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 The purpose of this study was to develop a smoking cessation program combined with an Internet-assisted instruction ( IAI ) program to help youth smokers quit smoking , and to evaluate the effectiveness of the program in changing youth 's attitudes toward smoking , smoking behavior , and self-efficacy for smoking cessation . METHODS To achieve this goal , a comparative study of 77 senior high students divided into two groups was conducted . One group , design ated as the experimental group , accepted a 6-week smoking cessation program plus an IAI program and the other group did not receive any intervention as the comparison group . All participants completed question naires before and after the program . RESULTS The results showed that the strategy of combining the smoking cessation program and an IAI program was highly effective in terms of effects upon the youth 's attitude towards smoking , smoking behavior , and self-efficacy . There was a highly positive correlation between the participants ' attitude toward smoking and self-efficacy . In contrast , cigarette consumption was in a strongly negative correlation with self-efficacy . CONCLUSION Most of all participants in the experimental group recognized the effectiveness of the program , and thought the smoking cessation program with an IAI program was helpful and welcomed by youth . This study can serve as reference for future design and implementation of IAI programs for youth smoking cessation OBJECTIVES This study aim ed to develop an Internet-assisted smoking cessation program accompanied with auricular acupressure , and compare the quit rate and self-efficacy of youth smokers receiving auricular acupressure with and without the Internet-assisted smoking cessation program . DESIGN A Website was constructed on IBM Websphere 5.0 and DB2 data base using HTML , Javascript , and JSP . A quasiexperimental research design was adopted . Subjects were assigned nonr and omly to two groups . Group 1 received auricular acupressure plus the Internet-assisted smoking cessation program , whereas group 2 received auricular acupressure only . MEASUREMENTS The data of demographic factors , serum cotinine , quitting rate , nicotine dependence , and self-efficacy of subjects were collected before and after a 4-week intervention . RESULTS After intervention , the quit rate was 15.78 % in group 1 and 2.56 % in group 2 . Nicotine dependence was significantly lowered in group 1 , but remained unchanged in group 2 . The improvement of self-efficacy between groups 1 and 2 was significantly different . CONCLUSIONS The combination of auricular acupressure and Internet-assisted smoking cessation program was more efficacious than auricular acupressure alone in terms of quit rate Objective To map the state of the existing literature evaluating the use of social media in patient and caregiver population s. Design Scoping review . Data sources Medline , CENTRAL , ERIC , PubMed , CINAHL Plus Full Text , Academic Search Complete , Alt Health Watch , Health Source , Communication and Mass Media Complete , Web of Knowledge and ProQuest ( 2000–2012 ) . Study selection Studies reporting primary research on the use of social media ( collaborative projects , blogs/microblogs , content communities , social networking sites , virtual worlds ) by patients or caregivers . Data extraction Two review ers screened studies for eligibility ; one review er extracted data from relevant studies and a second performed verification for accuracy and completeness on a 10 % sample . Data were analysed to describe which  social media tools  are being used , by whom , for what purpose and how they are being evaluated . Results Two hundred eighty-four studies were included .  Discussion forums were highly prevalent and constitute 66.6 % of the sample . Social networking sites ( 14.8 % ) and blogs/microblogs ( 14.1 % ) were the next most commonly used tools . The intended purpose of the tool was to facilitate self-care in 77.1 % of studies . While there were clusters of studies that focused on similar conditions ( eg , lifestyle/weight loss ( 12.7 % ) , cancer ( 11.3 % ) ) , there were no patterns in the objectives or tools used . A large proportion of the studies were descriptive ( 42.3 % ) ; however , there were also 48 ( 16.9 % ) r and omised controlled trials ( RCTs ) . Among the RCTs , 35.4 % reported statistically significant results favouring the social media intervention being evaluated ; however , 72.9 % presented positive conclusions regarding the use of social media . Conclusions There is an extensive body of literature examining the use of social media in patient and caregiver population s. Much of this work is descriptive ; however , with such widespread use , evaluations of effectiveness are required . In studies that have examined effectiveness , positive conclusions are often reported , despite non-significant findings Background Stories may be an effective tool to communicate with and influence patients because of their ability to engage the reader . The objective of this paper is to describe the