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: UNLABELLED This study evaluated a 90-min single session school-based body image intervention ( Dove Confident Me : Single Session ) , and investigated if delivery could be task-shifted to teachers . British adolescents ( N = 1707 ; 11 - 13 years ; 50.83 % girls ) participated in a cluster r and omised controlled trial [ lessons as usual control ; intervention teacher-led ( TL ) ; intervention research er-led ( RL ) ] . Body image , risk factors , and psychosocial and disordered eating outcomes were assessed 1-week pre-intervention , immediate post-intervention , and 4 - 9.5 weeks follow-up . Multilevel mixed-models showed post-intervention improvements for intervention students relative to control in body esteem ( TL ; girls only ) , negative affect ( TL ) , dietary restraint ( TL ; girls only ) , eating disorder symptoms ( TL ) , and life engagement ( TL ; RL ) . Awareness of sociocultural pressures increased at post-intervention ( TL ) . Effects were small-medium in size ( ds 0.19 - 0.76 ) and were not maintained at follow-up . There were no significant differences between conditions at post or follow-up on body satisfaction , appearance comparisons , teasing , appearance conversations and self-esteem . The intervention had short-term benefits for girls ' body image and dietary restraint , and for eating disorder symptoms and some psychosocial outcomes among girls and boys . A multi-session version of the intervention is likely to be necessary for sustained improvements . Teachers can deliver this intervention effectively with minimal training , indicating broader scale dissemination is feasible . TRIAL REGISTRATION IS RCT N16782819 Body Image in the Primary School ( Hutchinson & Call and , 2011 ) is a body image curriculum that is widely available but has not yet been evaluated . This study evaluates a set of 6 of the 49 available lessons from this curriculum . Seventy-four girls and 70 boys aged 9 - 10 were recruited from four primary schools in the UK . Schools were r and omly allocated into the intervention condition , where students received 6hours of body image lessons , or to lessons as normal .  Body esteem was significantly higher among girls in the intervention group , compared to the control group , immediately post intervention , and at 3-month follow-up . Moreover , girls with lowest levels of body esteem at baseline reported the largest gains . Internalization was significantly lower among boys in the control group compared to the intervention group at 3-month follow-up . The pattern of results among the control group raises interesting issues for intervention evaluation Body dissatisfaction is now recognized as having considerable negative impact on social , psychological , and physical health , particularly in adolescent girls . Consequently , we have developed a six-session co-educational body image intervention ( Happy Being Me Co-educational ) design ed to reduce body dissatisfaction and its risk factors in Grade 7 girls . In addition to evaluating the program 's efficacy , we aim ed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls ( co-educational delivery ) , or delivered as a selective intervention to girls only ( single-sex delivery ) . Participants were 200 Grade 7 girls from five schools in Melbourne , Australia . Schools were r and omly allocated to receive the intervention in single-sex classes ( n=74 ) , co-educational classes ( n=73 ) , or participate as a no-intervention control ( n=53 ) . Girls completed self-report assessment s of body dissatisfaction , psychological ( internalization of the thin ideal , appearance comparison , and self-esteem ) and peer environment ( weight-related teasing and appearance conversations ) risk factors for body dissatisfaction , and dietary restraint , at baseline , post-intervention , and at 6-month follow-up . Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors . Importantly , no significant differences between universal and selective delivery were observed , suggesting that the intervention is appropriate for dissemination in both modes Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development . Effective prevention programs are needed to prevent unhealthy developmental trajectories . This study evaluated the efficacy of the POPS-program ( POtsdam Prevention at Schools ) , a universal school-based eating disorder prevention program for adolescents . In a cluster-r and omized design , we compared the intervention group receiving the prevention program to a waiting control group . Outcomes included indicators of disordered eating and relevant risk factors for eating disorders ( body dissatisfaction , internalization of the thin ideal , perceived media pressure , perfectionism , emotional element of exercise , social comparison , and perceived teasing ) . Question naires were administered at the start of the intervention , 3 and 12 months post intervention . At baseline , 1112 adolescents aged 10 to 16 years participated ( 49 % girls ; 51 % intervention group ) . Intention-to-treat analyses with the complete data set and per- protocol analyses as a completer analysis were performed . The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing . Effect sizes were small but comparable to other primary prevention programs . At 1-year follow-up , a small but significant effect on disordered eating was observed . Results of the per- protocol analyses were mostly confirmed by the intention-to-treat analyses . Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal . Further studies are warranted examining successful program elements and whether gender-specific programs are needed BACKGROUND Body image dissatisfaction during adolescence is common but not benign . School-based interventions have the potential for wide reach , but scalability of previous programmes is limited by a reliance on external facilitators . AIMS To assess the acceptability , feasibility and efficacy of a teacher-delivered body image intervention . METHOD A pilot clustered r and omised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme ( n = 261 ) ,  or usual curriculum control ( n = 187 ) ( registration : IS RCT N42594993 ) . RESULTS Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation . Effects for body esteem and thin-ideal internalisation were maintained for 3 months . There were no group differences for eating pathology , peer factors or depression . Acceptability , feasibility and efficacy varied between schools . CONCLUSIONS Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools Objective : The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample . Method : We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospect i ve consumers of eating disorder treatment ( n = 32 ) . Transcripts were inputted into NVivo 8 for coding , sorting , and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants . We then examined the influence of key social barriers — including stigma and social stereotypes — on perceived impact on care . Results : The majority of respondents ( 78 % ) endorsed at least one social barrier to care for an eating or weight concern . Perceived stigma ( or shame ) and social stereotyping — identified both within social networks and among clinicians — had adversely impacted care for 59 % and 19 % of respondents , respectively . Discussion : Social barriers to care for eating and weight related concerns may be prevalent in the U.S. and impact both ethnic minority and non-minority health care consumers . © 2009 by Wiley Periodicals , Inc. ( Int J Eat Disord 2010 ; The aim of the current research was to evaluate Shapesville , a children 's picture book design ed to promote positive body image in young children . Participants were a convenience sample comprising 84 girls ( aged 5 - 9 years ) recruited from four private girls ' schools . Girls were r and omly allocated to be read either Shapesville or a control book . Individual measures of body image , stereotyping on the basis of weight and media internalisation , as well as knowledge of non-appearance topics , were obtained at pre- and post-intervention , as well as at 6-week follow-up . Relative to the control book , girls ' appearance satisfaction increased after reading Shapesville . In addition , stereotyping on the basis of weight and internalisation of media ideals was reduced . Finally , reading Shapesville also increased girls ' knowledge base of non-appearance topics , such as recognising their special talents and awareness of healthy eating , at post-intervention . These gains were somewhat reduced at follow-up , yet were largely still significantly greater than at pre-intervention . The present study demonstrates that Shapesville has the potential to be a successful prevention tool for use with young girls . Schools can incorporate Shapesville into their curriculum as early as school entry , in order to help prevent the early development of body dissatisfaction and disordered eating BACKGROUND A r and omized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing  eating disorder and obesity risk factors .  METHOD A total of 1316 grade 7 and 8 girls and boys ( mean age = 13.21 years ) across three Australian states were r and omly allocated to : Media Smart ; Life Smart ; the Helping , Encouraging , Listening and Protecting Peers ( HELPP ) initiative ; or control ( usual school class ) . Risk factors were measured at baseline , post-program ( 5 weeks later ) , and at the 6- and 12-month follow-ups . RESULTS Media Smart girls had half the rate of onset of clinical ly significant concerns about shape and weight than control girls at the 12-month follow-up . Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up . Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up . Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys . A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up , while a main effect for group found Media Smart participants reported less screen time than controls . CONCLUSIONS Media Smart was the only program to show benefit on both disordered eating and obesity risk factors . Whilst further investigations are indicated , this study suggests that this program is a promising approach to reducing risk factors for both problems OBJECTIVE The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media internalization in young adolescents . METHOD Eleven classes of 237 students ( 100 girls and 137 boys ; mean age = 13.79 years , SD = .42 ) r and omly received 1 of 6 lessons . Eating disorder risk factors were assessed at baseline , and the Sociocultural Attitudes Towards Appearance Question naire-3 ( SATAQ-3 ) was used to assess media internalization