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 Obesity remains a serious issue in many countries . Web-based programs offer good potential for delivery of weight loss programs . Yet , many Internet-delivered weight loss studies include support from medical or nutritional experts , and relatively little is known about purely web-based weight loss programs . Objective To determine whether supportive features and personalization in a 12-week web-based lifestyle intervention with no in-person professional contact affect retention and weight loss . Methods We assessed the effect of different features of a web-based weight loss intervention using a 12-week repeated- measures r and omized parallel design . We developed 7 sites representing 3 functional groups . A national mass media promotion was used to attract overweight/obese Australian adults ( based on body mass index [ BMI ] calculated from self-reported heights and weights ) . Eligible respondents ( n = 8112 ) were r and omly allocated to one of 3 functional groups : information-based ( n = 183 ) , supportive ( n = 3994 ) , or personalized-supportive ( n = 3935 ) . Both supportive sites included tools , such as a weight tracker , meal planner , and social networking platform . The personalized-supportive site included a meal planner that offered recommendations that were personalized using an algorithm based on a user ’s preferences for certain foods . Dietary and activity information were constant across sites , based on an existing and tested 12-week weight loss program ( the Total Wellbeing Diet ) . Before and /or after the intervention , participants completed demographic ( including self-reported weight ) , behavioral , and evaluation question naires online . Usage of the website and features was objective ly recorded . All screening and data collection procedures were performed online with no face-to-face contact . Results Across all 3 groups , attrition was high at around 40 % in the first week and 20 % of the remaining participants each week . Retention was higher for the supportive sites compared to the information-based site only at week 12 ( P = .01 ) . The average number of days that each site was used varied significantly ( P = .02 ) and was higher for the supportive site at 5.96 ( SD 11.36 ) and personalized-supportive site at 5.50 ( SD 10.35 ) , relative to the information-based site at 3.43 ( SD 4.28 ) . In total , 435 participants provided a valid final weight at the 12-week follow-up . Intention-to-treat analyses ( using multiple imputations ) revealed that there were no statistically significant differences in weight loss between sites ( P = .42 ) . On average , participants lost 2.76 % ( SE 0.32 % ) of their initial body weight , with 23.7 % ( SE 3.7 % ) losing 5 % or more of their initial weight . Within supportive conditions , the level of use of the online weight tracker was predictive of weight loss ( model estimate = 0.34 , P < .001 ) . Age ( model estimate = 0.04 , P < .001 ) and initial BMI ( model estimate = -0.03 , P < .002 ) were associated with frequency of use of the weight tracker . Conclusions Relative to a static control , inclusion of social networking features and personalized meal planning recommendations in a web-based weight loss program did not demonstrate additive effects for user weight loss or retention . These features did , however , increase the average number of days that a user engaged with the system . For users of the supportive websites , greater use of the weight tracker tool was associated with greater weight loss The transition to college has been identified as a critical period for increases in overweight status . Overweight college students are at-risk of becoming obese adults , and , thus prevention efforts targeting college age individuals are key to reducing adult obesity rates . The current study evaluated an Internet intervention with first year college students ( N=170 ) r and omly assigned to one of four treatment conditions : 1 ) no treatment , 2 ) 6-week online intervention 3 ) 6-week weight and caloric feedback only ( via email ) , and 4 ) 6-week combined feedback and online intervention . The combined intervention group had lower BMI s at post-testing than the other three groups . This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students Despite their popularity and potential to promote health in large population s , the effectiveness of online social networks ( e.g. , Facebook ) to improve health behaviors has been somewhat disappointing . Most of the research examining the effectiveness of such interventions has used r and omized controlled trials ( RCTs ) . It is asserted that the modest outcomes may be due to characteristics specific to both online social networks and RCTs . The highly controlled nature of RCTs stifles the dynamic nature of online social networks . Alternative and ecologically valid research design s that evaluate online social networks in real-life conditions are needed to advance the science in this area BACKGROUND Few weight loss interventions are evaluated for longer than a year , and even fewer employ social and mobile technologies commonly used among young adults . We assessed the efficacy of a 2 year , theory-based , weight loss intervention that was remotely and adaptively delivered via integrated user experiences with Facebook , mobile apps , text messaging , emails , a website , and technology-mediated communication with a health coach ( the SMART intervention ) . METHODS In this parallel-group , r and omised , controlled trial , we enrolled overweight or obese college students ( aged 18 - 35 years ) from three universities in San Diego , CA , USA . Participants were r and omly assigned ( 1:1 ) to receive either the intervention ( SMART intervention group ) or general information about health and wellness ( control group ) . We used computer-based permuted-block r and omisation with block sizes of four , stratified by sex , ethnicity , and college . Participants , study staff , and investigators were masked until the intervention was assigned . The primary outcome was objective ly measured weight in kg at 24 months . Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework . Objective ly measured weight at 6 , 12 , and 18 months was included as a secondary outcome . The trial is registered with Clinical Trials.gov , number NCT01200459 . FINDINGS Between May 18 , 2011 , and May 17 , 2012 , 404 individuals were r and omly assigned to the intervention ( n=202 ) or control ( n=202 ) . Participants ' mean ( SD ) age was 22·7 ( 3·8 ) years . 284 ( 70 % ) participants were female and 125 ( 31 % ) were Hispanic .  Mean ( SD ) body-mass index at baseline was 29·0 ( 2·8 ) kg/m(2 ) . At 24 months , weight was assessed in 341 ( 84 % ) participants , but all 404 were included in analyses . Weight , adjusted for sex , ethnicity , and college , was not significantly different between the groups at 24 months ( -0·79 kg [ 95 % CI -2·02 to 0·43 ] , p=0·204 ) . However , weight was significantly less in the intervention group compared with the control group at 6 months ( -1·33 kg [ 95 % CI -2·36 to -0·30 ] , p=0·011 ) and 12 months ( -1·33 kg [ -2·30 to -0·35 ] , p=0·008 ) , but not 18 months ( -0·67 kg [ 95 % CI -1·69 to 0·35 ] , p=0·200 ) . One serious adverse event in the intervention group ( gallstones ) could be attributable to rapid and excessive weight loss . INTERPRETATION Social and mobile technologies did not facilitate sustained reductions in weight among young adults , although these approaches might facilitate limited short-term weight loss . FUNDING The National Heart , Lung , and Blood Institute of the National Institutes of Health ( U01 HL096715 ) Background Overweight or obesity is prevalent among college students and many gain weight during this time . Traditional face-to-face weight loss interventions have not worked well in this population . Facebook is an attractive tool for delivering weight loss interventions for college students because of its popularity , potential to deliver strategies found in successful weight loss interventions , and ability to support ongoing adaptation of intervention content . Objective The objective of this study was to describe participant exposure to a Facebook page design ed to deliver content to overweight/obese college students in a weight loss r and omized controlled trial ( N=404 ) and examine participant engagement with behavior change campaigns for weight loss delivered via Facebook . Methods The basis of the intervention campaign model were 5 self-regulatory techniques : intention formation , action planning , feedback , goal review , and self-monitoring . Participants were encouraged to engage their existing social network to meet their weight loss goals . A health coach moderated the page and modified content based on usage patterns and user feedback . Quantitative analyses were conducted at the Facebook post- and participant-level of analysis . Participant engagement was quantified by Facebook post type ( eg , status up date ) and interaction ( eg , like ) and stratified by weight loss campaign ( sequenced vs nonsequenced ) . A subset of participants were interviewed to evaluate the presence of passive online engagement or “ lurking . ” Results The health coach posted 1816 unique messages to the study ’s Facebook page over 21 months , averaging 3.45 posts per day ( SD 1.96 , range 1 - 13 ) . In all , 72.96 % ( 1325/1816 ) of the posts were interacted with at least once ( eg , liked ) . Of these , approximately 24.75 % ( 328/1325 ) had 1 - 2 interactions , 23.39 % ( 310/1325 ) had 3 - 5 interactions , 25.13 % ( 333/1325 ) had 6 - 8 interactions , and 41 posts had 20 or more interactions ( 3.09 % , 41/1325 ) . There was significant variability among quantifiable ( ie , visible ) engagement . Of 199 participants in the final intervention sample , 32 ( 16.1 % ) were highly active users and 62 ( 31.2 % ) never visibly engaged with the intervention on Facebook . Polls were the most popular type of post followed by photos , with 97.5 % ( 79/81 ) and 80.3 % ( 386/481 ) interacted with at least once . Participants visibly engaged less with posts over time ( partial r=–.33 ; P<.001 ) . Approximately 40 % of the participants interviewed ( 12/29 , 41 % ) reported passively engaging with the Facebook posts by reading but not visibly interacting with them . Conclusions Facebook can be used to remotely deliver weight loss intervention content to college students with the help of a health coach who can iteratively tailor content and interact with participants . However , visible engagement with the study ’s Facebook page was highly variable and declined over time . Whether the level of observed engagement is meaningful in terms of influencing changes in weight behaviors and outcomes will be evaluated at the completion of the overall study Background In young men , unhealthy lifestyle behaviours can be detrimental to their physical and /or mental health and set them on a negative health trajectory into adulthood . Despite this , there is a lack of evidence to guide development of effective health behaviour change interventions for young men . This study assessed the feasibility and preliminary efficacy of the ‘ HEYMAN ’ ( Harnessing Ehealth to enhance Young men ’s Mental health , Activity and Nutrition ) healthy lifestyle program for young men . Methods A pilot RCT with 50 young men aged 18–25 years r and omised to the HEYMAN intervention ( n = 26 ) or waitlist control ( n = 24 ) .  