development of a story-based intervention for delivery of health evidence to parents of children with croup for use in a r and omized controlled trial . Methods A creative writer interviewed parents of children with croup presenting to the pediatric emergency department ( ED ) and drafted stories . We revised the stories based on written participant feedback and edited the stories to incorporate research evidence and health information . An illustrator and graphic design er developed story booklets which were evaluated through focus groups . Results Ten participants provided feedback on the five stories drafted by the creative writer . Participants liked the concept but found the writing overly sophisticated and wanted more character development and more medical/health information . Participants highlighted specific story content that they liked and disliked . The revised stories were evaluated through focus groups involving eight individuals . Feedback was generally positive ; one participant question ed the associated costs . Participants liked the graphics and layout ; felt that they could identify with the stories ; and felt that it was easier to get information compared to a st and ard medical information sheet . Participants provided feedback on the story content , errors and inconsistencies , and preferences of writing style and booklet format . Feedback on how to package the stories was provided by attendees at a national meeting of pediatric emergency research ers . Conclusions Several challenges arose during the development of the stories including : staying true to the story versus being evidence based ; addressing the use of the internet by consumers as a source of health information ; balancing the need to be comprehensive and widely applicable while being succinct ; considerations such as story length , reading level , narrative mode , representation of different demographics and illness experiences , graphics and layout . The process was greatly informed by feedback from the end-user group . This allowed us to shape our products to ensure accuracy , credibility , and relevance . Our experience is valuable for further work in the area of stories and narratives , as well as more broadly for identifying and developing communication strategies for healthcare consumers This study describes the development and usage of a Web-based component of a nutrition and physical activity behavioral intervention to promote bone health  among preadolescent girls . Thirty Girl Scout troops were r and omized to either an intervention or control group for a 2-year period . Girls in the intervention troops ( aged 10 to 12 years , N=194 ) were exposed to grade -specific Web sites that were developed to reinforce the content of the broader , face-to-face intervention . In 5th grade , 82 % of the girls logged on once and 48 % logged on more than once , compared to 56 % and 23 % of 6th grade rs , respectively . Results suggest that although Web-site usage decreased over time , a Web-site program may be useful as a component of a face-to-face , multicomponent intervention . More research is needed to determine ways to enhance and maintain Web-site use over time among youth in health-behavior intervention programs Adolescent sexual risk behavior is a serious and prevalent problem among American youth . Mothers may play a key role in discussing sex and sexual risk behavior with their adolescent children . However , mothers may lack the knowledge and skills to successfully communicate . The purpose of this study was to develop a Web site to teach mothers how to communicate with their children about sex and to demonstrate the efficacy of this Web-based program . This pilot study included 35 rural , low-income mothers of middle-school adolescents . Mothers were r and omly assigned to either the Web-based experimental group or written information-only control group . Mothers in the experimental group received computers and Internet access to the Web-based program , peer support , and expert advice from a pediatric nurse practitioner . Major findings of the study were that the Web-based intervention was equally effective at improving mothers ' knowledge , communication skills , and self-efficacy as the written material control and that low-income rural women who have had little to no prior experience with computers can effectively learn Web-based health-related information . Future implication s for nursing are discussed OBJECTIVE This article describes website use and behavioral outcomes in a multi-component lifestyle intervention promoting healthy diet and exercise . METHODS A 2-year r and omized clinical trial to improve  bone density in 228 adolescent girls , the intervention included a website design ed to enhance intervention adherence , retention of participants , and behavioral outcomes . Measures included diet and exercise recalls , surveys , and web-usage data . RESULTS Website use was associated with increases in calcium intake ( ss = 69.72 , p = .01 , ES = 0.15 ) and high-impact activity ( ss = 10.93 , p = .04 , ES = .13 ) . Use of web pages related to behavioral feedback and