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: Efforts to prevent postpartum weight retention in extant clinical trials of African American women have proven exceedingly challenging . The primary purpose of this pilot study was to determine whether a behavioral intervention implemented in early pregnancy through 6 months postpartum could increase the proportion of African American women who were at or below their early pregnancy weights by 6 months postpartum . We additionally evaluated whether mothers ' postpartum weight loss could be maintained at 12 months postpartum . Participants were 66 socioeconomically disadvantaged African American women ( 36 % overweight , 64 % obese ) r and omly assigned to a behavioral intervention or usual care group . The intervention , implemented from early pregnancy to 6 months postpartum , promoted weight control through : ( 1 ) empirically supported behavior change goals ; ( 2 ) interactive self-monitoring text messages ; ( 3 ) weekly to monthly health coach calls ; and ( 4 ) skills training and support through Facebook . In modified intent-to-treat analyses , participants assigned to the intervention were significantly more likely to be at or below their early pregnancy weights by 6 months postpartum compared to usual care ( 56 % vs. 29 % , p = 0.04 ) . At 12 months postpartum , the maternal weight difference between intervention and usual care groups was not maintained ( 41 % vs. 38 % respectively at or below early pregnancy weights , p = 0.83 ) . Findings suggest that a combined pregnancy and postpartum weight control intervention improves 6 month weight outcomes in socioeconomically disadvantaged African American women with obesity . Longer interventions may be needed to overcome late postpartum weight gain among this high risk group . Clinical trial registration number : Clinical Trials.gov identifier BACKGROUND Prepregnancy maternal obesity and excessive weight gain during pregnancy lead to significant morbidities in mothers and their children . Mothers who never return to their prepregnancy weight begin subsequent pregnancies at a greater weight and have a larger propensity for excess gestational weight gain and postpartum weight retention . METHODS In this pilot study , 40 postpartum women credentialed to receive postpartum women , infants , and children ( WIC ) service were  r and omized to usual care ( " WIC Moms " ) or a personalized health intervention delivered via a SmartPhone ( " E-Moms " ) . Assessment s , including body weight , vital signs , circumferences , and body composition , were completed at week 0 ( 6 - 8 weeks postpartum ) , week 8 , and week 16 . RESULTS Results are presented as change from week 0 at 16 . As per the completers analysis , body weight change was not different between the groups ( WIC Moms vs. E-Moms ; 1.8 ± 0.9 vs. -0.1 ± 0.9 kg ; p = 0.10 ) , neither was the change in percent body fat ( 1.7 ± 0.6 vs. 0.1 % ± 0.6 % ; p = 0.90 ) or waist/hip ratio ( -0.01 ± 0.01 vs. -0.02 ± 0.01 cm ; p = 0.60 ) . However , due to notable variability in intervention adherence as the study progressed , participants were classified post hoc as having low ( < 40 % adherence ) , medium ( 40%-70 % adherence ) , or high adherence ( > 70 % adherence ) . Participants with high intervention adherence ( n = 5 ) had a significant reduction in body weight ( -3.6 ± 1.6 vs. 1.8 ± 0.9 kg ; p = 0.005 ) and percent body fat ( -2.5 ± 1.0 vs. 1.7 % ± 0.6 % ; p = 0.001 ) when compared to WIC Moms . CONCLUSIONS Overall , the E-Moms intervention was not able to decrease postpartum weight retention in women receiving WIC benefits compared to usual care received through the current WIC program . However , there is some evidence to suggest improved adherence to the intervention would improve weight management OBJECTIVE To examine the feasibility , acceptability , and initial efficacy of a  technology-based weight loss intervention for urban , low-income mothers . METHODS Eighteen obese , ethnic minority , socioeconomically disadvantaged mothers in the first year after childbirth were r and omly assigned to either : 1 ) technology-based intervention , which included empirically supported behavior-change strategies , daily skills , and self-monitoring text messages with personalized feedback , biweekly counseling calls from a health coach , and access to a Facebook support group , or 2 ) usual-care control . RESULTS After 14 weeks of treatment , the technology-based intervention participants had significantly greater weight loss ( -2.9 ± 3.6 kg ) than usual care ( 0.5 ± 2.3 kg ; adjusted mean difference : -3.2 kg , 95 % confidence interval -6.2 to -0.1 kg , P = .04 ) . One-third of intervention participants ( 3 of 9 ) and no control participants lost > 5 % of their initial body weight at follow up . CONCLUSIONS AND IMPLICATION S Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities Background Pregnancy and childbirth are associated with weight gain in women , and retention of weight gained during pregnancy can lead to obesity in later life . Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth . Exercise guidelines exist for pregnancy , but recommendations for exercise after childbirth are virtually nonexistent . The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth . Methods We conducted a r and omized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were r and omly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer ( intervention group , n = 32 ) or routine postpartum care ( control group , n = 34 ) . During the 12-week study period , each woman in the intervention group wore a  pedometer and recorded her daily step count .  The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week . Assessed outcomes included anthropometric measures , physical activity level , and energy expenditure per week . Data were analyzed using the paired t-test , independent t-test , Mann-Whitney , chi-square , Wilcoxon , covariance analysis , and the general linear model repeated measures procedure as appropriate . Results After 12 weeks , women in the intervention group had significantly increased their physical activity and energy expenditure per week ( 4394 vs. 1651 calorie , p < 0.001 ) . Significant differences between-group in weight ( P = 0.001 ) , Body Mass Index ( P = 0.001 ) , waist circumference ( P = 0.001 ) , hip circumference ( P = 0.032 ) and waist-hip ratio ( P = 0.02 ) were presented after the intervention . The intervention group significantly increased their mean daily step count over the study period ( from 3249 before , to 9960 after the intervention , p < 0.001 ) . Conclusion A physical activity intervention based on pedometer is an effective means to increase physical activity ; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women . Trial registration IS RCT N : I RCT 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 OBJECTIVE Few postpartum ethnic minority women perform leisure-time moderate-to-vigorous physical activity ( MVPA ) . The study tested the effectiveness of a 12-month tailored intervention to increase MVPA in women with infants 2 - 12months old . METHODS From 2008 to 2011 , women ( n=311 ) with infants ( average age=5.7months ) from Honolulu , Hawaii were r and omly assigned to receive tailored telephone calls and access to a mom-centric website ( n=154 ) or access to a st and ard PA website ( n=157 ) . MVPA was measured at baseline , 6 , and 12months using self-report and acclerometers . RESULTS Controlling for covariates , the tailored condition significantly increased self-reported MVPA from an average of 44 to 246min/week compared with 46 to 156min/week for the st and ard condition ( p=0.027 ) . Mothers with≥2 children had significantly greater increases in MVPA in response to the tailored intervention than those with one child  ( p=0.016 ) . Accelerometer-measured MVPA significantly increased over time ( p=0.0001 ) , with no condition differences . There was evidence of reactivity to initially wearing accelerometers ; the tailored intervention significantly increased MVPA among women with low baseline accelerometer MVPA minutes , but not among those with high minutes ( pinteraction=0.053 ) . CONCLUSION A tailored intervention effectively increased MVPA over 12months in multiethnic women with infants , particularly those with more than one child Excessive gestational weight gain has been shown to relate to high-postpartum weight retention and the development of overweight and obesity later in life . Because many women are concerned about the health of their babies during pregnancy and are in frequent contact with their healthcare providers , pregnancy may be an especially powerful " teachable moment " for the promotion of healthy eating and physical activity behaviors among women . Initial research suggests that helping women gain the recommended amount during pregnancy through healthy eating and physical activity could make a major contribution to the prevention of postpartum weight retention . However , more r and omized controlled trials with larger sample sizes are needed to identify the most effective and disseminable intervention . Providers have the potential to prevent high postpartum weight retention and future obesity by monitoring weight gain during pregnancy and giving appropriate advice about recommended amounts of gestational weight gain Importance Effective long-term treatments are needed to address the obesity epidemic . Numerous wearable technologies specific to physical activity and diet are available , but it is unclear if these are effective at improving weight loss . Objective To test the hypothesis that , compared with a st and ard behavioral weight loss intervention ( st and ard intervention ) , a technology-enhanced weight loss intervention ( enhanced intervention ) would result in greater weight loss . Design , Setting , Participants R and omized clinical trial conducted at the University of Pittsburgh