HEYMAN was a 3-month intervention , targeted for young men to improve eating habits , activity levels and well-being . Intervention development was informed by a participatory research model ( PRECEDE-PROCEED ) . Intervention components included eHealth support ( website , wearable device , Facebook support group ) , face-to-face sessions ( group and individual ) , a personalised food and nutrient report , home-based resistance training equipment and a portion control tool . Outcomes included : feasibility of research procedures ( recruitment , r and omisation , data collection and retention ) and of intervention components . Generalized linear mixed models estimated the treatment effect at 3-months for the primary outcomes : pedometer steps/day , diet quality , well-being and several secondary outcomes . Results A 7-week recruitment period was required to enrol 50 young men .  A retention rate of 94 % was achieved at 3-months post-intervention . Retained intervention participants ( n = 24 ) demonstrated reasonable usage levels for most program components and also reported reasonable levels of program component acceptability for attractiveness , comprehension , usability , support , satisfaction and ability to persuade , with scores ranging from 3.0 to 4.6 ( maximum 5 ) . No significant intervention effects were observed for the primary outcomes of steps/day ( 1012.7 , 95 % CI = −506.2 , 2531.6 , p = 0.191 , d = 0.36 ) , diet quality score ( 3.6 , 95 % CI = −0.4 , 7.6 , p = 0.081 , d = 0.48 ) or total well-being score ( 0.4 , 95 % CI = −1.6 , 2.5 , p = 0.683 , d = 0.11 ) . Significant intervention effects were found for daily vegetable servings , energy-dense , nutrient-poor foods , MVPA , weight , BMI , fat mass , waist circumference and cholesterol ( all p < 0.05 ) . Conclusions The HEYMAN program demonstrated feasibility in assisting young men to make some positive lifestyle changes . This provides support 
    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 Obesity remains a serious issue in many countries . Web-based programs offer good potential for delivery of weight loss programs . Yet , many Internet-delivered weight loss studies include support from medical or nutritional experts , and relatively little is known about purely web-based weight loss programs . Objective To determine whether supportive features and personalization in a 12-week web-based lifestyle intervention with no in-person professional contact affect retention and weight loss . Methods We assessed the effect of different features of a web-based weight loss intervention using a 12-week repeated- measures r and omized parallel design . We developed 7 sites representing 3 functional groups . A national mass media promotion was used to attract overweight/obese Australian adults ( based on body mass index [ BMI ] calculated from self-reported heights and weights ) . Eligible respondents ( n = 8112 ) were r and omly allocated to one of 3 functional groups : information-based ( n = 183 ) , supportive ( n = 3994 ) , or personalized-supportive ( n = 3935 ) . Both supportive sites included tools , such as a weight tracker , meal planner , and social networking platform . The personalized-supportive site included a meal planner that offered recommendations that were personalized using an algorithm based on a user ’s preferences for certain foods . Dietary and activity information were constant across sites , based on an existing and tested 12-week weight loss program ( the Total Wellbeing Diet ) . Before and /or after the intervention , participants completed demographic ( including self-reported weight ) , behavioral , and evaluation question naires online . Usage of the website and features was objective ly recorded . All screening and data collection procedures were performed online with no face-to-face contact . Results Across all 3 groups , attrition was high at around 40 % in the first week and 20 % of the remaining participants each week . Retention was higher for the supportive sites compared to the information-based site only at week 12 ( P = .01 ) . The average number of days that each site was used varied significantly ( P = .02 ) and was higher for the supportive site at 5.96 ( SD 11.36 ) and personalized-supportive site at 5.50 ( SD 10.35 ) , relative to the information-based site at 3.43 ( SD 4.28 ) . In total , 435 participants provided a valid final weight at the 12-week follow-up . Intention-to-treat analyses ( using multiple imputations ) revealed that there were no statistically significant differences in weight loss between sites ( P = .42 ) . On average , participants lost 2.76 % ( SE 