extraction  was less than the average time for double data extraction ( relative difference : 36.1 % , P = .003 ) . CONCLUSION In the case that single data extraction is used in systematic review s , review ers and readers need to be mindful of the possibility for more errors and the potential impact these errors may have on effect estimates 
    Output:
    
Mean effects were small and non-significant for attendance and externalizing behaviors .
A moderate to large amount of heterogeneity was present ; however , no moderator variable tested explained the variance between studies .