communications was not significantly associated with behavioral outcomes . The most visited website pages had content related to incentive points , caption contests , and fun facts . CONCLUSIONS Web elements of a multi-component intervention may promote retention and engagement in target behaviors . Such websites may be most acceptable to adolescent participants if they blend fun and behavioral elements , rather than exclusively focusing on behavioral changes The purpose of this study was to develop an  Internet coping skills training program and to evaluate its feasibility and acceptability compared with an Internet education intervention for teenagers with type 1 diabetes . A multiphase mixed- methods design with focus groups , a r and omized pilot study , and a program evaluation was used . Teenagers with type 1 diabetes , parents , and health professionals were included in the development and evaluative phases along with the research and information technology team . The pilot study included 12 teenagers with type 1 diabetes ( mean [ SD ] age , 14.4 [ .90 ] years ; 58 % female ; mean [ SD ] duration of diabetes , 5.9 [ 3.0 ] years ) .  Psychosocial data and HbA1c levels were collected at baseline and at 3 and 6 months . Results indicate that the development of a psychosocial Internet intervention was complex and required multiple iterations of development and evaluation . Results of this study also indicate the feasibility and acceptability of translating a group-based intervention for teenagers with type 1 diabetes to the Internet . Thus , this study demonstrates a systematic approach to Internet intervention development . Including teenagers with type 1 diabetes and a multidisciplinary professional team into the intervention design was critical to the success of this project Objective : To describe our experience with a Web-based communications program for the patients , families , and referring physicians of patients admitted to our pediatric intensive care unit . Design : Prospect i ve descriptive case series for a 32-month period from April 2000 through January 2003 . Setting : Sixteen-bed multidisciplinary medical-surgical pediatric intensive care unit ( PICU ) . Subjects : Seventy-three of 78 patients admitted to the PICU for ≥3 days and their families participated in the study , along with 26 referring physicians . Intervention : None . Measurements and Main Results : We found that 77 % ( 474/619 ) of surveyed family members and friends thought that the Web page helped them share information , 13 % ( 82/619 ) were unsure , and only < 1 % ( 4/619 ) thought it did not help them share information . When comparing respondents who thought the Web page helped them share information with those who did not or those who did not know , internet use was significantly associated with thinking that the Web page helped them share information ( p = .0007 ) . Seventy-three percent ( 19/26 ) of physicians thought that Web page-based communication  was easier than present methods to convey patient information , and 62 % ( 16/26 ) replied that the Web-based communication met their expectation . Fifty-four percent ( 14/26 ) of physicians thought they were more likely to refer patients to our PICU because of the Web-based communication ; this was significantly associated with physician assessment that the Web-based communication was easier than the present methods of communicating with referring physicians ( p = .003 ) . Conclusions : We conclude that both families and referring physicians find Web-based communications during a child 's PICU hospitalization to be very helpful . We suggest that the Web-based PICU communications be developed and studied for both medical and economic impact In great dem and are efficient mechanisms for delivery of evidence -based interventions for promoting social-emotional development and early positive behavior of all children , and especially for those with or at risk for disabilities . The rise of Internet use has created potentially new avenues for intervention delivery , which , when paired with the many recent advances in computer networking and multimedia technology , is fueling this dem and . This article describes the development of an Internet-based , computer-delivered parent-training intervention , Infant Net  , with infants at risk for poor social-emotional outcomes . Results of a r and omized control trial of the Infant Net intervention with 40 parent-infant dyads showed significant increase , reflecting a medium to large effect size , in infant social engagement and engagement with the environment for infants in the intervention group as compared to the control group . Implication s are discussed with regard to future research OBJECTIVE Evaluation of novel treatment delivery methods , such as the Internet are notably absent from the adolescent smoking treatment literature . METHODS Adolescent smokers ages 11 - 18 years were r and omized to a  clinic-based , brief office intervention ( BOI ; N=69 ) consisting of four individual counseling sessions ; or to Stomp Out Smokes ( SOS ) , an Internet , home-based intervention  ( N= 