and enrolling 471 adult participants between October 2010 and October 2012 , with data collection completed by December 2014 . Interventions Participants were placed on a low-calorie diet , prescribed increases in physical activity , and had group counseling sessions . At 6 months , the interventions added telephone counseling sessions , text message prompts , and access to study material s on a website . At 6 months , participants r and omized to the st and ard intervention group initiated self-monitoring of diet and physical activity using a website , and those r and omized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity . Main Outcomes and Measures The primary outcome of weight was measured over 24 months at 6-month intervals , and the primary hypothesis tested the change in weight between 2 groups at 24 months . Secondary outcomes included body composition , fitness , physical activity , and dietary intake . Results Among the 471 participants r and omized ( body mass index [ BMI ] , 25 to < 40 ; age range , 18 - 35 years ; 28.9 % nonwhite , 77.2 % women ) , 470 ( 233 in the st and ard intervention group , 237 in the enhanced intervention group ) initiated the interventions as r and omized , and 74.5 % completed the study . For the enhanced intervention group , mean base line weight was 96.3 kg ( 95 % CI , 94.2 - 98.5 ) and 24-month weight 92.8 kg ( 95 % CI , 90.6- 95.0 ) [ corrected ] . For the st and ard intervention group , mean baseline weight was 95.2 kg ( 95%CI,93.0 - 97.3 ) and 24-month weight was 89.3 kg ( 95%CI , 87.1 - 91.5 ) [ corrected ] . Weight change at 24 months differed significantly by intervention group ( estimated mean weight loss , 3.5 kg [ 95 % CI , 2.6 - 4.5 } in the enhanced intervention group and 5.9 kg [ 95 % CI , 5.0 - 6.8 ] in the st and ard intervention group ; difference , 2.4 kg [ 95 % CI , 1.0 - 3.7 ] ; P = .002 ) . Both groups had significant improvements in body composition , fitness , physical activity , and diet , with no significant difference between groups . Conclusions and Relevance Among young adults with a BMI between 25 and less than 40 , the addition of a wearable technology device to a st and ard behavioral intervention result ed in less weight loss over 24 months . Devices that monitor and provide feedback on physical activity may not offer an advantage over st and ard behavioral weight loss approaches . Trial Registration clinical trials.gov Identifier : NCT01131871 The Internet 
    Output:
    
agent
***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: Efforts to prevent postpartum weight retention in extant clinical trials of African American women have proven exceedingly challenging . The primary purpose of this pilot study was to determine whether a behavioral intervention implemented in early pregnancy through 6 months postpartum could increase the proportion of African American women who were at or below their early pregnancy weights by 6 months postpartum . We additionally evaluated whether mothers ' postpartum weight loss could be maintained at 12 months postpartum . Participants were 66 socioeconomically disadvantaged African American women ( 36 % overweight , 64 % obese ) r and omly assigned to a behavioral intervention or usual care group . The intervention , implemented from early pregnancy to 6 months postpartum , promoted weight control through : ( 1 ) empirically supported behavior change goals ; ( 2 ) interactive self-monitoring text messages ; ( 3 ) weekly to monthly health coach calls ; and ( 4 ) skills training and support through Facebook . In modified intent-to-treat analyses , participants assigned to the intervention were significantly more likely to be at or below their early pregnancy weights by 6 months postpartum compared to usual care ( 56 % vs. 29 % , p = 0.04 ) . At 12 months postpartum , the maternal weight difference between intervention and usual care groups was not maintained ( 41 % vs. 38 % respectively at or below early pregnancy weights , p = 0.83 ) . Findings suggest that a combined pregnancy and postpartum weight control intervention improves 6 month weight outcomes in socioeconomically disadvantaged African American women with obesity . Longer interventions may be needed to overcome late postpartum weight gain among this high risk group . Clinical trial registration number : Clinical Trials.gov identifier BACKGROUND Prepregnancy maternal obesity and excessive weight gain during pregnancy lead to significant morbidities in mothers and their children . Mothers who never return to their prepregnancy weight begin subsequent pregnancies at a greater weight and have a larger propensity for excess gestational weight gain and postpartum weight retention . METHODS In this pilot study , 40 postpartum women credentialed to receive postpartum women , infants , and children ( WIC ) service were  r and omized to usual care ( " WIC Moms " ) or a personalized health intervention delivered via a SmartPhone ( " E-Moms " ) . Assessment s , including body weight , vital signs , circumferences , and body composition , were completed at week 0 ( 6 - 8 weeks postpartum ) , week 8 , and week 16 . RESULTS Results are presented as change from week 0 at 16 . As per the completers analysis , body weight change was not different between the groups ( WIC Moms vs. E-Moms ; 1.8 ± 0.9 vs. -0.1 ± 0.9 kg ; p = 0.10 ) , neither was the change in percent body fat ( 1.7 ± 0.6 vs. 0.1 % ± 0.6 % ; p = 0.90 ) or waist/hip ratio ( -0.01 ± 0.01 vs. -0.02 ± 0.01 cm ; p = 0.60 ) . However , due to notable variability in intervention adherence as the study progressed , participants were classified post hoc as having low ( < 40 % adherence ) , medium ( 40%-70 % adherence ) , or high adherence ( > 70 % adherence ) . Participants with high intervention adherence ( n = 5 ) had a significant reduction in body weight ( -3.6 ± 1.6 vs. 1.8 ± 0.9 kg ; p = 0.005 ) and percent body fat ( -2.5 ± 1.0 vs. 1.7 % ± 0.6 % ; p = 0.001 ) when compared to WIC Moms . CONCLUSIONS Overall , the E-Moms intervention was not able to decrease postpartum weight retention in women receiving WIC benefits compared to usual care received through the current WIC program . However , there is some evidence to suggest improved adherence to the intervention would improve weight management OBJECTIVE To examine the feasibility , acceptability , and initial efficacy of a  technology-based weight loss intervention for urban , low-income mothers . METHODS Eighteen obese , ethnic minority , socioeconomically disadvantaged mothers in the first year after childbirth were r and omly assigned to either : 1 ) technology-based intervention , which included empirically supported behavior-change strategies , daily skills , and self-monitoring text messages with personalized feedback , biweekly counseling calls from a health coach , and access to a Facebook support group , or 2 ) usual-care control . RESULTS After 14 weeks of treatment , the technology-based intervention participants had significantly greater weight loss ( -2.9 ± 3.6 kg ) than usual care ( 0.5 ± 2.3 kg ; adjusted mean difference : -3.2 kg , 95 % confidence interval -6.2 to -0.1 kg , P = .04 ) . One-third of intervention participants ( 3 of 9 ) and no control participants lost > 5 % of their initial body weight at follow up . CONCLUSIONS AND IMPLICATION S Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities Background Pregnancy and childbirth are associated with weight gain in women , and retention of weight gained during pregnancy can lead to obesity in later life . Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth . Exercise guidelines exist for pregnancy , but recommendations for exercise after childbirth are virtually nonexistent . The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth . Methods We conducted a r and omized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were r and omly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer ( intervention group , n = 32 ) or routine postpartum care ( control group , n = 34 ) . During the 12-week study period , each woman in the intervention group wore a  pedometer and recorded her daily step count .  The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week . Assessed outcomes included anthropometric measures , physical activity level , and energy expenditure per week . Data were analyzed using the paired t-test , independent t-test , Mann-Whitney , chi-square , Wilcoxon , covariance analysis , and the general linear model repeated measures procedure as appropriate . Results After 12 weeks , women in the intervention group had significantly increased their physical activity and energy expenditure per week ( 4394 vs. 1651 calorie , p < 0.001 ) . Significant differences between-group in weight ( P = 0.001 ) , Body Mass Index ( P = 0.001 ) , waist circumference ( P = 0.001 ) , hip circumference ( P = 0.032 ) and waist-hip ratio ( P = 0.02 ) were presented after the intervention . The intervention group significantly increased their mean daily step count over the study period ( from 3249 before , to 9960 after the intervention , p < 0.001 ) . Conclusion A physical activity intervention based on pedometer is an effective means to increase physical activity ; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women . Trial registration IS RCT N : I RCT 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 OBJECTIVE Few postpartum ethnic minority women perform leisure-time moderate-to-vigorous physical activity ( MVPA ) . The study tested the effectiveness of a 12-month tailored intervention to increase MVPA in women with infants 2 - 12months old . METHODS From 2008 to 2011 , women ( n=311 ) with infants ( average age=5.7months ) from Honolulu , Hawaii were r and omly assigned to receive tailored telephone calls and access to a mom-centric website ( n=154 ) or access to a st and ard PA website ( n=157 ) . MVPA was measured at baseline , 6 , and 12months using self-report and