postintervention . RESULTS At postintervention , boys had significantly lower SATAQ-3 scores on 4 of the 5 subscales ( effect sizes = .42-.71 ) , whereas girls had significantly lower scores on 1 subscale ( effect size = .54 ) . Higher baseline levels of dietary restraint , magazines bought/read , and perceived sociocultural pressure predicted smaller reductions in boys ' scores , whereas depression predicted smaller reductions in girls ' scores . CONCLUSION The current study provides support that boys be included in eating disorder prevention programs and that media literacy may represent a promising prevention approach OBJECTIVE To evaluate a community-based intervention aim ed at the primary prevention of disordered eating among preadolescent girls . DESIGN Girl Scout troop members were r and omized into control and intervention groups . Program feasibility and effect at postintervention and 3-month follow-up were evaluated . SUBJECTS/ SETTING 226 girls ( mean age = 10.6 years , st and ard deviation = 0.7 ) from 24 Girl Scout troops . INTERVENTION Six 90-minute sessions focusing on media literacy and advocacy skills . MAIN OUTCOME MEASURES Evaluation focused on program satisfaction and short-term effect on dieting behaviors , body image attitudes , and media knowledge , attitudes , and habits . STATISTICAL ANALYSES Performed t tests , chi 2 tests , and analyses of covariance including troop as a r and om source of variation . RESULTS At baseline , 29 % of the girls were trying to lose weight . The program had a notable positive influence on media-related attitudes and behaviors including internalization of sociocultural ideals , self-efficacy to impact weight-related social norms , and print media habits . A modest program effect on body-related knowledge and attitudes was apparent at post-intervention ( i.e. , on body size acceptance , puberty knowledge , and perceived weight status ) but not at follow-up . Significant changes were not noted for dieting behaviors , but they were in the hypothesized direction . Satisfaction with the program was high among girls , parents , and leaders . APPLICATIONS/ CONCLUSIONS It is feasible to use community youth setting s , such as the Girl Scouts , to implement interventions to prevent disordered eating behaviors . The program led to positive trends in outcome variables ; however , longer and more intensive interventions are needed for lasting changes in body image and dieting behaviors Objective To identify disordered eating behaviour and attitudes in a large representative population in order to determine the relationship with body weight status , and to assess associated psychopathology 
    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: UNLABELLED This study evaluated a 90-min single session school-based body image intervention ( Dove Confident Me : Single Session ) , and investigated if delivery could be task-shifted to teachers . British adolescents ( N = 1707 ; 11 - 13 years ; 50.83 % girls ) participated in a cluster r and omised controlled trial [ lessons as usual control ; intervention teacher-led ( TL ) ; intervention research er-led ( RL ) ] . Body image , risk factors , and psychosocial and disordered eating outcomes were assessed 1-week pre-intervention , immediate post-intervention , and 4 - 9.5 weeks follow-up . Multilevel mixed-models showed post-intervention improvements for intervention students relative to control in body esteem ( TL ; girls only ) , negative affect ( TL ) , dietary restraint ( TL ; girls only ) , eating disorder symptoms ( TL ) , and life engagement ( TL ; RL ) . Awareness of sociocultural pressures increased at post-intervention ( TL ) . Effects were small-medium in size ( ds 0.19 - 0.76 ) and were not maintained at follow-up . There were no significant differences between conditions at post or follow-up on body satisfaction , appearance comparisons , teasing , appearance conversations and self-esteem . The intervention had short-term benefits for girls ' body image and dietary restraint , and for eating disorder symptoms and some psychosocial outcomes among girls and boys . A multi-session version of the intervention is likely to be necessary for sustained improvements . Teachers can deliver this intervention effectively with minimal training , indicating broader scale dissemination is feasible . TRIAL REGISTRATION IS RCT N16782819 Body Image in the Primary School ( Hutchinson & Call and , 2011 ) is a body image curriculum that is widely available but has not yet been evaluated . This study evaluates a set of 6 of the 49 available lessons from this curriculum . Seventy-four girls and 70 boys aged 9 - 10 were recruited from four primary schools in the UK . Schools were r and omly allocated into the intervention condition , where students received 6hours of body image lessons , or to lessons as normal .  