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: Background Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population . The Health Action Process Approach ( HAPA ) , which was the theoretical framework of this study , focuses on individual self-regulation variables for successful health behavior change . One key self-regulation variable of this model is action control with its three subfacets awareness of intentions , self-monitoring and regulatory effort . The social context of individuals , however , is usually neglected in common health behavior change theories . In order to integrate social influences into the HAPA , this r and omized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity . Methods / Design This protocol describes the design of a single-blind r and omized controlled trial , which comprises four experimental groups : a dyadic action control group , an individual action control group and two control groups .  Participants of this study are overweight or obese , heterosexual adult couples who intend to increase their physical activity . Blocking as means of a gender-balanced r and omization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition . The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention . Follow-ups are one month and six months later . Subsequent to the six-months follow-up another 14 days diary phase takes place . The main outcome measures are self-reported and accelerometer-assessed physical activity . Secondary outcome measures are Body Mass Index ( BMI ) , aerobic fitness and habitual physical activity . Discussion This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind r and omized control trial . Challenges with running couples studies as well as advantages and disadvantages of certain design -related decisions are discussed . This RCT was funded by the Swiss National Science Foundation ( PP00P1_133632/1 ) and was registered on 27/04/2012 at http://www.is rct n.com/IS RCT N15705531 OBJECTIVE The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity ! , a r and omized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler ( 2 - 5 years old ) dyads in North Carolina ( 2007 - 2011 ) . The outcomes include change from baseline in the child 's diet , physical activity and weight , and in the mother 's parenting behaviors , diet , physical activity , and weight . METHOD The intervention targeted parenting through maternal emotion regulation , home environment , feeding practice s , and modeling of healthy behaviors .  400 mother-child dyads were r and omized . RESULTS Mothers in the intervention arm , compared to the control arm , reduced  instrumental feeding  ( -0.24 vs. 0.01 , p<0.001 ) and TV snacks ( -.069 vs. -0.24 , p=0.001 ) . There were also improvements in emotional feeding ( p=0.03 ) , mother 's sugary beverage ( p=0.03 ) and fruit/vegetable ( p=0.04 ) intake , and dinners eaten in front of TV ( p=0.01 ) ; these differences were not significant after adjustment for multiple comparisons . CONCLUSION KAN-DO , design ed to maximize the capacity of mothers as agents of change , improved several channels of maternal influence . There were no group differences in the primary outcomes , but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers ' diets . Long-term follow-up will address whether these short-term trends ultimately improve weight status IMPORTANCE Couples are highly concordant for unhealthy behaviors , and a change in one partner 's health behavior is often associated with a change in the other partner 's behavior . However , no studies have explicitly compared the influence of having a partner who takes up healthy behavior ( eg , quits smoking ) with one whose behavior is consistently healthy ( eg , never smokes ) . OBJECTIVE To examine the influence of partner 's behavior on making positive health behavior changes . DESIGN , SETTING , AND PARTICIPANTS We used prospect i ve data from married and cohabiting couples ( n , 3722 ) participating in the English Longitudinal Study of Ageing , a large population -based cohort of older adults ( ≥50 years ) . Study ing men and women who had unhealthy behaviors in 3 domains at baseline ( ie , smoking , physically inactive , or overweight/obese ) , we used logistic regression analysis to examine the influence of the partner 's behavior in the same domain on the odds of positive health behavior change over time . MAIN OUTCOMES AND MEASURES Smoking cessation , increased physical activity , and 5 % weight loss or greater . RESULTS Across all domains , we found that when one partner changed to a healthier behavior ( newly healthy ) , the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy ( smoking : men 48 % vs 8 % , adjusted odds