0.32 % ) of their initial body weight , with 23.7 % ( SE 3.7 % ) losing 5 % or more of their initial weight . Within supportive conditions , the level of use of the online weight tracker was predictive of weight loss ( model estimate = 0.34 , P < .001 ) . Age ( model estimate = 0.04 , P < .001 ) and initial BMI ( model estimate = -0.03 , P < .002 ) were associated with frequency of use of the weight tracker . Conclusions Relative to a static control , inclusion of social networking features and personalized meal planning recommendations in a web-based weight loss program did not demonstrate additive effects for user weight loss or retention . These features did , however , increase the average number of days that a user engaged with the system . For users of the supportive websites , greater use of the weight tracker tool was associated with greater weight loss The transition to college has been identified as a critical period for increases in overweight status . Overweight college students are at-risk of becoming obese adults , and , thus prevention efforts targeting college age individuals are key to reducing adult obesity rates . The current study evaluated an Internet intervention with first year college students ( N=170 ) r and omly assigned to one of four treatment conditions : 1 ) no treatment , 2 ) 6-week online intervention 3 ) 6-week weight and caloric feedback only ( via email ) , and 4 ) 6-week combined feedback and online intervention . The combined intervention group had lower BMI s at post-testing than the other three groups . This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students Despite their popularity and potential to promote health in large population s , the effectiveness of online social networks ( e.g. , Facebook ) to improve health behaviors has been somewhat disappointing . Most of the research examining the effectiveness of such interventions has used r and omized controlled trials ( RCTs ) . It is asserted that the modest outcomes may be due to characteristics specific to both online social networks and RCTs . The highly controlled nature of RCTs stifles the dynamic nature of online social networks . Alternative and ecologically valid research design s that evaluate online social networks in real-life conditions are needed to advance the science in this area BACKGROUND Few weight loss interventions are evaluated for longer than a year , and even fewer employ social and mobile technologies commonly used among young adults . We assessed the efficacy of a 2 year , theory-based , weight loss intervention that was remotely and adaptively delivered via integrated user experiences with Facebook , mobile apps , text messaging , emails , a website , and technology-mediated communication with a health coach ( the SMART intervention ) . METHODS In this parallel-group , r and omised , controlled trial , we enrolled overweight or obese college students ( aged 18 - 35 years ) from three universities in San Diego , CA , USA . Participants were r and omly assigned ( 1:1 ) to receive either the intervention ( SMART intervention group ) or general information about health and wellness ( control group ) . We used computer-based permuted-block r and omisation with block sizes of four , stratified by sex , ethnicity , and college . Participants , study staff , and investigators were masked until the intervention was assigned . The primary outcome was objective ly measured weight in kg at 24 months . Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework . Objective ly measured weight at 6 , 12 , and 18 months was included as a secondary outcome . The trial is registered with Clinical Trials.gov , number NCT01200459 . FINDINGS Between May 18 , 2011 , and May 17 , 2012 , 404 individuals were r and omly assigned to the intervention ( n=202 ) or control ( n=202 ) . Participants ' mean ( SD ) age was 22·7 ( 3·8 ) years . 284 ( 70 % ) participants were female and 125 ( 31 % ) were Hispanic .  Mean ( SD ) body-mass index at baseline was 29·0 ( 2·8 ) kg/m(2 ) . At 24 months , weight was assessed in 341 ( 84 % ) participants , but all 404 were included in analyses . Weight , adjusted for sex , ethnicity , and college , was not significantly different between the groups at 24 months ( -0·79 kg [ 95 % CI -2·02 to 0·43 ] , p=0·204 ) . However , weight was significantly less in the intervention group compared with the control group at 6 months ( -1·33 kg [ 95 % CI -2·36 to -0·30 ] , p=0·011 ) and 12 months ( -1·33 kg [ -2·30 to -0·35 ] , p=0·008 ) , but not 18 months ( -0·67 kg [ 95 % CI -1·69 to 0·35 ] , p=0·200 ) . One serious adverse event in the intervention group ( gallstones ) could be attributable to rapid and excessive weight loss . INTERPRETATION Social and mobile technologies did not facilitate sustained reductions in weight among young adults , although these approaches might facilitate limited short-term weight loss . FUNDING The National Heart , Lung , and Blood Institute of the National Institutes of Health ( U01 HL096715 ) Background Overweight or obesity is prevalent among college students and many gain weight during this time . Traditional face-to-face weight loss interventions have not worked well in this population . Facebook is an attractive tool for delivering weight loss interventions for college students because of its popularity , potential to deliver strategies found in successful weight