Body esteem was significantly higher among girls in the intervention group , compared to the control group , immediately post intervention , and at 3-month follow-up . Moreover , girls with lowest levels of body esteem at baseline reported the largest gains . Internalization was significantly lower among boys in the control group compared to the intervention group at 3-month follow-up . The pattern of results among the control group raises interesting issues for intervention evaluation Body dissatisfaction is now recognized as having considerable negative impact on social , psychological , and physical health , particularly in adolescent girls . Consequently , we have developed a six-session co-educational body image intervention ( Happy Being Me Co-educational ) design ed to reduce body dissatisfaction and its risk factors in Grade 7 girls . In addition to evaluating the program 's efficacy , we aim ed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls ( co-educational delivery ) , or delivered as a selective intervention to girls only ( single-sex delivery ) . Participants were 200 Grade 7 girls from five schools in Melbourne , Australia . Schools were r and omly allocated to receive the intervention in single-sex classes ( n=74 ) , co-educational classes ( n=73 ) , or participate as a no-intervention control ( n=53 ) . Girls completed self-report assessment s of body dissatisfaction , psychological ( internalization of the thin ideal , appearance comparison , and self-esteem ) and peer environment ( weight-related teasing and appearance conversations ) risk factors for body dissatisfaction , and dietary restraint , at baseline , post-intervention , and at 6-month follow-up . Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors . Importantly , no significant differences between universal and selective delivery were observed , suggesting that the intervention is appropriate for dissemination in both modes Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development . Effective prevention programs are needed to prevent unhealthy developmental trajectories . This study evaluated the efficacy of the POPS-program ( POtsdam Prevention at Schools ) , a universal school-based eating disorder prevention program for adolescents . In a cluster-r and omized design , we compared the intervention group receiving the prevention program to a waiting control group . Outcomes included indicators of disordered eating and relevant risk factors for eating disorders ( body dissatisfaction , internalization of the thin ideal , perceived media pressure , perfectionism , emotional element of exercise , social comparison , and perceived teasing ) . Question naires were administered at the start of the intervention , 3 and 12 months post intervention . At baseline , 1112 adolescents aged 10 to 16 years participated ( 49 % girls ; 51 % intervention group ) . Intention-to-treat analyses with the complete data set and per- protocol analyses as a completer analysis were performed . The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing . Effect sizes were small but comparable to other primary prevention programs . At 1-year follow-up , a small but significant effect on disordered eating was observed . Results of the per- protocol analyses were mostly confirmed by the intention-to-treat analyses . Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal . Further studies are warranted examining successful program elements and whether gender-specific programs are needed BACKGROUND Body image dissatisfaction during adolescence is common but not benign . School-based interventions have the potential for wide reach , but scalability of previous programmes is limited by a reliance on external facilitators . AIMS To assess the acceptability , feasibility and efficacy of a teacher-delivered body image intervention . METHOD A pilot clustered r and omised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme ( n = 261 ) ,  or usual curriculum control ( n = 187 ) ( registration : IS RCT N42594993 ) . RESULTS Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation . Effects for body esteem and thin-ideal internalisation were maintained for 3 months . There were no group differences for eating pathology , peer factors or depression . Acceptability , feasibility and efficacy varied between schools . CONCLUSIONS Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools Objective : The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample . Method : We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospect i ve consumers of eating disorder treatment ( n = 32 ) . Transcripts were inputted into NVivo 8 for coding , sorting , and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants . We then examined the influence of key social barriers — including stigma and social stereotypes — on perceived impact on care . Results : The majority of respondents ( 78 % ) endorsed at least one social barrier to care for an eating or weight concern . Perceived stigma ( or shame ) and social stereotyping — identified both within social networks and among clinicians — had adversely impacted care for 59 % and 19 % of respondents , respectively . Discussion : Social barriers to care for eating and weight related concerns may be prevalent in the U.S. and impact both ethnic minority and non-minority health care consumers . © 2009 by Wiley Periodicals , Inc. ( Int J Eat Disord 2010 ; The aim of the current research was to evaluate Shapesville , a children 's picture book design ed to promote positive body image in young children . Participants were a convenience sample comprising 84 girls ( aged 5 - 9 years ) recruited from four private girls ' schools . Girls were r and omly allocated to be read either Shapesville or a control book . Individual measures of body image , stereotyping on the basis of weight and