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: 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 Purpose . Assess the effectiveness of a two-step health education program by nurses delivered through nonsmoking mothers to help fathers of sick children quit smoking . Design . R and omized , controlled trial . Setting . General pediatric wards of four major hospitals in Hong Kong . Subjects . Nonsmoking mothers who had a live-in smoking spouse were recruited when they brought sick children to the hospital . A total of 752 mothers were r and omized into the intervention arm and 731 into the control arm . Intervention . The intervention group received st and ardized health advice , behavior modification booklets , and a 1–week telephone reminder . The control group received usual care . Measurements . The main outcome measure was the quit rate ( 7–day point prevalence ) of smoking fathers as determined by telephone follow-up with mothers at 3 and 12 months . Quit attempts and smoking reduction were secondary outcome measures . Results . At 3 months , more fathers in the intervention group had quit smoking ( 7.4 % vs. 4.8 % ; p = .03 ) , reduced daily cigarette consumption by 50 % or more ( 30.6 % vs. 22.6 % ; p < .001 ) , and reported quit attempts ( 6.5 % vs. 3.6 % ; p = .01 ) . The differences were not statistically significant by 12 months . Conclusion . A simple health education intervention provided by nurses to mothers of sick children has a short-term effect in helping smoking fathers  quit , reduce consumption , and trigger quit attempts . Future studies should confirm the longer-term sustainability of the effect Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Diet and physical activity habits may deteriorate after cohabitation , leading to weight gain and increased risk of lifestyle diseases . We carried out a 4-month , r and omized controlled trial of a diet and physical activity program for couples with a 1-year follow-up , comparing two methods of delivery . The program used six modules , which , after an initial group session , were mailed to the low-level intervention group .  In the high-level intervention group , half of the modules were mailed , and the others were delivered at interactive group sessions . A control group received no intervention . Postintervention and at follow-up , physical fitness improved in the high-level group , saturated fat intake decreased in both intervention groups , and low-density lipoprotein cholesterol fell in the high-level group . Fewer participants in the high-level group became overweight or obese . Health promotion for couples can improve health behaviors and potentially lower the risk of lifestyle diseases in participants and their future families This study was undertaken to determine the effects of a partner-support , incentive-baed educational program on breast feeding knowledge , attitudes and support and to examine the relationship between feeding intentions and feeding behavior among low-income women . Women who expressed a willingness to participate in the intervention were r and omly assigned to “ intervention ” and “ usual breast feeding ” ( control ) groups . Sixty-eight primipara women , with expected due date s between May and December , 1992 , volunteered to participate in the study . Of these , 34 were r and omly assigned to each of the two groups . Approximately 81 percent of the women completed the study , leaving n=29 in the control group and n-26 in the intervention group . The intervention consisted of special incentives ( prizes ) for women and their partners to participate in several breast feeding education and promotion activities . Intervention group women and their partners experienced positive changes in breast feeding knowledge and attitudes . Furthermore , the intervention seemed to have influenced more women in the treatment group to breast feed despite their prenatal feeding intentions . In addition , the partners of intervention group women were perceived to be more supportive of , breast feeding than control group partners . These findings suggest that incentives , such as donated prizes , can be used to attract lower socioeconomic group women and their partners to breast feeding promotion interventions . Participation in such interventions can produce positive changes in breast feeding knowledge , attitudes , and support , and can have a dramatic effect in promoting breast feeding OBJECTIVE To examine the role of  partner assistance in learning and implementation of an intervention design ed to promote skin self-examination ( SSE ) behaviors in persons at risk of developing melanoma . DESIGN R and omized controlled trial with immediate and 4-month follow-up visits . SETTING Clinical offices in the ambulatory care area of a hospital . Patients The study included 130 participants and their cohabiting partners drawn from a melanoma registry . Intervention The subjects were r and omly assigned to receive the intervention either as solo learning or as dyadic learning . The intervention consisted of a 10-minute demonstration of the ABCDE ( asymmetry of shape , border irregularity , color variegation , diameter > or = 6 mm , and evolution of the lesion ) rule and skills training . MAIN OUTCOME MEASURES Behavioral measures included self-reported performance of SSE and use of a body map design ed to record areas of concern found during SSE . Intentions , along with attitudinal measures such as perceived importance of SSE and self-efficacy in performing SSE , were also assessed at the 4-month follow-up visit . RESULTS The participants in the dyadic learning group were significantly more