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: OBJECTIVE To test the feasibility , acceptability , and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , among African-American girls . DESIGN Twelve-week , 2-arm parallel group , r and omized controlled trial . SETTING Low-income neighborhoods . PARTICIPANTS Sixty-one 8 - 10-year-old African-American girls and their parents/guardians . INTERVENTIONS The treatment intervention consisted of after-school dance classes at 3 community centers , and a 5-lesson intervention , delivered in participants ' homes , and design ed to reduce television , videotape , and video game use . The active control intervention consisted of disseminating newsletters and delivering health education lectures . MAIN OUTCOME MEASURES Implementation and process measures , body mass index , waist circumference , physical activity measured by accelerometry , self-reported media use , and meals eaten with TV . RESULTS Recruitment and retention goals were exceeded . High rates of participation were achieved for assessment s and intervention activities , except where transportation was lacking . All interventions received high satisfaction ratings . At follow up , girls in the treatment group , as compared to the control group , exhibited trends toward lower body mass index ( adjusted difference = -.32 kg/m2 , 95 % confidence interval [ CI ] -.77 , .12 ; Cohen 's d = .38 st and ard deviation units ) and waist circumference ( adjusted difference = -.63 cm , 95 % CI -1.92 , .67 ; d = .25 ) ; increased after-school physical activity ( adjusted difference = 55.1 counts/minute , 95 % CI -115.6 , 225.8 ; d = .21 ) ; and reduced television , videotape , and video game use ( adjusted difference = -4.96 hours/week , 95 % CI -11.41 , 1.49 ; d = .40 ) . The treatment group reported significantly reduced household television viewing ( d = .73 , P = .007 ) and fewer dinners eaten while watching TV ( adjusted difference = -1.60 meals/week , 95 % CI -2.99 , -.21 ; d = .59 ; P = .03 ) . Treatment group girls also reported less concern about weight ( d = .60 ; P = .03 ) , and a trend toward improved school grade s ( d = .51 ; P = .07 ) . CONCLUSIONS This study confirmed the feasibility , acceptability , and potential efficacy of using dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , in African-American girls To assess the feasibility of conducting empirically supported family-based paediatric obesity group treatment via TeleMedicine .  Seventeen families were r and omly assigned to one of two conditions ( physician visit , TeleMedicine ) . Measures included feasibility , satisfaction and intervention outcome measures such as BMI percentile , and nutrition and activity behaviours . Measures were completed at baseline , post-treatment and at 1-year follow-up . Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive . Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviours for either treatment group . A behavioural family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers . Due to the small sample size , null findings regarding intervention outcome should be interpreted with caution . Future research should focus on methods to increase the impact of this intervention on key outcome variables OBJECTIVE This study evaluated the suitability of a patient satisfaction question naire to survey health care consumers of traditional Arabic background . DESIGN A cross-sectional survey using an Arabic language question naire that drew upon concepts of patient satisfaction measurement in Western research literature . All participants were interviewed once by experienced interviewers to ascertain their levels of satisfaction with their health care service . SETTING Patient satisfaction was compared between the only re source -intensive clinic ( RIC ) in the United Arab Emirates and one re source -thrifty clinic ( RTC ) located in an adjacent suburb and serving essentially the same population . STUDY PARTICIPANTS A r and om sample of patients attending the RIC and RTC over a 5-day period . MAIN OUTCOME MEASURES Six domains of patient satisfaction were measured . RESULTS Compared with the RTC ( n = 125 ) , the RIC ( n = 156 ) scored significantly higher in continuity ( P = 0.001 ) , comprehensiveness ( P < 0.001 ) , health education ( P = 0.05 ) , effectiveness ( P = 0.001 ) , and overall satisfaction ( P < 0.001 ) , while accessibility ( P = 0.130 ) and humaneness ( P = 0.102 ) were not significantly different . Humaneness scored the highest and continuity the lowest at both clinics . Older people 's satisfaction was higher for comprehensiveness but otherwise the same as those who were younger . More highly educated people 's satisfaction was lower for effectiveness , but otherwise the same as those who were less educated . Men and women had equal levels of satisfaction . CONCLUSIONS The significantly higher patient satisfaction in the RIC compared with the RTC was a strong a priori expectation , suggesting that this satisfaction question naire is a useful quality assurance tool in this setting Most patient satisfaction scales produce high , undifferentiated levels of reported satisfaction that fail to detect program areas that consumers do not like . Method ological problems apparently contribute to these results . An alternative procedure , the  Evaluation Ranking Scale  ( ERS ) , was formulated and tested . A 2 X 3 design was employed with 246 public health center patients r and omly assigned to one of two measurement techniques ( ERS vs. a global measure ) and one of three informational sets . A secondary group of subjects was a convenience sample of 26 staff members , which allowed comparisons of staff evaluations of the health center to patients ' evaluations of the health center . Compared to the global measure , the ERS provided more specific information about particular program components , was more discriminating , and result ed in mean satisfaction scores that were significantly lower . This new approach may be a more effective technique for assessing the psychosocial effectiveness of human service programs This study examined the feasibility of implementing an innovative theater-based after-school program , ' Ready . Set . ACTION ! ' , to reach ethnically diverse and low-income children and their parents with obesity prevention messages . The study population included 96 children and 61 parents . Children were in fourth to sixth grade and 41 % were overweight at baseline .  