ratio [ OR ] , 11.82 [ 95 % CI , 4.84 - 28.90 ] ; women 50 % vs 8 % , OR , 11.23 [ 4.58 - 27.52 ] ) ( physical activity : men 67 % vs 26 % , OR , 5.28 [ 3.70 - 7.54 ] ; women 66 % vs 24 % , OR , 5.36 [ 3.74 - 7.68 ] ) ( weight loss : men 26 % vs 10 % , OR , 3.05 [ 1.96 - 4.74 ] ; women 36 % vs 15 % , OR , 3.08 [ 1.98 - 4.80 ] ) . For smoking and physical activity , having a consistently healthy partner also predicted positive change , but for each domain , the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner ( smoking : men OR , 3.08 [ 1.43 - 6.62 ] ; women OR , 5.45 [ 2.44 - 12.16 ] ) ( physical activity : men OR , 1.92 [ 1.37 - 2.70 ] ; women OR , 1.84 [ 1.33 - 2.53 ] ) ( weight loss : men OR , 2.28 [ 1.36 - 3.84 ] ; women OR , 2.86 [ 1.55 - 5.26 ] ) . CONCLUSIONS AND RELEVANCE Men and women are more likely to make a positive health behavior change if their partner does too , and with a stronger effect than if the partner had been consistently healthy in that domain . Involving partners in behavior change interventions may therefore help improve outcomes 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 Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses . What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness . Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise , nutrition , and medication adherence . Ninety-three patients and their spouses/partners consented to participate ( 26 % of those eligible ) and were r and omized into either the individual or couples condition . However , only 80 couples , distributed across conditions , contributed data to the analyses , due to missing data and missing data points . For exercise , there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time . In addition , there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment , while both distressed and nondistressed patients in the couples treatment exhibited accelerating gains throughout treatment . In terms of medication adherence , patients in the couples treatment exhibited virtually no change in medication adherence over time , while patients in the individuals treatment showed a 9 % relative decrease across time . There were no condition or time effects for nutritional outcomes . Finally , there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction , while non satisfied patients in the couples treatment showed improvement over time Background A key barrier to achieving recommended intensity and duration of physical activity is motivation . Purpose We investigated whether a virtually present partner would influence participants ’ motivation ( duration ) during aerobic exercise . Method Fifty-eight females ( Mage = 20.54 ± 1.86 ) were r and omly assigned to either a coactive condition ( exercising alongside another person , independently ) , a conjunctive condition ( performance determined by whichever partner stops exercising first ) where they exercised with a superior partner , or to an individual condition . Participants exercised on a stationary bike at 65 % of heart rate reserve on six separate days . Results Across sessions , conjunctive condition participants exercised significantly longer ( M = 21.89 min , SD = ±10.08 min ) than those in coactive ( M = 19.77 min , SD = ± 9.00 min ) and individual ( M = 10.6 min , SD = ±5.84 min ) conditions ( p < 0.05 ) . Conclusion Exercising with a virtually present partner can improve performance on an aerobic exercise task across multiple sessions Objective To develop and test a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes . Methods In this r and omized trial , dyads consisting of African American adult with overweight or obesity and type 2 diabetes ( index participant ) paired with a family partner with overweight or obesity , but not diagnosed with diabetes , were assigned in a 2:1 ratio to a 20-week special intervention ( SI ) or delayed intervention ( DI ) control group . The primary outcome was weight loss among index participants at 20 weeks follow-up . Results One hundred-eight participants ( 54 dyads – 36 ( SI ) and 18 ( DI ) dyads ) were enrolled : 81 % females ; mean age , 51 years ; mean weight,103 kg ; and mean BMI , 37 kg/m2 . At post-intervention , 96 participants ( 89 % ) returned for follow-up measures . Among index participants , mean difference in weight loss between groups was −5.0 kg , p<.0001 ( −3.6 kg loss among SI ; 1.4 kg gain in DI ) . SI index participants showed significantly greater improvements in hemoglobin A1c , depressive symptoms , family interactions , and dietary , physical activity , and diabetes self-care behaviors . SI family partners also had significant weight loss ( −3.9 kg ( SI ) vs. −1.0 kg ( DI ) p=0.02 ) . Conclusions A