likely to report engaging in SSE behaviors ( P<.05 ) . The dyadic learning group also exhibited greater intentions to perform future SSE ( P<.01 ) , higher perceived importance of SSE ( P<.01 ) , and higher perceived self-efficacy ( P<.01 ) . CONCLUSION Dyadic learning may be more effective than solo learning in regard to interventions design ed to teach and promote health behaviors , such as SSE BACKGROUND Lifestyle has been shown to affect fertility in both males and females , with compelling evidence that smoking and being under or overweight impairs natural and assisted fertility , and other factors such as stress and caffeine have also been implicated . The objective of this study was to determine whether providing infertile couples with individualized lifestyle assessment s and ongoing support facilitates positive lifestyle changes enhancing healthy fertility . METHODS We conducted a prospect i ve cohort pilot study of 23 infertile couples attending an Adelaide-based fertility clinic for advice and treatment relating to infertility . The intervention was a comprehensive assessment interview with the couple , focused on health and lifestyle . Motivational interviewing techniques were used and ongoing support provided . The assessment was repeated after 4 months and included an exit question naire . The main outcome measure(s ) was self-reported lifestyle changes , including increased exercise , modified diet , reduced caffeine and alcohol consumption , ceased or reduced smoking and decreased psychological stress . RESULTS Following the initial lifestyle assessment interview , all participants reported adverse lifestyle behaviour . CONCLUSIONS The results suggest that the FAST ( Fertility ASsessment and advice Targeting lifestyle choices and behaviours ) approach of an individualized assessment of current lifestyle practice followed by ongoing one to two weekly telephone support is effective in promoting healthy lifestyle change . Larger studies using this methodology are now required In a pilot health promotion program for couples , we aim ed to build on re-evaluation of attitudes to health occurring early in marriage , and social support provided by partners , to address the weight gain and physical inactivity which may follow marriage . A r and omized controlled trial lasting 16 weeks used six modules focusing on nutrition and physical activity but including information about alcohol and smoking . Thirty-four of 39 couples enrolled completed the study .  Self-efficacy for diet and physical activity increased significantly in the program group while ranking of barriers to healthy behaviours decreased and ranking of beliefs about the benefits of health behaviours increased relative to controls . Intake of fat , take-away foods and alcohol decreased , and consumption of fruit , vegetables and reduced-fat foods increased significantly in the program group .  Physical activity  in the program group increased by the equivalent of 50 min of brisk walking weekly but did not differ significantly from controls . Cholesterol fell significantly by 6 % more in the program group than controls . In focus groups , participants unanimously found the program valuable . Health promotion programs design ed for couples can achieve short-term changes in behaviour and risk factors . Larger trials with longer-term monitoring , incorporating feedback from focus groups and cost-benefit analysis , are in progress The objective of this study was to evaluate the efficacy of a couple-tailored print ( CTP ) intervention on  colorectal cancer screening ( CRCS ) , CRCS intentions , and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS . A total of 168 married couples with both members non-adherent with CRCS were r and omly assigned to receive either a CTP pamphlet accompanied by a generic print ( GP ) pamphlet or a GP pamphlet only . Couples completed measures of CRCS , intentions , relational perspective on CRCS , discussion s about CRCS , spouse support for CRCS , spouse influence strategies , CRC knowledge , perceived CRC risk , and CRCS benefits and barriers . Results indicated there was no significant benefit of CTP vs. GP on CRCS , but there was a significant increase in CRCS intentions in CTP compared with GP . There was also a significant increase in relationship perspective on CRCS , a significant increase in husb and s ’ support of their wives ’ CRCS , and a significant increase in CRCS benefits in CTP . In summary , CTP did not increase CRCS practice s but increased intentions and perceived benefits of CRCS as well as improving couples ’ ability to view CRCS as having benefit for the marital relationship PURPOSE / OBJECTIVES To assess the efficacy of  Korean Immigrants and Mammography-Culture-Specific Health Intervention ( KIM-CHI ) , an educational program for Korean American ( KA ) couples design ed to improve  mammography uptake among KA women . DESIGN A two-group cluster r and omized , longitudinal , controlled design . SETTING 50 KA religious organizations in the Chicago area . SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year . The women and their husb and s were recruited from 50 KA religious organizations . METHODS Couples were r and omly assigned to intervention or attention control groups . Those in the KIM-CHI program ( n = 211 couples ) were compared to an attention control group ( n = 217 couples ) at baseline , as well as at 6 and 15 months postintervention on mammogram uptake . MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured . Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale . Research ers asked questions about healthcare re sources 
