human
***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: Abstract Objective : To evaluate the effectiveness of combinations of three methods to promote physical activity . Design : R and omised controlled trial . Baseline assessment with post-intervention follow up at 12 weeks and 1 year . Setting : One urban general practice , 1995 - 7 . Participants : 523 adults aged 40 to 64 years , r and omised to four intervention groups and a control group . Interventions : Brief ( one interview ) or intensive ( six interviews over 12 weeks ) motivational interviewing based on the stages of change model of behaviour change , with or without financial incentive ( 30 vouchers entitling free access to leisure facilities ) . Main outcome measures : Physical activity score ; sessions of moderate and vigorous activity in the preceding four weeks . Results : Response rate was 81 % at 12 weeks and 85 % at one year . More participants in the intervention group reported increased physical activity scores at 12 weeks than controls ( 38 % v 16 % , difference 22 % , 95 % confidence interval for difference 13 % to 32 % ) , with a 55 % increase observed in those offered six interviews plus vouchers . Vigorous activity increased in 29 % of intervention participants and 11 % of controls ( difference 18 % , 10 % to 26 % ) , but differences between the intervention groups were not significant . Short term increases in activity were not sustained , regardless of intensity of intervention . Conclusions : The most effective intervention for promoting adoption of exercise was the most intensive . Even this did not promote long term adherence to exercise . Brief interventions promoting physical activity that are used by many schemes in the United Kingdom are of question able effectiveness . Key messages Schemes promoting physical activity are currently popular in general practice in Britain , but few have been rigorously evaluated and their effectiveness is unknown . In this study , the most effective intervention for promoting adoption of physical activity was the most intensive , involving six motivational interviews and a financial incentive A comparatively brief intervention ( one interview ) was only effective in the short term in around a third of participants Short term increases in physical activity were not maintained at one year follow up and even the most intensive intervention was ineffective in promoting long term adherence to increased physical activity . National and local government , health authorities , and primary healthcare teams should be cautious about current and future expenditure on , and implementation of , exercise prescription or referral This study investigated the relative and combined effectiveness of the Canadian Home Fitness Test ( CHFT ) and Health Hazard Appraisal ( HHA ) to modify ( 1 ) intention to exercise with and without knowledge of the results and ( 2 ) intention and behavior to exercise over 3 months . The 200 subjects were r and omly attributed to groups , either ( 1 ) physical-fitness evaluation ( PF ) , ( 2 ) appraised health age ( HA ) , ( 3 ) physical-fitness evaluation and health-hazard appraisal ( PF-HA ) , or ( 4 ) control ( C ) , The immediate impact on the intention to exercise of passing one and /or the other tests , without knowledge of the results , was not significant . With knowledge of the results , the intentions of the PF and PF-HA groups differed from those of the C group . This effect disappeared after 3 months . There was no significant impact on exercise behavior over 3 months . The results indicated a short-term motivational effect from being informed of CHFT results . Maintaining this effect might require intervention on a long-term basis Although telephone and mail are often used to promote physical activity adoption , their ability to produce long-term maintenance is unclear . In this study , 140 men and women aged 50 - 65 years received 1 year of telephone counseling  to adopt higher ( i.e. , more vigorous ) versus lower intensity ( i.e. , moderate ) exercise . After 1 year , participants were rer and omized to a 2nd year of contact via ( a ) telephone and mail or ( b ) predominantly mail . Participants who were prescribed higher intensity exercise and received predominantly mail had better exercise adherence during the maintenance year than those who received telephone and mail . Both strategies were similarly effective in promoting maintenance in the lower intensity condition . Results suggest that after successful adoption of physical activity with the help of telephone counseling , less intensive interventions are successful for physical activity maintenance in older adults BACKGROUND It is important to determine if permanent lifestyle changes may result from physical activity interventions and whether health may be affected by these changes . OBJECTIVE To conduct a 10-year follow-up of physical activity and self-reported health status in participants of a r and omized clinical trial of walking intervention .  