    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 The purpose of this study was to develop a smoking cessation program combined with an Internet-assisted instruction ( IAI ) program to help youth smokers quit smoking , and to evaluate the effectiveness of the program in changing youth 's attitudes toward smoking , smoking behavior , and self-efficacy for smoking cessation . METHODS To achieve this goal , a comparative study of 77 senior high students divided into two groups was conducted . One group , design ated as the experimental group , accepted a 6-week smoking cessation program plus an IAI program and the other group did not receive any intervention as the comparison group . All participants completed question naires before and after the program . RESULTS The results showed that the strategy of combining the smoking cessation program and an IAI program was highly effective in terms of effects upon the youth 's attitude towards smoking , smoking behavior , and self-efficacy . There was a highly positive correlation between the participants ' attitude toward smoking and self-efficacy . In contrast , cigarette consumption was in a strongly negative correlation with self-efficacy . CONCLUSION Most of all participants in the experimental group recognized the effectiveness of the program , and thought the smoking cessation program with an IAI program was helpful and welcomed by youth . This study can serve as reference for future design and implementation of IAI programs for youth smoking cessation OBJECTIVES This study aim ed to develop an Internet-assisted smoking cessation program accompanied with auricular acupressure , and compare the quit rate and self-efficacy of youth smokers receiving auricular acupressure with and without the Internet-assisted smoking cessation program . DESIGN A Website was constructed on IBM Websphere 5.0 and DB2 data base using HTML , Javascript , and JSP . A quasiexperimental research design was adopted . Subjects were assigned nonr and omly to two groups . Group 1 received auricular acupressure plus the Internet-assisted smoking cessation program , whereas group 2 received auricular acupressure only . MEASUREMENTS The data of demographic factors , serum cotinine , quitting rate , nicotine dependence , and self-efficacy of subjects were collected before and after a 4-week intervention . RESULTS After intervention , the quit rate was 15.78 % in group 1 and 2.56 % in group 2 . Nicotine dependence was significantly lowered in group 1 , but remained unchanged in group 2 . The improvement of self-efficacy between groups 1 and 2 was significantly different . CONCLUSIONS The combination of auricular acupressure and Internet-assisted smoking cessation program was more efficacious than auricular acupressure alone in terms of quit rate Objective To map the state of the existing literature evaluating the use of social media in patient and caregiver population s. Design Scoping review . Data sources Medline , CENTRAL , ERIC , PubMed , CINAHL Plus Full Text , Academic Search Complete , Alt Health Watch , Health Source , Communication and Mass Media Complete , Web of Knowledge and ProQuest ( 2000–2012 ) . Study selection Studies reporting primary research on the use of social media ( collaborative projects , blogs/microblogs , content communities , social networking sites , virtual worlds ) by patients or caregivers . Data extraction Two review ers screened studies for eligibility ; one review er extracted data from relevant studies and a second performed verification for accuracy and completeness on a 10 % sample . Data were analysed to describe which  social media tools  are being used , by whom , for what purpose and how they are being evaluated . Results Two hundred eighty-four studies were included .  Discussion forums were highly prevalent and constitute 66.6 % of the sample . Social networking sites ( 14.8 % ) and blogs/microblogs ( 14.1 % ) were the next most commonly used tools . The intended purpose of the tool was to facilitate self-care in 77.1 % of studies . While there were clusters of studies that focused on similar conditions ( eg , lifestyle/weight loss ( 12.7 % ) , cancer ( 11.3 % ) ) , there were no patterns in the objectives or tools used . A large proportion of the studies were descriptive ( 42.3 % ) ; however , there were also 48 ( 16.9 % ) r and omised controlled trials ( RCTs ) . Among the RCTs , 35.4 % reported statistically significant results favouring the social media intervention being evaluated ; however , 72.9 % presented positive conclusions regarding the use of social media . Conclusions There is an extensive body of literature examining the use of social media in patient and caregiver population s. Much of this work is descriptive ; however , with such widespread use , evaluations of effectiveness are required . In studies that have examined effectiveness , positive conclusions are often reported , despite non-significant findings Background Stories may be an effective tool to communicate with and influence patients because of their ability to engage the reader . The objective of this paper is to describe the development