acclerometers . RESULTS Controlling for covariates , the tailored condition significantly increased self-reported MVPA from an average of 44 to 246min/week compared with 46 to 156min/week for the st and ard condition ( p=0.027 ) . Mothers with≥2 children had significantly greater increases in MVPA in response to the tailored intervention than those with one child  ( p=0.016 ) . Accelerometer-measured MVPA significantly increased over time ( p=0.0001 ) , with no condition differences . There was evidence of reactivity to initially wearing accelerometers ; the tailored intervention significantly increased MVPA among women with low baseline accelerometer MVPA minutes , but not among those with high minutes ( pinteraction=0.053 ) . CONCLUSION A tailored intervention effectively increased MVPA over 12months in multiethnic women with infants , particularly those with more than one child Excessive gestational weight gain has been shown to relate to high-postpartum weight retention and the development of overweight and obesity later in life . Because many women are concerned about the health of their babies during pregnancy and are in frequent contact with their healthcare providers , pregnancy may be an especially powerful " teachable moment " for the promotion of healthy eating and physical activity behaviors among women . Initial research suggests that helping women gain the recommended amount during pregnancy through healthy eating and physical activity could make a major contribution to the prevention of postpartum weight retention . However , more r and omized controlled trials with larger sample sizes are needed to identify the most effective and disseminable intervention . Providers have the potential to prevent high postpartum weight retention and future obesity by monitoring weight gain during pregnancy and giving appropriate advice about recommended amounts of gestational weight gain Importance Effective long-term treatments are needed to address the obesity epidemic . Numerous wearable technologies specific to physical activity and diet are available , but it is unclear if these are effective at improving weight loss . Objective To test the hypothesis that , compared with a st and ard behavioral weight loss intervention ( st and ard intervention ) , a technology-enhanced weight loss intervention ( enhanced intervention ) would result in greater weight loss . Design , Setting , Participants R and omized clinical trial conducted at the University of Pittsburgh and enrolling 471 adult participants between October 2010 and October 2012 , with data collection completed by December 2014 . Interventions Participants were placed on a low-calorie diet , prescribed increases in physical activity , and had group counseling sessions . At 6 months , the interventions added telephone counseling sessions , text message prompts , and access to study material s on a website . At 6 months , participants r and omized to the st and ard intervention group initiated self-monitoring of diet and physical activity using a website , and those r and omized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity . Main Outcomes and Measures The primary outcome of weight was measured over 24 months at 6-month intervals , and the primary hypothesis tested the change in weight between 2 groups at 24 months . Secondary outcomes included body composition , fitness , physical activity , and dietary intake . Results Among the 471 participants r and omized ( body mass index [ BMI ] , 25 to < 40 ; age range , 18 - 35 years ; 28.9 % nonwhite , 77.2 % women ) , 470 ( 233 in the st and ard intervention group , 237 in the enhanced intervention group ) initiated the interventions as r and omized , and 74.5 % completed the study . For the enhanced intervention group , mean base line weight was 96.3 kg ( 95 % CI , 94.2 - 98.5 ) and 24-month weight 92.8 kg ( 95 % CI , 90.6- 95.0 ) [ corrected ] . For the st and ard intervention group , mean baseline weight was 95.2 kg ( 95%CI,93.0 - 97.3 ) and 24-month weight was 89.3 kg ( 95%CI , 87.1 - 91.5 ) [ corrected ] . Weight change at 24 months differed significantly by intervention group ( estimated mean weight loss , 3.5 kg [ 95 % CI , 2.6 - 4.5 } in the enhanced intervention group and 5.9 kg [ 95 % CI , 5.0 - 6.8 ] in the st and ard intervention group ; difference , 2.4 kg [ 95 % CI , 1.0 - 3.7 ] ; P = .002 ) . Both groups had significant improvements in body composition , fitness , physical activity , and diet , with no significant difference between groups . Conclusions and Relevance Among young adults with a BMI between 25 and less than 40 , the addition of a wearable technology device to a st and ard behavioral intervention result ed in less weight loss over 24 months . Devices that monitor and provide feedback on physical activity may not offer an advantage over st and ard behavioral weight loss approaches . Trial Registration clinical trials.gov Identifier : NCT01131871 The Internet 
    Output:
    