METHODS Of the original 229 volunteer postmenopausal women who participated in the original clinical trial , 196 ( N = 96 intervention and 100 controls ) completed the 10-year follow-up telephone interview . The interview protocol included questions on  self-reported walking for exercise  and purpose s other than exercise , the Paffenbarger sport and exercise index , functional status , and various chronic diseases and conditions . RESULTS The median values for both usual walking for exercise and total walking  were significantly higher for walkers compared with controls ( for both , P = .01 ) , with median differences of 706 and 420 kcal/wk , respectively . After excluding women who reported heart disease during the original trial , 2 women in the walking group ( 2 % ) and 11 women in the control group ( 12 % ) reported physician-diagnosed heart disease over the last 10 years ( P = .07 ) . There were also fewer hospitalizations , surgeries , and falls among women in the walking group , although these differences were not statistically significant ( P>.05 ) . CONCLUSIONS Although limited by self-report , this study may be the first to demonstrate long-term exercise compliance to a r and omized control trial in older women and to suggest that health benefits may have ensued as a result of these increased activity levels BACKGROUND Project ACTIVE was a r and omized clinical trial comparing two physical activity interventions , lifestyle and traditional structured exercise . The two interventions were evaluated and compared in terms of cost effectiveness and ability to enhance physical activity among sedentary adults . DESIGN This was a r and omized clinical trial . SETTING / PARTICIPANTS The study included 235 sedentary but healthy community-dwelling adults . INTERVENTION A center-based lifestyle intervention that consisted of behavioral skills training was compared to a structured exercise intervention that included supervised , center-based exercise . MAIN OUTCOME MEASURES The main outcome measures of interest included cost , cardiorespiratory fitness , and physical activity . RESULTS Both interventions were effective in increasing physical activity and fitness . At 6 months , the costs of the lifestyle and structured interventions were , respectively , $ 46.53 and $ 190.24 per participant per month . At 24 months these costs were $ 17.15 and $ 49.31 per participant per month . At both 6 months and 24 months , the lifestyle intervention was more cost-effective than the structured intervention for most outcomes measures . CONCLUSIONS A behaviorally-based lifestyle intervention approach in which participants are taught behavioral skills to increase their physical activity by integrating moderate-intensity physical activity into their daily lives is more cost-effective than a structured exercise program in improving physical activity and cardiorespiratory health . This study represents one of the first attempts to compare the efficiency of intervention alternatives for improving physical activity among healthy , sedentary adults Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes Lifestyle factors like weight , alcohol consumption , salt intake and physical activity have shown to be important in treating hypertension . There have been made some r and omised trials about the effects of lifestyle interventions , but the numbers of patients have been relatively small and the duration s of follow-ups have been short . No controlled trials assessing the effects of lifestyle intervention in a rehabilitation setting have been reported . In this study , the effects of multidisciplinary lifestyle intervention in rehabilitation centres among middle-aged hypertensive employees were described . A total of 731 hypertensives from 45 worksites were r and omised to lifestyle intervention in a rehabilitation centre or to usual care in an occupational or primary health-care centre for 12 months . St and ard measurements were conducted before the intervention and 1-year later . Blood pressure ( BP ) levels were clearly reduced in the intervention group , while only minor changes were observed in the control group . The net changes between the two groups both for systolic and diastolic BPs were −2.1 mmHg ( 95 % confidence intervals ( CI ) −4.0 to −0.1 ) and −1.5 mmHg ( 95 % CI −2.6 to −0.4 ) , respectively . The net changes were greater among men than women . The multidisciplinary lifestyle intervention in a rehabilitation centre setting produced significant reductions in BP among middle-aged employees with hypertension INTRODUCTION Project Graduate Ready for Activity Daily evaluated a program to promote physical activity through the transition of university graduation in a r and omized controlled trial . METHODS Three hundred thirty-eight university seniors participated in either a cognitive-behavioral intervention course or a knowledge-oriented general health course during the semester before graduation .  Behaviorally oriented phone and mail follow-up was delivered to the intervention group for 18 months . Physical activity outcomes and mediating variables were assessed at baseline , 1 and 2 years ( 93 % retention rate ) . RESULTS There were no significant intervention effects on physical activity outcomes at 2 years for either men or women . Experiential and behavioral processes of change were significantly improved for intervention women over 2 years . CONCLUSIONS Despite excellent participation in a theoretically based , well-attended intervention , few long-term effects on physical activity or its mediators were found . Additional research is needed to determine optimal interventions for physical activity and to vali date or alter current behavior change theory The purpose of this study was to determine whether a brief , tailored counselling intervention is effective for increasing physical activity in sedentary women when delivered in the workplace . This prospect i ve r and omized trial used a brief intervention based on the Transtheoretical Model . The intervention group received health screening , a brief intervention , and , 2 weeks later , a booster telephone call from a nurse practitioner . The intervention was tailored to each woman 's reported exercise behaviour . The 134 women r and omized to the intervention were compared with 153 women in a control group who received health counselling not tailored to their exercise behaviour and no telephone call . Six weeks later , the intervention group , when compared to baseline , had significantly improved their physical