media internalisation , as well as knowledge of non-appearance topics , were obtained at pre- and post-intervention , as well as at 6-week follow-up . Relative to the control book , girls ' appearance satisfaction increased after reading Shapesville . In addition , stereotyping on the basis of weight and internalisation of media ideals was reduced . Finally , reading Shapesville also increased girls ' knowledge base of non-appearance topics , such as recognising their special talents and awareness of healthy eating , at post-intervention . These gains were somewhat reduced at follow-up , yet were largely still significantly greater than at pre-intervention . The present study demonstrates that Shapesville has the potential to be a successful prevention tool for use with young girls . Schools can incorporate Shapesville into their curriculum as early as school entry , in order to help prevent the early development of body dissatisfaction and disordered eating BACKGROUND A r and omized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing  eating disorder and obesity risk factors .  METHOD A total of 1316 grade 7 and 8 girls and boys ( mean age = 13.21 years ) across three Australian states were r and omly allocated to : Media Smart ; Life Smart ; the Helping , Encouraging , Listening and Protecting Peers ( HELPP ) initiative ; or control ( usual school class ) . Risk factors were measured at baseline , post-program ( 5 weeks later ) , and at the 6- and 12-month follow-ups . RESULTS Media Smart girls had half the rate of onset of clinical ly significant concerns about shape and weight than control girls at the 12-month follow-up . Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up . Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up . Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys . A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up , while a main effect for group found Media Smart participants reported less screen time than controls . CONCLUSIONS Media Smart was the only program to show benefit on both disordered eating and obesity risk factors . Whilst further investigations are indicated , this study suggests that this program is a promising approach to reducing risk factors for both problems OBJECTIVE The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media internalization in young adolescents . METHOD Eleven classes of 237 students ( 100 girls and 137 boys ; mean age = 13.79 years , SD = .42 ) r and omly received 1 of 6 lessons . Eating disorder risk factors were assessed at baseline , and the Sociocultural Attitudes Towards Appearance Question naire-3 ( SATAQ-3 ) was used to assess media internalization postintervention . RESULTS At postintervention , boys had significantly lower SATAQ-3 scores on 4 of the 5 subscales ( effect sizes = .42-.71 ) , whereas girls had significantly lower scores on 1 subscale ( effect size = .54 ) . Higher baseline levels of dietary restraint , magazines bought/read , and perceived sociocultural pressure predicted smaller reductions in boys ' scores , whereas depression predicted smaller reductions in girls ' scores . CONCLUSION The current study provides support that boys be included in eating disorder prevention programs and that media literacy may represent a promising prevention approach OBJECTIVE To evaluate a community-based intervention aim ed at the primary prevention of disordered eating among preadolescent girls . DESIGN Girl Scout troop members were r and omized into control and intervention groups . Program feasibility and effect at postintervention and 3-month follow-up were evaluated . SUBJECTS/ SETTING 226 girls ( mean age = 10.6 years , st and ard deviation = 0.7 ) from 24 Girl Scout troops . INTERVENTION Six 90-minute sessions focusing on media literacy and advocacy skills . MAIN OUTCOME MEASURES Evaluation focused on program satisfaction and short-term effect on dieting behaviors , body image attitudes , and media knowledge , attitudes , and habits . STATISTICAL ANALYSES Performed t tests , chi 2 tests , and analyses of covariance including troop as a r and om source of variation . RESULTS At baseline , 29 % of the girls were trying to lose weight . The program had a notable positive influence on media-related attitudes and behaviors including internalization of sociocultural ideals , self-efficacy to impact weight-related social norms , and print media habits . A modest program effect on body-related knowledge and attitudes was apparent at post-intervention ( i.e. , on body size acceptance , puberty knowledge , and perceived weight status ) but not at follow-up . Significant changes were not noted for dieting behaviors , but they were in the hypothesized direction . Satisfaction with the program was high among girls , parents , and leaders . APPLICATIONS/ CONCLUSIONS It is feasible to use community youth setting s , such as the Girl Scouts , to implement interventions to prevent disordered eating behaviors . The program led to positive trends in outcome variables ; however , longer and more intensive interventions are needed for lasting changes in body image and dieting behaviors Objective To identify disordered eating behaviour and attitudes in a large representative population in order to determine the relationship with body weight status , and to assess associated psychopathology 
    Output:
    