    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: 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 Purpose . Assess the effectiveness of a two-step health education program by nurses delivered through nonsmoking mothers to help fathers of sick children quit smoking . Design . R and omized , controlled trial . Setting . General pediatric wards of four major hospitals in Hong Kong . Subjects . Nonsmoking mothers who had a live-in smoking spouse were recruited when they brought sick children to the hospital . A total of 752 mothers were r and omized into the intervention arm and 731 into the control arm . Intervention . The intervention group received st and ardized health advice , behavior modification booklets , and a 1–week telephone reminder . The control group received usual care . Measurements . The main outcome measure was the quit rate ( 7–day point prevalence ) of smoking fathers as determined by telephone follow-up with mothers at 3 and 12 months . Quit attempts and smoking reduction were secondary outcome measures . Results . At 3 months , more fathers in the intervention group had quit smoking ( 7.4 % vs. 4.8 % ; p = .03 ) , reduced daily cigarette consumption by 50 % or more ( 30.6 % vs. 22.6 % ; p < .001 ) , and reported quit attempts ( 6.5 % vs. 3.6 % ; p = .01 ) . The differences were not statistically significant by 12 months . Conclusion . A simple health education intervention provided by nurses to mothers of sick children has a short-term effect in helping smoking fathers  quit , reduce consumption , and trigger quit attempts . Future studies should confirm the longer-term sustainability of the effect Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Diet and physical activity habits may deteriorate after cohabitation , leading to weight gain and increased risk of lifestyle diseases . We carried out a 4-month , r and omized controlled trial of a diet and physical activity program for couples with a 1-year follow-up , comparing two methods of delivery . The program used six modules , which , after an initial group session , were mailed to the low-level intervention group .  In the high-level intervention group , half of the modules were mailed , and the others were delivered at interactive group sessions . A control group received no intervention . Postintervention and at follow-up , physical fitness improved in the high-level group , saturated fat intake decreased in both intervention groups , and low-density lipoprotein cholesterol fell in the high-level group . Fewer participants in the high-level group became overweight or obese . Health promotion for couples can improve health behaviors and potentially lower the risk of lifestyle diseases in participants and their future families This study was undertaken to determine the effects of a partner-support , incentive-baed educational program on breast feeding knowledge , attitudes and support and to examine the relationship between feeding intentions and feeding behavior among low-income women . Women who expressed a willingness to participate in the intervention were r and omly assigned to “ intervention ” and “ usual breast feeding ” ( control ) groups . Sixty-eight primipara women , with expected due date s between May and December , 1992 , volunteered to participate in the study . Of these , 34 were r and omly assigned to each of the two groups . Approximately 81 percent of the women completed the study , leaving n=29 in the control group and n-26 in the intervention group . The intervention consisted of special incentives ( prizes ) for women and their partners to participate in several breast feeding education and promotion activities . Intervention group women and their partners experienced positive changes in breast feeding knowledge and attitudes . Furthermore , the intervention seemed to have influenced more women in the treatment group to breast feed despite their prenatal feeding intentions . In addition , the partners of intervention group women were perceived to be more supportive of , breast feeding than control group partners . These findings suggest that incentives , such as donated prizes , can be used to attract lower socioeconomic group women and their partners to breast feeding promotion interventions . Participation in such interventions can produce positive changes in breast feeding knowledge , attitudes , and support , and can have a dramatic effect in promoting breast feeding OBJECTIVE To examine the role of  partner assistance in learning and implementation of an intervention design ed to promote skin self-examination ( SSE ) behaviors in persons at risk of developing melanoma . DESIGN R and omized controlled trial with immediate and 4-month follow-up visits . SETTING Clinical offices in the ambulatory care area of a hospital . Patients The study included 130 participants and their cohabiting partners drawn from a melanoma registry . Intervention The subjects were r and omly assigned to receive the intervention either as solo learning or as dyadic learning . The intervention consisted of a 10-minute demonstration of the ABCDE ( asymmetry of shape , border irregularity , color variegation , diameter > or = 6 mm , and evolution of the lesion ) rule and skills training . MAIN OUTCOME MEASURES Behavioral measures included self-reported performance of SSE and use of a body map design ed to record areas of concern found during SSE . Intentions , along with attitudinal measures such as perceived importance of SSE and self-efficacy in performing SSE , were also assessed at the 4-month follow-up visit . RESULTS The participants in the dyadic learning group were significantly more likely