Program impact was evaluated with a pre/post-r and omized controlled study design , but a major focus was placed on the process evaluation conducted in the intervention schools . Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation . However , few meaningful differences between the intervention and control conditions were found at follow-up . Thus , the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change , but was not powerful enough on its own to lead to behavioral change . From this feasibility study , we concluded that Ready . Set . ACTION ! offers promise as a creative intervention strategy . The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions , with both educational and environmental components , and evaluate program impact OBJECTIVE This study evaluates the post-treatment and short-term follow-up efficacy of , as well as participant satisfaction for , a 4-month behavioral weight control program for overweight adolescents initiated in a primary care setting and extended through telephone and mail contact . RESEARCH METHODS AND PROCEDURES 44 overweight adolescents were r and omly assigned to either a multiple component behavioral weight control intervention ( Healthy Habits [ HH ] ; n = 23 ) or a single session of physician weight counseling ( typical care [ TC ] ; n = 21 ) . Weight , height , dietary intake , physical activity , sedentary behavior , and problematic weight-related and eating behaviors and beliefs were assessed before treatment , after the 4-month treatment , and at 3-month follow-up . Participant satisfaction and behavioral skills use were measured . RESULTS HH adolescents evidence d better change in body mass index z scores to post-treatment than TC adolescents . Body mass index z scores changed similarly in the conditions from post-treatment through follow-up . Behavioral skills use was higher among HH than TC adolescents , and higher behavioral skills use was related to better weight outcome . Energy intake , percentage of calories from fat , physical activity , sedentary behavior , and problematic weight-related or eating behaviors/beliefs did not differ by condition or significantly change over time independent of condition . The behavioral intervention evidence d good feasibility and participant satisfaction . DISCUSSION A telephone- and mail-based behavioral intervention initiated in primary care result ed in better weight control efficacy relative to care typically provided to overweight adolescents . Innovative and efficacious weight control intervention delivery approaches could decrease provider and participant burden and improve dissemination to the increasing population of overweight youth BACKGROUND : Pediatric weight management clinics experience significant dropout , and few studies have investigated this problem . The objective of this study was to identify family and clinic characteristics associated with attrition from a tertiary care pediatric weight management clinic . METHODS : This was a prospect i ve and retrospective clinical data base study of a multidisciplinary clinic for obese children 2 - 18 years with a weight-related co-morbidity . All patients seen between November , 2007 , and July , 2009 , were included . Characteristics of Active and Inactive families were compared using chi-squared and t-tests , and logistic regression was used to identify independent correlates of program status . A one-page survey was mailed to all Inactive families . RESULTS : A total of 133 patients were seen during the study period . Their mean age was 12 years old , mean BMI was 38 kg/m(2 ) , 53 % were female , 52 % represented racial/ethnic minorities , and 50 % were Medicaid recipients . In all , 32 % dropped out of treatment . Inactive children had significantly lower BMI z-scores , were older , and were more likely to have poor school performance than active children . Similar results were found on regression analysis : Children with higher BMI z-scores , commercial insurance , average school performance , and a major weight-related co-morbidity were less likely to be inactive . The most common parent-reported reasons for dropping out were : Child not wanting to make changes , weight not improving , child desired to leave program , and program not meeting parent or child 's expectations . CONCLUSIONS : Attrition from pediatric weight management treatment is high , with age , weight , school performance , and health associated with dropout . Parents mostly reported child-related issues , including lack of weight loss , as reasons for dropout Objective . The objective was to evaluate the feasibility of delivering a pediatric weight management intervention adapted for low-income families . Academic research ers , a Medicaid health plan , a State Medicaid agency , and community pediatric providers partnered in the project . Methods . Participants were 48 families with 52 overweight/obese children aged 4 to 12 recruited from Medicaid health plan and providers ’ offices . Elements of efficacious pediatric obesity interventions were modified for low literacy and implemented in person and telephonically with parents . Results . Families report ents in food shopping and preparation , and child eating and activity habits . The retention rate was 88 % . Children grew significantly taller ( F = 7.1 ; P = .012 ) but did not gain significant weight ( F = 0.91 ; P = .35 ) , with a trend toward decreased BMI ( F = 3.2 ; P = .08 ) . Conclusions . The authors demonstrate the feasibility of delivering an adapted pediatric obesity intervention with low-income families . They also discuss implication s for public — private partnerships among key stakeholders to address pediatric obesity in this high-risk population BACKGROUND This study tests the feasibility of an innovative school-based program for  obesity prevention  among adolescent girls . New Moves was implemented as a multicomponent , girls-only , high-school physical education class . METHODS Six schools were equally r and omized into intervention and control conditions . Data were collected at baseline , postintervention , and 8-month follow-up to assess program impact on physical activity , eating patterns , self-perceptions , and body mass index ( BMI ) among 89 girls in the intervention and 112 girls in the control conditions . Program evaluation also included interviews with school staff , parent surveys , and participant interviews and process evaluation surveys . RESULTS The feasibility of implementing New Moves was high , as indicated by strong satisfaction among participants , parents , and school staff , and by program sustainability . Participants perceived a positive program impact on their physical activity , eating patterns , and self-image . Girls in the intervention significantly progressed in their stage of behavioral change for physical activity from baseline to follow-up . However , for the majority of outcome variables , differences between intervention and control schools at postintervention and follow-up were not statistically significant . CONCLUSIONS New Moves was well received and fills a needed niche within school physical education programs . An exp and ed intervention and evaluation is needed to enhance and assess long-term program effectiveness OBJECTIVE A school-based nutrition education minimal intervention ( MI ) was evaluated . DESIGN The design was experimental , with r and om assignment at the school level . SETTING Seven schools were r and omly assigned as experimental , and 7 as delayed-treatment . PARTICIPANTS The experimental group included 551 teens , and the delayed treatment group included 329 teens . INTERVENTION The minimal intervention was Present and Prevent , a commercially available PowerPoint program presented in two 30-minute time slots over 1 week . MAIN OUTCOME MEASURES The dependent variables were nutrition knowledge , attitudes , peer and family influences , behavioral intentions , and program satisfaction . The independent variable was group assignment . ANALYSES A matched-pairs and 2- 
    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: OBJECTIVE To test the feasibility , acceptability , and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , among African-American girls . DESIGN Twelve-week , 2-arm parallel group , r and omized controlled trial . SETTING Low-income neighborhoods . PARTICIPANTS Sixty-one 8 - 10-year-old African-American girls and their parents/guardians . INTERVENTIONS The treatment intervention consisted of after-school dance classes at 3 community centers , and a 5-lesson intervention , delivered in participants ' homes , and design ed to reduce television , videotape , and video game use . The active control intervention consisted of disseminating newsletters and delivering health education lectures . MAIN OUTCOME MEASURES Implementation and process measures , body mass index , waist circumference , physical activity measured by accelerometry , self-reported media use , and meals eaten with TV . RESULTS Recruitment and retention goals were exceeded . High rates of participation were achieved for assessment s and intervention activities , except where transportation was lacking . All interventions received high satisfaction ratings . At follow up , girls in the treatment group , as compared to the control group , exhibited trends toward lower body mass index ( adjusted difference = -.32 kg/m2 , 95 % confidence interval [ CI ] -.77 , .12 ; Cohen 's d = .38 st and ard deviation units ) and waist circumference ( adjusted difference = -.63 cm , 95 % CI -1.92 , .67 ; d = .25 ) ; increased after-school physical activity ( adjusted difference = 55.1 counts/minute , 95 % CI -115.6 , 225.8 ; d = .21 ) ; and reduced television , videotape , and video game use ( adjusted difference = -4.96 hours/week , 95 % CI -11.41 , 1.49 ; d = .40 ) . The treatment group reported significantly reduced household television viewing ( d = .73 , P = .007 ) and fewer dinners eaten while watching TV ( adjusted difference = -1.60 meals/week , 95 % CI -2.99 , -.21 ; d = .59 ; P = .03 ) . Treatment group girls also reported less concern about weight ( d = .60 ; P = .03 ) , and a trend toward improved school grade s ( d = .51 ; P = .07 ) . CONCLUSIONS This study confirmed the feasibility , acceptability , and potential efficacy of using dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , in African-American girls To assess the feasibility of conducting empirically supported family-based paediatric obesity group treatment via TeleMedicine .  Seventeen families were r and omly assigned to one of two conditions ( physician visit , TeleMedicine ) . Measures included feasibility , satisfaction and intervention outcome measures such as BMI percentile , and nutrition and activity behaviours . Measures were completed at baseline , post-treatment and at 1-year follow-up . Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive . Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviours for either treatment group . A behavioural family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers . Due to the small sample size , null findings regarding intervention outcome should be interpreted with caution . Future research should focus on methods to increase the impact of this intervention on key outcome variables OBJECTIVE This study evaluated the suitability of a patient satisfaction question naire to survey health care consumers of traditional Arabic background . DESIGN A cross-sectional survey using an Arabic language question naire that drew upon concepts of patient satisfaction measurement in Western research literature . All participants were interviewed once by experienced interviewers to ascertain their levels of satisfaction with their health care service . SETTING Patient satisfaction was compared between the only re source -intensive clinic ( RIC ) in the United Arab Emirates and one re source -thrifty clinic ( RTC ) located in an adjacent suburb and serving essentially the same population . STUDY PARTICIPANTS A r and om sample of patients attending the RIC and RTC over a 5-day period . MAIN OUTCOME MEASURES Six domains of patient satisfaction were measured . RESULTS Compared with the RTC ( n = 125 ) , the RIC ( n = 156 ) scored significantly higher in continuity ( P = 0.001 ) , comprehensiveness ( P < 0.001 ) , health education ( P = 0.05 ) , effectiveness ( P = 0.001 ) , and overall satisfaction ( P < 0.001 ) , while accessibility ( P = 0.130 ) and humaneness ( P = 0.102 ) were not significantly different . Humaneness scored the highest and continuity the lowest at both clinics . Older people 's satisfaction was higher for comprehensiveness but otherwise the same as those who were younger . More highly educated people 's satisfaction was lower for effectiveness , but otherwise the same as those who were less educated . Men and women had equal levels of satisfaction . CONCLUSIONS The significantly higher patient satisfaction in the RIC compared with the RTC was a strong a priori expectation , suggesting that this satisfaction question naire is a useful quality assurance tool in this setting Most patient satisfaction scales produce high , undifferentiated levels of reported satisfaction that fail to detect program areas that consumers do not like . Method ological problems apparently contribute to these results . An alternative procedure , the  Evaluation Ranking Scale  ( ERS ) , was formulated and tested . A 2 X 3 design was employed with 246 public health center patients r and omly assigned to one of two measurement techniques ( ERS vs. a global measure ) and one of three informational sets . A secondary group of subjects was a convenience sample of 26 staff members , which allowed comparisons of staff evaluations of the health center to patients ' evaluations of the health center . Compared to the global measure , the ERS provided more specific information about particular program components , was more discriminating , and result ed in mean satisfaction scores that were significantly lower . This new approach may be a more effective technique for assessing the psychosocial effectiveness of human service programs This study examined the feasibility of implementing an innovative theater-based after-school program , ' Ready . Set . ACTION ! ' , to reach ethnically diverse and low-income children and their parents with obesity prevention messages . The study population included 96 children and 61 parents . Children were in fourth to sixth grade and 41 % were overweight at baseline .  Program impact was evaluated with a pre/post-r and omized controlled study design , but a major focus was placed on the process evaluation conducted in the intervention schools . Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation . However , few meaningful differences between the intervention and control conditions were found at follow-up . Thus , the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change , but was not powerful enough on its own to lead to behavioral change . From this feasibility study , we concluded that Ready . Set . ACTION ! offers promise as a creative intervention strategy . The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions , with both educational and environmental components , and evaluate program impact OBJECTIVE This study evaluates the post-treatment and short-term follow-up efficacy of , as well as participant satisfaction for , a 4-month behavioral weight control program for overweight adolescents initiated in a primary care setting and extended through telephone and mail contact . RESEARCH METHODS AND PROCEDURES 44 overweight adolescents were r and omly assigned to either a multiple component behavioral weight control intervention ( Healthy Habits [ HH ] ; n = 23 ) or a single session of physician weight counseling ( typical care [ TC ] ; n = 21 ) . Weight , height , dietary intake , physical activity , sedentary behavior , and problematic weight-related and eating behaviors and beliefs were assessed before treatment , after the 4-month treatment , and at 3-month follow-up . Participant satisfaction and behavioral skills use were measured . RESULTS HH adolescents evidence d better change in body mass index z scores to post-treatment than TC adolescents . Body mass index z scores changed similarly in the conditions from post-treatment through follow-up . Behavioral skills use was higher among HH than TC adolescents , and higher behavioral skills use was related to better weight outcome . Energy intake , percentage of calories from fat , physical activity , sedentary behavior , and problematic weight-related or eating behaviors/beliefs did not differ by condition or significantly change over time independent of condition . The behavioral intervention evidence d good