of a story-based intervention for delivery of health evidence to parents of children with croup for use in a r and omized controlled trial . Methods A creative writer interviewed parents of children with croup presenting to the pediatric emergency department ( ED ) and drafted stories . We revised the stories based on written participant feedback and edited the stories to incorporate research evidence and health information . An illustrator and graphic design er developed story booklets which were evaluated through focus groups . Results Ten participants provided feedback on the five stories drafted by the creative writer . Participants liked the concept but found the writing overly sophisticated and wanted more character development and more medical/health information . Participants highlighted specific story content that they liked and disliked . The revised stories were evaluated through focus groups involving eight individuals . Feedback was generally positive ; one participant question ed the associated costs . Participants liked the graphics and layout ; felt that they could identify with the stories ; and felt that it was easier to get information compared to a st and ard medical information sheet . Participants provided feedback on the story content , errors and inconsistencies , and preferences of writing style and booklet format . Feedback on how to package the stories was provided by attendees at a national meeting of pediatric emergency research ers . Conclusions Several challenges arose during the development of the stories including : staying true to the story versus being evidence based ; addressing the use of the internet by consumers as a source of health information ; balancing the need to be comprehensive and widely applicable while being succinct ; considerations such as story length , reading level , narrative mode , representation of different demographics and illness experiences , graphics and layout . The process was greatly informed by feedback from the end-user group . This allowed us to shape our products to ensure accuracy , credibility , and relevance . Our experience is valuable for further work in the area of stories and narratives , as well as more broadly for identifying and developing communication strategies for healthcare consumers This study describes the development and usage of a Web-based component of a nutrition and physical activity behavioral intervention to promote bone health  among preadolescent girls . Thirty Girl Scout troops were r and omized to either an intervention or control group for a 2-year period . Girls in the intervention troops ( aged 10 to 12 years , N=194 ) were exposed to grade -specific Web sites that were developed to reinforce the content of the broader , face-to-face intervention . In 5th grade , 82 % of the girls logged on once and 48 % logged on more than once , compared to 56 % and 23 % of 6th grade rs , respectively . Results suggest that although Web-site usage decreased over time , a Web-site program may be useful as a component of a face-to-face , multicomponent intervention . More research is needed to determine ways to enhance and maintain Web-site use over time among youth in health-behavior intervention programs Adolescent sexual risk behavior is a serious and prevalent problem among American youth . Mothers may play a key role in discussing sex and sexual risk behavior with their adolescent children . However , mothers may lack the knowledge and skills to successfully communicate . The purpose of this study was to develop a Web site to teach mothers how to communicate with their children about sex and to demonstrate the efficacy of this Web-based program . This pilot study included 35 rural , low-income mothers of middle-school adolescents . Mothers were r and omly assigned to either the Web-based experimental group or written information-only control group . Mothers in the experimental group received computers and Internet access to the Web-based program , peer support , and expert advice from a pediatric nurse practitioner . Major findings of the study were that the Web-based intervention was equally effective at improving mothers ' knowledge , communication skills , and self-efficacy as the written material control and that low-income rural women who have had little to no prior experience with computers can effectively learn Web-based health-related information . Future implication s for nursing are discussed OBJECTIVE This article describes website use and behavioral outcomes in a multi-component lifestyle intervention promoting healthy diet and exercise . METHODS A 2-year r and omized clinical trial to improve  bone density in 228 adolescent girls , the intervention included a website design ed to enhance intervention adherence , retention of participants , and behavioral outcomes . Measures included diet and exercise recalls , surveys , and web-usage data . RESULTS Website use was associated with increases in calcium intake ( ss = 69.72 , p = .01 , ES = 0.15 ) and high-impact activity ( ss = 10.93 , p = .04 , ES = .13 ) . Use of web pages related to behavioral feedback and communications