to report engaging in SSE behaviors ( P<.05 ) . The dyadic learning group also exhibited greater intentions to perform future SSE ( P<.01 ) , higher perceived importance of SSE ( P<.01 ) , and higher perceived self-efficacy ( P<.01 ) . CONCLUSION Dyadic learning may be more effective than solo learning in regard to interventions design ed to teach and promote health behaviors , such as SSE BACKGROUND Lifestyle has been shown to affect fertility in both males and females , with compelling evidence that smoking and being under or overweight impairs natural and assisted fertility , and other factors such as stress and caffeine have also been implicated . The objective of this study was to determine whether providing infertile couples with individualized lifestyle assessment s and ongoing support facilitates positive lifestyle changes enhancing healthy fertility . METHODS We conducted a prospect i ve cohort pilot study of 23 infertile couples attending an Adelaide-based fertility clinic for advice and treatment relating to infertility . The intervention was a comprehensive assessment interview with the couple , focused on health and lifestyle . Motivational interviewing techniques were used and ongoing support provided . The assessment was repeated after 4 months and included an exit question naire . The main outcome measure(s ) was self-reported lifestyle changes , including increased exercise , modified diet , reduced caffeine and alcohol consumption , ceased or reduced smoking and decreased psychological stress . RESULTS Following the initial lifestyle assessment interview , all participants reported adverse lifestyle behaviour . CONCLUSIONS The results suggest that the FAST ( Fertility ASsessment and advice Targeting lifestyle choices and behaviours ) approach of an individualized assessment of current lifestyle practice followed by ongoing one to two weekly telephone support is effective in promoting healthy lifestyle change . Larger studies using this methodology are now required In a pilot health promotion program for couples , we aim ed to build on re-evaluation of attitudes to health occurring early in marriage , and social support provided by partners , to address the weight gain and physical inactivity which may follow marriage . A r and omized controlled trial lasting 16 weeks used six modules focusing on nutrition and physical activity but including information about alcohol and smoking . Thirty-four of 39 couples enrolled completed the study .  Self-efficacy for diet and physical activity increased significantly in the program group while ranking of barriers to healthy behaviours decreased and ranking of beliefs about the benefits of health behaviours increased relative to controls . Intake of fat , take-away foods and alcohol decreased , and consumption of fruit , vegetables and reduced-fat foods increased significantly in the program group .  Physical activity  in the program group increased by the equivalent of 50 min of brisk walking weekly but did not differ significantly from controls . Cholesterol fell significantly by 6 % more in the program group than controls . In focus groups , participants unanimously found the program valuable . Health promotion programs design ed for couples can achieve short-term changes in behaviour and risk factors . Larger trials with longer-term monitoring , incorporating feedback from focus groups and cost-benefit analysis , are in progress The objective of this study was to evaluate the efficacy of a couple-tailored print ( CTP ) intervention on  colorectal cancer screening ( CRCS ) , CRCS intentions , and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS . A total of 168 married couples with both members non-adherent with CRCS were r and omly assigned to receive either a CTP pamphlet accompanied by a generic print ( GP ) pamphlet or a GP pamphlet only . Couples completed measures of CRCS , intentions , relational perspective on CRCS , discussion s about CRCS , spouse support for CRCS , spouse influence strategies , CRC knowledge , perceived CRC risk , and CRCS benefits and barriers . Results indicated there was no significant benefit of CTP vs. GP on CRCS , but there was a significant increase in CRCS intentions in CTP compared with GP . There was also a significant increase in relationship perspective on CRCS , a significant increase in husb and s ’ support of their wives ’ CRCS , and a significant increase in CRCS benefits in CTP . In summary , CTP did not increase CRCS practice s but increased intentions and perceived benefits of CRCS as well as improving couples ’ ability to view CRCS as having benefit for the marital relationship PURPOSE / OBJECTIVES To assess the efficacy of  Korean Immigrants and Mammography-Culture-Specific Health Intervention ( KIM-CHI ) , an educational program for Korean American ( KA ) couples design ed to improve  mammography uptake among KA women . DESIGN A two-group cluster r and omized , longitudinal , controlled design . SETTING 50 KA religious organizations in the Chicago area . SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year . The women and their husb and s were recruited from 50 KA religious organizations . METHODS Couples were r and omly assigned to intervention or attention control groups . Those in the KIM-CHI program ( n = 211 couples ) were compared to an attention control group ( n = 217 couples ) at baseline , as well as at 6 and 15 months postintervention on mammogram uptake . MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured . Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale . Research ers asked questions about healthcare re sources 
    Output:
    