family-centered , behavioral weight loss intervention led to clinical ly significant short-term weight loss among family dyads Background Emerging technologies ( ie , mobile phones , Internet ) may be effective tools for promoting  physical activity ( PA ) . However , few interventions have provided effective means to enhance social support through these platforms . Face-to-face programs that use group dynamics-based principles of behavior change have been shown to be highly effective in enhancing social support through promoting group cohesion and PA , but to date , no studies have examined their effects in Web-based programs . Objective The aim was to explore proof of concept and test the efficacy of a brief , online group dynamics-based intervention on PA  in a controlled experiment . We expected that the impact of the intervention on PA would be moderated by perceptions of cohesion and the partner ’s degree of presence in the online media . Methods Participants ( n=135 ) were r and omized into same-sex dyads and r and omly assigned to one of four experimental conditions : st and ard social support ( st and ard ) , group dynamics-based – high presence , group dynamics-based – low presence , or individual control . Participants performed two sets of planking exercises ( pre-post ) . Between sets , participants in partnered conditions interacted with a virtual partner using either a st and ard social support app or a group dynamics-based app ( group dynamics-based – low presence and group dynamics-based – high presence ) , the latter of which they participated in a series of online team-building exercises . Individual participants were given an equivalent rest period between sets . To increase presence during the second set , participants in the group dynamics-based – high presence group saw a live video stream of their partner exercising . Perceptions of cohesion were measured using a modified PA Group Environment Question naire . Physical activity was calculated as the time persisted during set 2 after controlling for persistence in set 1 . Results Perceptions of cohesion were higher in the group dynamics-based – low presence ( overall mean 5.81 , SD 1.04 ) condition compared to the st and ard ( overall mean 5.04 , SD 0.81 ) conditions ( P=.006 ) , but did not differ between group dynamics-based – low presence and group 
    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: Background Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population . The Health Action Process Approach ( HAPA ) , which was the theoretical framework of this study , focuses on individual self-regulation variables for successful health behavior change . One key self-regulation variable of this model is action control with its three subfacets awareness of intentions , self-monitoring and regulatory effort . The social context of individuals , however , is usually neglected in common health behavior change theories . In order to integrate social influences into the HAPA , this r and omized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity . Methods / Design This protocol describes the design of a single-blind r and omized controlled trial , which comprises four experimental groups : a dyadic action control group , an individual action control group and two control groups .  Participants of this study are overweight or obese , heterosexual adult couples who intend to increase their physical activity . Blocking as means of a gender-balanced r and omization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition . The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention . Follow-ups are one month and six months later . Subsequent to the six-months follow-up another 14 days diary phase takes place . The main outcome measures are self-reported and accelerometer-assessed physical activity . Secondary outcome measures are Body Mass Index ( BMI ) , aerobic fitness and habitual physical activity . Discussion This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind r and omized control trial . Challenges with running couples studies as well as advantages and disadvantages of certain design -related decisions are discussed . This RCT was funded by the Swiss National Science Foundation ( PP00P1_133632/1 ) and was registered on 27/04/2012 at http://www.is rct n.com/IS RCT N15705531 OBJECTIVE The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity ! , a r and omized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler ( 2 - 5 years old ) dyads in North Carolina ( 2007 - 2011 ) . The outcomes include change from baseline in the child 's diet , physical activity and weight , and in the mother 's parenting behaviors , diet , physical activity , and weight . METHOD The intervention targeted parenting through maternal emotion regulation , home environment , feeding practice s , and modeling of healthy behaviors .  