activity , increasing their amount of weekend physical activity as well as minutes walked for exercise , on err and s , total walking , and total daily blocks walked . When compared to controls , they showed significantly greater gains . This test of a brief , tailored strategy provides a critical contribution to the search for efficient , effective ways for nurses to deliver workplace health promotion interventions BACKGROUND Few primary care physicians routinely counsel for exercise , despite the benefits of physical activity and the high prevalence of inactivity . The objective of this study is to assess the effectiveness of Physician-Based Assessment and Counseling for Exercise ( PACE ) , a brief , behavior-based tool for primary care providers counseling healthy adults . METHODS This study is a r and omized controlled trial of 812 patients age 30 years or older registered for well visits at 32 primary care physician offices at a staff model health maintenance organization . Intervention physicians were trained to deliver PACE exercise counseling protocol s at the index visit , and one reminder telephone call occurred at 1 month . An enhanced intervention group received additional activity reminders . RESULTS At the 6-month follow-up , the control group did not differ significantly from the intervention group for energy expended ( 2,048 kcal/week versus 2,108 kcal/ week , P = 0.77 ) , time spent in walking or other moderate to vigorous activities ( 202 min/week versus 187 min/ week , P = 0.99 ) , mental health , physical function , or behaviors previously shown to predict activity change . Among the intervention patients , the stages-of-change score for Contemplators increased significantly compared with controls ( P = 0.03 ) , but without a significant change in energy expended . Baseline levels of physical activity counseling were high ( 50 % ) , as were baseline patient physical activity levels ( 61 % exercised at least three times a week ) . CONCLUSIONS These results suggest that a one-time PACE counseling session with minimal reinforcement , in a setting with high baseline levels of activity , does not further increase activity . The finding that Contemplators advanced in stage of behavior change suggests that further studies are needed to examine long-term , repeated counseling interventions Purpose . This study examined the broader use of a print-media intervention , which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community , as a strategy suitable for a more diverse statewide population sample . Methods . Participants were r and omly selected adults who responded to 
    Output:
    
agent
The heterogeneity in reported effects was reduced in higher quality studies , when physical activity was self-directed with some professional guidance and when there was on-going professional support .
Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness , but not on achieving a predetermined level of physical activity .
Due to the clinical and statistical heterogeneity of the studies , only limited conclusions can be drawn about the effectiveness of individual components of the interventions .
***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: Abstract Objective : To evaluate the effectiveness of combinations of three methods to promote physical activity . Design : R and omised controlled trial . Baseline assessment with post-intervention follow up at 12 weeks and 1 year . Setting : One urban general practice , 1995 - 7 . Participants : 523 adults aged 40 to 64 years , r and omised to four intervention groups and a control group . Interventions : Brief ( one interview ) or intensive ( six interviews over 12 weeks ) motivational interviewing based on the stages of change model of behaviour change , with or without financial incentive ( 30 vouchers entitling free access to leisure facilities ) . Main outcome measures : Physical activity score ; sessions of moderate and vigorous activity in the preceding four weeks . Results : Response rate was 81 % at 12 weeks and 85 % at one year . More participants in the intervention group reported increased physical activity scores at 12 weeks than controls ( 38 % v 16 % , difference 22 % , 95 % confidence interval for difference 13 % to 32 % ) , with a 55 % increase observed in those offered six interviews plus vouchers . Vigorous activity increased in 29 % of intervention participants and 11 % of controls ( difference 18 % , 10 % to 26 % ) , but differences between the intervention groups were not significant . Short term increases in activity were not sustained , regardless of intensity of intervention . Conclusions : The most effective intervention for promoting adoption of exercise was the most intensive . Even this did not promote long term adherence to exercise . Brief interventions promoting physical activity that are used by many schemes in the United Kingdom are of question able effectiveness . Key messages Schemes promoting physical activity are currently popular in general practice in Britain , but few have been rigorously evaluated and their effectiveness is unknown . In this study , the most effective intervention for promoting adoption of physical activity was the most intensive , involving six motivational interviews and a financial incentive A comparatively brief intervention ( one interview ) was only effective in the short term in around a third of participants Short term increases in physical activity were not maintained at one year follow up and even the most intensive intervention was ineffective in promoting long term adherence to increased physical activity . National and local government , health authorities , and primary healthcare teams should be cautious about current and future expenditure on , and implementation of , exercise prescription or referral This study investigated the relative and combined effectiveness of the Canadian Home Fitness Test ( CHFT ) and Health Hazard Appraisal ( HHA ) to modify ( 1 ) intention to exercise with and without knowledge of the results and ( 2 ) intention and behavior to exercise over 3 months . The 200 subjects were r and omly attributed to groups , either ( 1 ) physical-fitness evaluation ( PF ) , ( 2 ) appraised health age ( HA ) , ( 3 ) physical-fitness evaluation and health-hazard appraisal ( PF-HA ) , or ( 4 ) control ( C ) , The immediate impact on the intention to exercise of passing one and /or the other tests , without knowledge of the results , was not significant . With knowledge of the results , the intentions of the PF and PF-HA groups differed from those of the C group . This effect disappeared after 3 months . There was no significant impact on exercise behavior over 3 months . The results indicated a short-term motivational effect from being informed of CHFT results . Maintaining this effect might require intervention on a long-term basis Although telephone and mail are often used to promote physical activity adoption , their ability to produce long-term maintenance is unclear . In this study , 140 men and women aged 50 - 65 years received 1 year of telephone counseling  to adopt higher ( i.e. , more vigorous ) versus lower intensity ( i.e. , moderate ) exercise . After 1 year , participants were rer and omized to a 2nd year of contact via ( a ) telephone and mail or ( b ) predominantly mail . Participants who were prescribed higher intensity exercise and received predominantly mail had better exercise adherence during the maintenance year than those who received telephone and mail . Both strategies were similarly effective in promoting maintenance in the lower intensity condition . Results suggest that after successful adoption of physical activity with the help of telephone counseling , less intensive interventions are successful for physical activity maintenance in older adults BACKGROUND It is important to determine if permanent lifestyle changes may result from physical activity interventions and whether health may be affected by these changes . OBJECTIVE To conduct a 10-year follow-up of physical activity and self-reported health status in participants of a r and omized clinical trial of walking intervention .  METHODS Of the original 229 volunteer postmenopausal women who participated in the original clinical trial , 196 ( N = 96 intervention and 100 controls ) completed the 10-year follow-up telephone interview . The interview protocol included questions on  self-reported walking for exercise  and purpose s other than exercise , the Paffenbarger sport and exercise index , functional status , and various chronic diseases and conditions . RESULTS The median values for both usual walking for exercise and total walking  were significantly higher for walkers compared with controls ( for both , P = .01 ) , with median differences of 706 and 420 kcal/wk , respectively . After excluding women who reported heart disease during the original trial , 2 women in the walking group ( 2 % ) and 11 women in the control group ( 12 % ) reported physician-diagnosed heart disease over the last 10 years ( P = .07 ) . There were also fewer hospitalizations , surgeries , and falls among women in the walking group , although these differences were not statistically significant ( P>.05 ) . CONCLUSIONS Although limited by self-report , this study may be the first to demonstrate long-term exercise compliance to a r and omized control trial in older women and to suggest that health benefits may have ensued as a result of these increased activity levels BACKGROUND Project ACTIVE was a r and omized clinical trial comparing two physical activity interventions , lifestyle and traditional structured exercise . The two interventions were evaluated and compared in terms of cost effectiveness and ability to enhance physical activity among sedentary adults . DESIGN This was a r and omized clinical trial . SETTING / PARTICIPANTS The study included 235 sedentary but healthy community-dwelling adults . INTERVENTION A center-based lifestyle intervention that consisted of behavioral skills training was compared to a structured exercise intervention that included supervised , center-based exercise . MAIN OUTCOME MEASURES The main outcome measures of interest included cost , cardiorespiratory fitness , and physical activity . RESULTS Both interventions were effective in increasing physical activity and fitness . At 6 months , the costs of the lifestyle and structured interventions were , respectively , $ 46.53 and $ 190.24 per participant per month . At 24 months these costs were $ 17.15 and $ 49.31 per participant per month . At both 6 months and 24 months , the lifestyle intervention was more cost-effective than the structured intervention for most outcomes measures . CONCLUSIONS A behaviorally-based lifestyle intervention approach in which participants are taught behavioral skills to increase their physical activity by integrating moderate-intensity physical activity into their daily lives is more cost-effective than a structured exercise program in improving physical activity and cardiorespiratory health . This study represents one of the first attempts to compare the efficiency of intervention alternatives for improving physical activity among healthy , sedentary adults Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes Lifestyle factors like weight , alcohol consumption , salt intake and physical activity have shown to be important in treating hypertension . There have been made some r and omised trials about the effects of lifestyle interventions , but the numbers of patients have been relatively