loss interventions , and ability to support ongoing adaptation of intervention content . Objective The objective of this study was to describe participant exposure to a Facebook page design ed to deliver content to overweight/obese college students in a weight loss r and omized controlled trial ( N=404 ) and examine participant engagement with behavior change campaigns for weight loss delivered via Facebook . Methods The basis of the intervention campaign model were 5 self-regulatory techniques : intention formation , action planning , feedback , goal review , and self-monitoring . Participants were encouraged to engage their existing social network to meet their weight loss goals . A health coach moderated the page and modified content based on usage patterns and user feedback . Quantitative analyses were conducted at the Facebook post- and participant-level of analysis . Participant engagement was quantified by Facebook post type ( eg , status up date ) and interaction ( eg , like ) and stratified by weight loss campaign ( sequenced vs nonsequenced ) . A subset of participants were interviewed to evaluate the presence of passive online engagement or “ lurking . ” Results The health coach posted 1816 unique messages to the study ’s Facebook page over 21 months , averaging 3.45 posts per day ( SD 1.96 , range 1 - 13 ) . In all , 72.96 % ( 1325/1816 ) of the posts were interacted with at least once ( eg , liked ) . Of these , approximately 24.75 % ( 328/1325 ) had 1 - 2 interactions , 23.39 % ( 310/1325 ) had 3 - 5 interactions , 25.13 % ( 333/1325 ) had 6 - 8 interactions , and 41 posts had 20 or more interactions ( 3.09 % , 41/1325 ) . There was significant variability among quantifiable ( ie , visible ) engagement . Of 199 participants in the final intervention sample , 32 ( 16.1 % ) were highly active users and 62 ( 31.2 % ) never visibly engaged with the intervention on Facebook . Polls were the most popular type of post followed by photos , with 97.5 % ( 79/81 ) and 80.3 % ( 386/481 ) interacted with at least once . Participants visibly engaged less with posts over time ( partial r=–.33 ; P<.001 ) . Approximately 40 % of the participants interviewed ( 12/29 , 41 % ) reported passively engaging with the Facebook posts by reading but not visibly interacting with them . Conclusions Facebook can be used to remotely deliver weight loss intervention content to college students with the help of a health coach who can iteratively tailor content and interact with participants . However , visible engagement with the study ’s Facebook page was highly variable and declined over time . Whether the level of observed engagement is meaningful in terms of influencing changes in weight behaviors and outcomes will be evaluated at the completion of the overall study Background In young men , unhealthy lifestyle behaviours can be detrimental to their physical and /or mental health and set them on a negative health trajectory into adulthood . Despite this , there is a lack of evidence to guide development of effective health behaviour change interventions for young men . This study assessed the feasibility and preliminary efficacy of the ‘ HEYMAN ’ ( Harnessing Ehealth to enhance Young men ’s Mental health , Activity and Nutrition ) healthy lifestyle program for young men . Methods A pilot RCT with 50 young men aged 18–25 years r and omised to the HEYMAN intervention ( n = 26 ) or waitlist control ( n = 24 ) .  HEYMAN was a 3-month intervention , targeted for young men to improve eating habits , activity levels and well-being . Intervention development was informed by a participatory research model ( PRECEDE-PROCEED ) . Intervention components included eHealth support ( website , wearable device , Facebook support group ) , face-to-face sessions ( group and individual ) , a personalised food and nutrient report , home-based resistance training equipment and a portion control tool . Outcomes included : feasibility of research procedures ( recruitment , r and omisation , data collection and retention ) and of intervention components . Generalized linear mixed models estimated the treatment effect at 3-months for the primary outcomes : pedometer steps/day , diet quality , well-being and several secondary outcomes . Results A 7-week recruitment period was required to enrol 50 young men .  A retention rate of 94 % was achieved at 3-months post-intervention . Retained intervention participants ( n = 24 ) demonstrated reasonable usage levels for most program components and also reported reasonable levels of program component acceptability for attractiveness , comprehension , usability , support , satisfaction and ability to persuade , with scores ranging from 3.0 to 4.6 ( maximum 5 ) . No significant intervention effects were observed for the primary outcomes of steps/day ( 1012.7 , 95 % CI = −506.2 , 2531.6 , p = 0.191 , d = 0.36 ) , diet quality score ( 3.6 , 95 % CI = −0.4 , 7.6 , p = 0.081 , d = 0.48 ) or total well-being score ( 0.4 , 95 % CI = −1.6 , 2.5 , p = 0.683 , d = 0.11 ) . Significant intervention effects were found for daily vegetable servings , energy-dense , nutrient-poor foods , MVPA , weight , BMI , fat mass , waist circumference and cholesterol ( all p < 0.05 ) . Conclusions The HEYMAN program demonstrated feasibility in assisting young men to make some positive lifestyle changes . This provides support 
    Output:
    