***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: This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer BACKGROUND School-based body mass index screenings ( S BMI S ) have been controversial . We aim ed to determine if parents would indicate improved utility with S BMI S when the report included parent education and whether parental intent to modify obesity risk factors would vary with report type or child weight . METHODS A cluster-controlled trial was conducted with 31 elementary schools r and omized to distribute a st and ard S BMI S report or the st and ard report plus education ( S BMI S+ ) . A r and om sub sample of parents completed a mailed survey ( 731 S BMI S , 738 S BMI S+ ) . Using a two-stage cluster sampling design , logistic regression models with school-level r and om effect were used to assess differences between conditions and by weight category . RESULTS Parents in the S BMI S+ condition vs. the st and ard condition were more likely to indicate that the report provided useful information ( not significant ) and an intent to help their child get enough sleep ( p < 0.001 ) . Parents of children who were overweight or obese were less likely than parents of children who were not to indicate that the report provided useful information about their child 's weight status ( p < 0.001 ) or access to re sources ( p < 0.05 ) . However , these parents were more likely to plan a visit to healthcare provider ( p < 0.001 ) and to intend to limit sugar-sweetened beverages ( p < 0.05 ) . CONCLUSIONS Parental education can enhance the utility of the S BMI S report and parental intention to modify at least one obesity risk factor . S BMI S reports prompted parents of children with overweight and obesity to seek clinical care and limit sugar-sweetened drinks Objectives As parents of young children are often unaware their child is overweight , screening provides the opportunity to inform parents and provide the impetus for behaviour change . We aim ed to determine if parents could recall and underst and the information they received about their overweight child after weight screening . Design R and omised controlled trial of different methods of feedback . Setting Participants were recruited through primary and secondary care but appointments took place at a University research clinic . Participants and intervention 1093 children aged 4–8 years were screened . Only overweight children ( n=271 , 24.7 % ) are included in this study . Parents of overweight children were r and omised to receive feedback regarding their child 's weight using best practice care ( BPC ) or motivational interviewing ( MI ) at face-to-face interviews typically lasting 20–40 min . 244 ( 90 % ) parents participated in a follow-up interview 2 weeks later to assess recall and underst and ing of information from the feedback session . Primary and secondary outcome measures Interviews were audio-taped and transcribed verbatim before coding for amount and accuracy of recall . Scores were calculated for total recall and sub-categories of interest . Results Overall , 39 % of the information was recalled ( mean score 6.3 from possible score of 16 ) . Parents given feedback via BPC  recalled more than those in the MI group ( difference in total score 0.48 ; 95 % CI 0.05 to 0.92 ) . Although 94 % of parents were able to correctly recall their child 's weight status , fewer than 10 parents could accurately describe what the measurements meant . Maternal education ( 0.81 ; 0.25 to 1.37 ) and parental ratings of how useful they found the information ( 0.19 ; 0.04 to 0.35 ) were significant predictors of recall score in multivariate analyses . Conclusions While parents remember that their child 's body mass index is higher than recommended , they are unable to remember much of the information and advice provided about the result . Trial registration number Australian New Zeal and Clinical Trials Registry ACTRN12609000749202 Background Because parental recognition of overweight in young children is poor , we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and supports motivation for positive change . This study will assess 1 ) whether weight feedback delivered using motivational interviewing increases parental acceptance of their child 's weight status and enhances motivation for behaviour change , and 2 ) whether a family-based individualised lifestyle intervention , delivered primarily by a MInT mentor with limited support from " expert " consultants in psychology , nutrition and physical activity , can improve weight outcomes after 12 and 24 months in young overweight children , compared with usual care . Methods / Design 1500 children aged 4 - 8 years will be screened for overweight ( height , weight , waist , blood pressure , body composition ) . Parents will complete question naires on feeding practice s , physical activity , diet , parenting , motivation for healthy lifestyles , and demographics . Parents of children classified as overweight ( BMI ≥ CDC 85th ) will receive feedback about the results using Motivational interviewing or Usual care . Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention . Additional baseline measurements ( accelerometry , diet , quality of life , child behaviour ) will be collected and families will be r and omised to Tailored package or Usual care . Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity . Parents in the Tailored package condition will attend a single session with an " expert team " ( MInT mentor , dietitian , physical activity advisor , clinical psychologist ) to identify current challenges for the family , develop tailored goals for change , and plan behavioural strategies that best suit each family . The mentor will continue to provide support to the family via telephone and in-person consultations , decreasing in frequency over the two-year intervention . Outcome measures will be obtained at baseline , 12 and 24 months . Discussion This trial offers a unique opportunity to identify effective ways of providing feedback to parents about their child 's weight status and to assess the efficacy of a supportive , individualised early intervention to improve weight outcomes in young children . Trial registration Australian New Zeal and Clinical Trials Registry Background The National Child Measurement Programme was established to measure the height and weight of children at primary school in Engl and and provides parents with feedback about their child ’s weight status . In this study we will evaluate the impact of the National Child Measurement Programme feedback on parental risk perceptions of overweight , lifestyle behaviour and health service use . Methods The study will be a prospect i ve cohort study of parents of children enrolled in the National Child Measurement Programme and key service providers from 5 primary care trusts ( administrative bodies responsible for providing primary and secondary care services ) . We will conduct baseline question naires , followed by provision of weight feedback and 3 follow up question naires over the course of a year . Question naires will measure change in parental risk perception of overweight , health behaviours and health service use . Qualitative interviews will be used to identify barriers and facilitators to change . This study will produce preliminary data on National Health Service costs associated with weight feedback and determine which feedback approach ( letter and letter plus telephone ) is more effective . Discussion This study will provide the first large scale evaluation of the National Child Measurement Programme feedback . Findings from this evaluation will inform future planning of the National Child Measurement Programme AIM To determine whether a single session of motivational interviewing ( MI ) for feedback of a child 's overweight status promotes engagement in treatment following screening . METHODS One thous and ninety-three children aged 4 - 8 years were recruited through primary and secondary care to attend health screening , including assessment of parenting practice s and motivation ( question naire ) . Families with normal-weight children were informed about their child 's weight but had no further involvement . Parents of overweight ( body mass index ≥ 85th percentile ) children ( n = 271 ) were r and omised to receive weight feedback via MI or best practice care ( BPC ) using a traffic light concept to indicate degree of health risk . Follow-up interviews were held 2 weeks later to examine intervention uptake , changes to motivation and behaviour , and parental response to feedback . RESULTS Recruitment into the intervention was high ( 76 % ) and not altered by feedback condition ( percentage difference 6.6 ( 95 % confidence interval -2.9 , 16.0 ) . High scores on the Health Care Climate Question naire ( rating of the interviewer ) indicated satisfaction with how the information was provided to parents . No differences were observed in multiple indicators of harm . However , self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up ( 0.18 : 0.00 , 0.35 ) , after only a single session of MI . CONCLUSIONS MI and BPC were both successful in encouraging parents to participate in a family-based intervention , with MI offering little significant benefit over BPC . A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news School-based body mass index ( BMI ) screening and reporting could have a positive impact on student health , but best practice s for writing a report are unknown . Building on previous qualitative work , 8 focus groups were conducted with a diverse group of California parents ( n = 79 ) to elicit feedback on report content and design . Results indicate that parents want a visually appealing , picture-heavy report that clearly defines BMI , avoids stigmatizing language , and includes recommendations for appropriate actions whole families can take . Next steps involve using the final report in a statewide , r and omized trial to determine the effectiveness of school-based BMI screening and reporting in reducing childhood obesity 
    Output:
    
Studies of effect found that the format of feedback made little or no difference in parents attending further treatment , recognising their child as overweight or obese , reactions to the way the weight notification is given , motivation for lifestyle change , underst and ing how to reduce the risk of overweight , or taking any action .
However , parents receiving feedback with motivational interviewing have somewhat greater satisfaction with the way the healthcare provider supports them .
Qualitative studies found that parents had clear preferences for the format , timing , content and amount of information they wanted to receive in relation to both the weighing process and weight notification .
They also had clear preferences for how they wanted health care providers to interact and communicate with them and their children .
Both parents and children often felt that they were not receiving enough information and worried about how their results would be kept private .
Many parents experienced an emotional response when told about their child ’s weight ranging from positive , disbelief and negative feelings .
Those who reacted with disbelief or negatively were less likely to accept their child ’s weight status and /or act upon the notification letter .