small and the duration s of follow-ups have been short . No controlled trials assessing the effects of lifestyle intervention in a rehabilitation setting have been reported . In this study , the effects of multidisciplinary lifestyle intervention in rehabilitation centres among middle-aged hypertensive employees were described . A total of 731 hypertensives from 45 worksites were r and omised to lifestyle intervention in a rehabilitation centre or to usual care in an occupational or primary health-care centre for 12 months . St and ard measurements were conducted before the intervention and 1-year later . Blood pressure ( BP ) levels were clearly reduced in the intervention group , while only minor changes were observed in the control group . The net changes between the two groups both for systolic and diastolic BPs were −2.1 mmHg ( 95 % confidence intervals ( CI ) −4.0 to −0.1 ) and −1.5 mmHg ( 95 % CI −2.6 to −0.4 ) , respectively . The net changes were greater among men than women . The multidisciplinary lifestyle intervention in a rehabilitation centre setting produced significant reductions in BP among middle-aged employees with hypertension INTRODUCTION Project Graduate Ready for Activity Daily evaluated a program to promote physical activity through the transition of university graduation in a r and omized controlled trial . METHODS Three hundred thirty-eight university seniors participated in either a cognitive-behavioral intervention course or a knowledge-oriented general health course during the semester before graduation .  Behaviorally oriented phone and mail follow-up was delivered to the intervention group for 18 months . Physical activity outcomes and mediating variables were assessed at baseline , 1 and 2 years ( 93 % retention rate ) . RESULTS There were no significant intervention effects on physical activity outcomes at 2 years for either men or women . Experiential and behavioral processes of change were significantly improved for intervention women over 2 years . CONCLUSIONS Despite excellent participation in a theoretically based , well-attended intervention , few long-term effects on physical activity or its mediators were found . Additional research is needed to determine optimal interventions for physical activity and to vali date or alter current behavior change theory The purpose of this study was to determine whether a brief , tailored counselling intervention is effective for increasing physical activity in sedentary women when delivered in the workplace . This prospect i ve r and omized trial used a brief intervention based on the Transtheoretical Model . The intervention group received health screening , a brief intervention , and , 2 weeks later , a booster telephone call from a nurse practitioner . The intervention was tailored to each woman 's reported exercise behaviour . The 134 women r and omized to the intervention were compared with 153 women in a control group who received health counselling not tailored to their exercise behaviour and no telephone call . Six weeks later , the intervention group , when compared to baseline , had significantly improved their physical activity , increasing their amount of weekend physical activity as well as minutes walked for exercise , on err and s , total walking , and total daily blocks walked . When compared to controls , they showed significantly greater gains . This test of a brief , tailored strategy provides a critical contribution to the search for efficient , effective ways for nurses to deliver workplace health promotion interventions BACKGROUND Few primary care physicians routinely counsel for exercise , despite the benefits of physical activity and the high prevalence of inactivity . The objective of this study is to assess the effectiveness of Physician-Based Assessment and Counseling for Exercise ( PACE ) , a brief , behavior-based tool for primary care providers counseling healthy adults . METHODS This study is a r and omized controlled trial of 812 patients age 30 years or older registered for well visits at 32 primary care physician offices at a staff model health maintenance organization . Intervention physicians were trained to deliver PACE exercise counseling protocol s at the index visit , and one reminder telephone call occurred at 1 month . An enhanced intervention group received additional activity reminders . RESULTS At the 6-month follow-up , the control group did not differ significantly from the intervention group for energy expended ( 2,048 kcal/week versus 2,108 kcal/ week , P = 0.77 ) , time spent in walking or other moderate to vigorous activities ( 202 min/week versus 187 min/ week , P = 0.99 ) , mental health , physical function , or behaviors previously shown to predict activity change . Among the intervention patients , the stages-of-change score for Contemplators increased significantly compared with controls ( P = 0.03 ) , but without a significant change in energy expended . Baseline levels of physical activity counseling were high ( 50 % ) , as were baseline patient physical activity levels ( 61 % exercised at least three times a week ) . CONCLUSIONS These results suggest that a one-time PACE counseling session with minimal reinforcement , in a setting with high baseline levels of activity , does not further increase activity . The finding that Contemplators advanced in stage of behavior change suggests that further studies are needed to examine long-term , repeated counseling interventions Purpose . This study examined the broader use of a print-media intervention , which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community , as a strategy suitable for a more diverse statewide population sample . Methods . Participants were r and omly selected adults who responded to 
    Output:
    