feasibility and participant satisfaction . DISCUSSION A telephone- and mail-based behavioral intervention initiated in primary care result ed in better weight control efficacy relative to care typically provided to overweight adolescents . Innovative and efficacious weight control intervention delivery approaches could decrease provider and participant burden and improve dissemination to the increasing population of overweight youth BACKGROUND : Pediatric weight management clinics experience significant dropout , and few studies have investigated this problem . The objective of this study was to identify family and clinic characteristics associated with attrition from a tertiary care pediatric weight management clinic . METHODS : This was a prospect i ve and retrospective clinical data base study of a multidisciplinary clinic for obese children 2 - 18 years with a weight-related co-morbidity . All patients seen between November , 2007 , and July , 2009 , were included . Characteristics of Active and Inactive families were compared using chi-squared and t-tests , and logistic regression was used to identify independent correlates of program status . A one-page survey was mailed to all Inactive families . RESULTS : A total of 133 patients were seen during the study period . Their mean age was 12 years old , mean BMI was 38 kg/m(2 ) , 53 % were female , 52 % represented racial/ethnic minorities , and 50 % were Medicaid recipients . In all , 32 % dropped out of treatment . Inactive children had significantly lower BMI z-scores , were older , and were more likely to have poor school performance than active children . Similar results were found on regression analysis : Children with higher BMI z-scores , commercial insurance , average school performance , and a major weight-related co-morbidity were less likely to be inactive . The most common parent-reported reasons for dropping out were : Child not wanting to make changes , weight not improving , child desired to leave program , and program not meeting parent or child 's expectations . CONCLUSIONS : Attrition from pediatric weight management treatment is high , with age , weight , school performance , and health associated with dropout . Parents mostly reported child-related issues , including lack of weight loss , as reasons for dropout Objective . The objective was to evaluate the feasibility of delivering a pediatric weight management intervention adapted for low-income families . Academic research ers , a Medicaid health plan , a State Medicaid agency , and community pediatric providers partnered in the project . Methods . Participants were 48 families with 52 overweight/obese children aged 4 to 12 recruited from Medicaid health plan and providers ’ offices . Elements of efficacious pediatric obesity interventions were modified for low literacy and implemented in person and telephonically with parents . Results . Families report ents in food shopping and preparation , and child eating and activity habits . The retention rate was 88 % . Children grew significantly taller ( F = 7.1 ; P = .012 ) but did not gain significant weight ( F = 0.91 ; P = .35 ) , with a trend toward decreased BMI ( F = 3.2 ; P = .08 ) . Conclusions . The authors demonstrate the feasibility of delivering an adapted pediatric obesity intervention with low-income families . They also discuss implication s for public — private partnerships among key stakeholders to address pediatric obesity in this high-risk population BACKGROUND This study tests the feasibility of an innovative school-based program for  obesity prevention  among adolescent girls . New Moves was implemented as a multicomponent , girls-only , high-school physical education class . METHODS Six schools were equally r and omized into intervention and control conditions . Data were collected at baseline , postintervention , and 8-month follow-up to assess program impact on physical activity , eating patterns , self-perceptions , and body mass index ( BMI ) among 89 girls in the intervention and 112 girls in the control conditions . Program evaluation also included interviews with school staff , parent surveys , and participant interviews and process evaluation surveys . RESULTS The feasibility of implementing New Moves was high , as indicated by strong satisfaction among participants , parents , and school staff , and by program sustainability . Participants perceived a positive program impact on their physical activity , eating patterns , and self-image . Girls in the intervention significantly progressed in their stage of behavioral change for physical activity from baseline to follow-up . However , for the majority of outcome variables , differences between intervention and control schools at postintervention and follow-up were not statistically significant . CONCLUSIONS New Moves was well received and fills a needed niche within school physical education programs . An exp and ed intervention and evaluation is needed to enhance and assess long-term program effectiveness OBJECTIVE A school-based nutrition education minimal intervention ( MI ) was evaluated . DESIGN The design was experimental , with r and om assignment at the school level . SETTING Seven schools were r and omly assigned as experimental , and 7 as delayed-treatment . PARTICIPANTS The experimental group included 551 teens , and the delayed treatment group included 329 teens . INTERVENTION The minimal intervention was Present and Prevent , a commercially available PowerPoint program presented in two 30-minute time slots over 1 week . MAIN OUTCOME MEASURES The dependent variables were nutrition knowledge , attitudes , peer and family influences , behavioral intentions , and program satisfaction . The independent variable was group assignment . ANALYSES A matched-pairs and 2- 
    Output:
    