400 mother-child dyads were r and omized . RESULTS Mothers in the intervention arm , compared to the control arm , reduced  instrumental feeding  ( -0.24 vs. 0.01 , p<0.001 ) and TV snacks ( -.069 vs. -0.24 , p=0.001 ) . There were also improvements in emotional feeding ( p=0.03 ) , mother 's sugary beverage ( p=0.03 ) and fruit/vegetable ( p=0.04 ) intake , and dinners eaten in front of TV ( p=0.01 ) ; these differences were not significant after adjustment for multiple comparisons . CONCLUSION KAN-DO , design ed to maximize the capacity of mothers as agents of change , improved several channels of maternal influence . There were no group differences in the primary outcomes , but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers ' diets . Long-term follow-up will address whether these short-term trends ultimately improve weight status IMPORTANCE Couples are highly concordant for unhealthy behaviors , and a change in one partner 's health behavior is often associated with a change in the other partner 's behavior . However , no studies have explicitly compared the influence of having a partner who takes up healthy behavior ( eg , quits smoking ) with one whose behavior is consistently healthy ( eg , never smokes ) . OBJECTIVE To examine the influence of partner 's behavior on making positive health behavior changes . DESIGN , SETTING , AND PARTICIPANTS We used prospect i ve data from married and cohabiting couples ( n , 3722 ) participating in the English Longitudinal Study of Ageing , a large population -based cohort of older adults ( ≥50 years ) . Study ing men and women who had unhealthy behaviors in 3 domains at baseline ( ie , smoking , physically inactive , or overweight/obese ) , we used logistic regression analysis to examine the influence of the partner 's behavior in the same domain on the odds of positive health behavior change over time . MAIN OUTCOMES AND MEASURES Smoking cessation , increased physical activity , and 5 % weight loss or greater . RESULTS Across all domains , we found that when one partner changed to a healthier behavior ( newly healthy ) , the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy ( smoking : men 48 % vs 8 % , adjusted odds ratio [ OR ] , 11.82 [ 95 % CI , 4.84 - 28.90 ] ; women 50 % vs 8 % , OR , 11.23 [ 4.58 - 27.52 ] ) ( physical activity : men 67 % vs 26 % , OR , 5.28 [ 3.70 - 7.54 ] ; women 66 % vs 24 % , OR , 5.36 [ 3.74 - 7.68 ] ) ( weight loss : men 26 % vs 10 % , OR , 3.05 [ 1.96 - 4.74 ] ; women 36 % vs 15 % , OR , 3.08 [ 1.98 - 4.80 ] ) . For smoking and physical activity , having a consistently healthy partner also predicted positive change , but for each domain , the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner ( smoking : men OR , 3.08 [ 1.43 - 6.62 ] ; women OR , 5.45 [ 2.44 - 12.16 ] ) ( physical activity : men OR , 1.92 [ 1.37 - 2.70 ] ; women OR , 1.84 [ 1.33 - 2.53 ] ) ( weight loss : men OR , 2.28 [ 1.36 - 3.84 ] ; women OR , 2.86 [ 1.55 - 5.26 ] ) . CONCLUSIONS AND RELEVANCE Men and women are more likely to make a positive health behavior change if their partner does too , and with a stronger effect than if the partner had been consistently healthy in that domain . Involving partners in behavior change interventions may therefore help improve outcomes 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 Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses . What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness . Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise , nutrition , and medication adherence . Ninety-three patients and their spouses/partners consented to participate ( 26 % of those eligible ) and were r and omized into either the individual or couples condition . However , only 80 couples , distributed across conditions , contributed data to the analyses , due to missing data and missing data points . For exercise , there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time . In addition , there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment , while both distressed and nondistressed patients in the couples treatment exhibited accelerating gains throughout treatment . In terms of medication adherence , patients in the couples treatment exhibited virtually no change in medication adherence over time , while patients in the individuals treatment showed a 9 % relative decrease across time . There were no condition or time effects for nutritional outcomes . Finally , there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction , while non satisfied patients in the couples treatment