was not significantly associated with behavioral outcomes . The most visited website pages had content related to incentive points , caption contests , and fun facts . CONCLUSIONS Web elements of a multi-component intervention may promote retention and engagement in target behaviors . Such websites may be most acceptable to adolescent participants if they blend fun and behavioral elements , rather than exclusively focusing on behavioral changes The purpose of this study was to develop an  Internet coping skills training program and to evaluate its feasibility and acceptability compared with an Internet education intervention for teenagers with type 1 diabetes . A multiphase mixed- methods design with focus groups , a r and omized pilot study , and a program evaluation was used . Teenagers with type 1 diabetes , parents , and health professionals were included in the development and evaluative phases along with the research and information technology team . The pilot study included 12 teenagers with type 1 diabetes ( mean [ SD ] age , 14.4 [ .90 ] years ; 58 % female ; mean [ SD ] duration of diabetes , 5.9 [ 3.0 ] years ) .  Psychosocial data and HbA1c levels were collected at baseline and at 3 and 6 months . Results indicate that the development of a psychosocial Internet intervention was complex and required multiple iterations of development and evaluation . Results of this study also indicate the feasibility and acceptability of translating a group-based intervention for teenagers with type 1 diabetes to the Internet . Thus , this study demonstrates a systematic approach to Internet intervention development . Including teenagers with type 1 diabetes and a multidisciplinary professional team into the intervention design was critical to the success of this project Objective : To describe our experience with a Web-based communications program for the patients , families , and referring physicians of patients admitted to our pediatric intensive care unit . Design : Prospect i ve descriptive case series for a 32-month period from April 2000 through January 2003 . Setting : Sixteen-bed multidisciplinary medical-surgical pediatric intensive care unit ( PICU ) . Subjects : Seventy-three of 78 patients admitted to the PICU for ≥3 days and their families participated in the study , along with 26 referring physicians . Intervention : None . Measurements and Main Results : We found that 77 % ( 474/619 ) of surveyed family members and friends thought that the Web page helped them share information , 13 % ( 82/619 ) were unsure , and only < 1 % ( 4/619 ) thought it did not help them share information . When comparing respondents who thought the Web page helped them share information with those who did not or those who did not know , internet use was significantly associated with thinking that the Web page helped them share information ( p = .0007 ) . Seventy-three percent ( 19/26 ) of physicians thought that Web page-based communication  was easier than present methods to convey patient information , and 62 % ( 16/26 ) replied that the Web-based communication met their expectation . Fifty-four percent ( 14/26 ) of physicians thought they were more likely to refer patients to our PICU because of the Web-based communication ; this was significantly associated with physician assessment that the Web-based communication was easier than the present methods of communicating with referring physicians ( p = .003 ) . Conclusions : We conclude that both families and referring physicians find Web-based communications during a child 's PICU hospitalization to be very helpful . We suggest that the Web-based PICU communications be developed and studied for both medical and economic impact In great dem and are efficient mechanisms for delivery of evidence -based interventions for promoting social-emotional development and early positive behavior of all children , and especially for those with or at risk for disabilities . The rise of Internet use has created potentially new avenues for intervention delivery , which , when paired with the many recent advances in computer networking and multimedia technology , is fueling this dem and . This article describes the development of an Internet-based , computer-delivered parent-training intervention , Infant Net  , with infants at risk for poor social-emotional outcomes . Results of a r and omized control trial of the Infant Net intervention with 40 parent-infant dyads showed significant increase , reflecting a medium to large effect size , in infant social engagement and engagement with the environment for infants in the intervention group as compared to the control group . Implication s are discussed with regard to future research OBJECTIVE Evaluation of novel treatment delivery methods , such as the Internet are notably absent from the adolescent smoking treatment literature . METHODS Adolescent smokers ages 11 - 18 years were r and omized to a  clinic-based , brief office intervention ( BOI ; N=69 ) consisting of four individual counseling sessions ; or to Stomp Out Smokes ( SOS ) , an Internet , home-based intervention  ( N= 
    Output:
    