You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Evidence, Theory and Context: Using intervention mapping to develop a worksite physical activity intervention
Abstract 1:
Background The workplace is an ideal setting for health promotion . Helping employees to be more physically active can not only improve their physical and mental health , but can also have economic benefits such as reduced sickness absence . The current paper describes the development of a three month theory-based intervention that aims to increase levels of moderate intensity physical activity amongst employees in sedentary occupations . Methods The intervention was developed using an intervention mapping protocol . The intervention was also informed by previous literature , qualitative focus groups , an expert steering group , and feedback from key contacts within a range of organisations . Results The intervention was design ed to target awareness ( e.g. provision of information ) , motivation ( e.g. goal setting , social support ) and environment ( e.g. management support ) and to address behavioural ( e.g. increasing moderate physical activity in work ) and interpersonal outcomes ( e.g. encourage colleagues to be more physically active ) . The intervention can be implemented by local facilitators without the requirement for a large investment of re sources . A facilitator manual was developed which listed step by step instructions on how to implement each component along with a suggested timetable . Conclusion Although time consuming , intervention mapping was found to be a useful tool for developing a theory based intervention . The length of this process has implication s for the way in which funding bodies allow for the development of interventions as part of their funding policy . The intervention will be evaluated in a cluster r and omised trial involving 1350 employees from 5 different organisations , results available September 2009


Title 2:
Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies.
Abstract 2:
1 The AAPD encourages oral health care providers and caregivers to implement 17 simple preventive practice s that can decrease a childs risks of developing this devastating disease . 18 19 20 21 Methods This policy revision is based on a review of the current pediatric dental , medical , and public health literature related to ECC , including 22 the proceedings of the 2005 Symposium on the Prevention of Oral Disease in Children and Adolescents , Chicago , Illinois1997 Conference on Early Childhood Caries , Bethesda , Md.1 A MEDLINE search was conducted using the terms  early childhood caries , nursing caries  , and baby bottle caries. 25 The literature includes studies that used sound scientific methodology , were reported in refereed journals , and are accepted by the dental profession as state of the art in caries causes and prevention . The literature on the consequences of ECC is based on both prospect i ve and retrospective clinical studies that followed accepted clinical protocol s. Preventive recommendations were based primarily upon review of published studies and proceedings . In cases where the data did not appear sufficient or were inconclusive , recommendations were based upon expert and consensus opinion . 23


Title 3:
A Randomised Controlled Trial of the Efficacy of Supervised Toothbrushing in High-Caries-Risk Children
Abstract 3:
Scottish children have one of the highest levels of caries experience in Europe . Only 33 % of 5-year-old children in Dundee who developed caries in their first permanent molars by 7  brushed their teeth twice a day . High-caries-risk children should benefit if they brush more often with fluori date d toothpaste . The aim of this clinical trial was to determine the reduction in 2-year caries increment that can be achieved by daily supervised toothbrushing on school-days with a toothpaste containing 1,000 ppm fluoride ( as sodium monofluorophosphate ) and 0.13 % calcium glycerophosphate , combined with recommended daily home use , compared to a control group involving no intervention other than 6-monthly clinical examinations . Five hundred and thirty-four children , mean age 5.3 , in schools in deprived areas of Tayside were recruited . Each school had two parallel classes , one r and omly selected to be the brushing class and the other , the control . Local mothers were trained as toothbrushing supervisors . Children brushed on school-days and received home supplies . A single examiner undertook 6-monthly examinations recording plaque , caries ( D1 level ) , and used FOTI to supplement the visual caries examination . For children in the brushing classes , the 2-year mean caries increment on first permanent molars was 0.81 at D1 and 0.21 at D3 compared to 1.19 and 0.48 for children in the control classes ( significant reductions of 32 % at D1 and 56 % at D3 ) . In conclusion , high-caries-risk children have been shown to have significantly less caries after participating in a supervised toothbrushing programme with a fluori date d toothpaste


Title 4:
Oral hygiene in relation to caries development and immigrant status in infants and toddlers.
Abstract 4:
The purpose of this study was to describe  oral hygiene factors  in infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 yr of age and to immigrant status . The study was design ed as a prospect i ve , longitudinal study starting with 671 children aged 1 yr . At 3 yr , all the children were invited to a further examination . A total of 298 children , r and omly selected from the original group , were also examined at 2 yr . The accompanying parent was interviewed about the child 's oral health habits . Children who were free of caries at 3 yr had had their teeth brushed more frequently at 1 and 2 yr of age , had used fluoride (F)-toothpaste  more often at 2 yr of age , and had a lower prevalence of visible plaque at 1 and 2 yr of age than children with caries . Immigrant children had had their teeth brushed less frequently , had used less F-toothpaste , and had a higher prevalence of visible plaque at 1 yr of age than nonimmigrant children . Early establishment of good oral hygiene habits and regular use of F-toothpaste seem to be important for achieving good oral health in pre-schoolchildren
Results The comprehensive needs assessment highlighted key barriers to PSB , such as knowledge , skills , self-efficacy , routine setting and behaviour regulation and underlined the importance of individual , social and structural influences .
Parenting skills ( routine setting and the ability to manage the behaviour of a reluctant child ) were emphasised as critical to the success of PSB .
IM , although a time-consuming process , allowed us to capture this complexity and allowed us to develop two community-based intervention pathways covering both universal and targeted approaches , which can be integrated into current provision .