showed improvement over time Background A key barrier to achieving recommended intensity and duration of physical activity is motivation . Purpose We investigated whether a virtually present partner would influence participants ’ motivation ( duration ) during aerobic exercise . Method Fifty-eight females ( Mage = 20.54 ± 1.86 ) were r and omly assigned to either a coactive condition ( exercising alongside another person , independently ) , a conjunctive condition ( performance determined by whichever partner stops exercising first ) where they exercised with a superior partner , or to an individual condition . Participants exercised on a stationary bike at 65 % of heart rate reserve on six separate days . Results Across sessions , conjunctive condition participants exercised significantly longer ( M = 21.89 min , SD = ±10.08 min ) than those in coactive ( M = 19.77 min , SD = ± 9.00 min ) and individual ( M = 10.6 min , SD = ±5.84 min ) conditions ( p < 0.05 ) . Conclusion Exercising with a virtually present partner can improve performance on an aerobic exercise task across multiple sessions Objective To develop and test a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes . Methods In this r and omized trial , dyads consisting of African American adult with overweight or obesity and type 2 diabetes ( index participant ) paired with a family partner with overweight or obesity , but not diagnosed with diabetes , were assigned in a 2:1 ratio to a 20-week special intervention ( SI ) or delayed intervention ( DI ) control group . The primary outcome was weight loss among index participants at 20 weeks follow-up . Results One hundred-eight participants ( 54 dyads – 36 ( SI ) and 18 ( DI ) dyads ) were enrolled : 81 % females ; mean age , 51 years ; mean weight,103 kg ; and mean BMI , 37 kg/m2 . At post-intervention , 96 participants ( 89 % ) returned for follow-up measures . Among index participants , mean difference in weight loss between groups was −5.0 kg , p<.0001 ( −3.6 kg loss among SI ; 1.4 kg gain in DI ) . SI index participants showed significantly greater improvements in hemoglobin A1c , depressive symptoms , family interactions , and dietary , physical activity , and diabetes self-care behaviors . SI family partners also had significant weight loss ( −3.9 kg ( SI ) vs. −1.0 kg ( DI ) p=0.02 ) . Conclusions A family-centered , behavioral weight loss intervention led to clinical ly significant short-term weight loss among family dyads Background Emerging technologies ( ie , mobile phones , Internet ) may be effective tools for promoting  physical activity ( PA ) . However , few interventions have provided effective means to enhance social support through these platforms . Face-to-face programs that use group dynamics-based principles of behavior change have been shown to be highly effective in enhancing social support through promoting group cohesion and PA , but to date , no studies have examined their effects in Web-based programs . Objective The aim was to explore proof of concept and test the efficacy of a brief , online group dynamics-based intervention on PA  in a controlled experiment . We expected that the impact of the intervention on PA would be moderated by perceptions of cohesion and the partner ’s degree of presence in the online media . Methods Participants ( n=135 ) were r and omized into same-sex dyads and r and omly assigned to one of four experimental conditions : st and ard social support ( st and ard ) , group dynamics-based – high presence , group dynamics-based – low presence , or individual control . Participants performed two sets of planking exercises ( pre-post ) . Between sets , participants in partnered conditions interacted with a virtual partner using either a st and ard social support app or a group dynamics-based app ( group dynamics-based – low presence and group dynamics-based – high presence ) , the latter of which they participated in a series of online team-building exercises . Individual participants were given an equivalent rest period between sets . To increase presence during the second set , participants in the group dynamics-based – high presence group saw a live video stream of their partner exercising . Perceptions of cohesion were measured using a modified PA Group Environment Question naire . Physical activity was calculated as the time persisted during set 2 after controlling for persistence in set 1 . Results Perceptions of cohesion were higher in the group dynamics-based – low presence ( overall mean 5.81 , SD 1.04 ) condition compared to the st and ard ( overall mean 5.04 , SD 0.81 ) conditions ( P=.006 ) , but did not differ between group dynamics-based – low presence and group 
    Output:
    