***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: OBJECTIVES This study examined differences between  nurses and paraprofessionals  in implementation of a home visiting program for low-income , first-time parents during pregnancy and the first 2 years of the child 's life . METHODS Mothers were r and omly assigned to either a nurse-visited ( n = 236 ) or a paraprofessional-visited ( n = 244 ) condition .  Nurse- and paraprofessional-visited families were compared on number and length of visits , topics covered , number of program dropouts , and relationship with home visitor . RESULTS On average , nurses completed more visits than paraprofessionals ( 28 vs 23 ; P < .001 ) and spent a greater proportion of time on physical health issues during pregnancy ( 38 % vs 27 % ; P < .001 ) and on parenting issues during infancy ( 46 % vs 32 % ; P < .001 ) . Paraprofessionals conducted visits that lasted longer and spent a greater proportion of time on environmental health and safety issues ( 15 % vs 7 % pregnancy ; 15 % vs 8 % infancy ; P < .001 ) . While home visitors were viewed equally positively by mothers , nurses had fewer dropouts than did paraprofessionals ( 38 % vs 48 % ; P = .04 ) . More paraprofessional-visited families than nurse-visited families experienced staff turnover . CONCLUSIONS Nurses and paraprofessionals , even when using the same model , provide home visiting services in different ways 4 successive cohorts of low-income families were r and omly assigned either to a home-based intervention program that focused on modeling verbal interaction between mother and child around selected toys and books or to comparison treatments . Large program effects were found on maternal interaction styles in videotaped observations . Small IQ and program-specific effects were found for children in contrast to much larger IQ effects found in earlier research . IQ effects did not appear to have been mediated by changes in maternal behavior . A variation in which toys and books were supplied without home visits was as effective as the full program on IQ but not on maternal behavior . 3 years postprogram , there were no detectable effects in achievement or IQ tests or in first grade teachers ' ratings of school adjustment and performance , but IQ and achievement scores were near national norms . Reasons for discrepancies with earlier results are discussed . The results highlight the need for continued experimental evaluation of early intervention programs with safeguards to insure that sample s are educationally at risk OBJECTIVE --To see whether non-professional volunteer community mothers  could deliver a child development programme to disadvantaged first time mothers for children aged up to 1 year . DESIGN --R and omised controlled trial . SETTING --A regional health authority in Dublin . SUBJECTS--262 first time mothers who were delivered during six months in 1989 and who lived in a deprived area of Dublin ; 30 experienced mothers from the same community recruited as community mothers . INTERVENTIONS --All the first time mothers received st and ard support from the public health nurse . In addition , those in the intervention group received the services of a community mother , who was scheduled to visit monthly during the first year of the child 's life . RESULTS --232 ( 89 % ) first time mothers completed the study --127 in the intervention group , 105 controls . At the end of the study children in the intervention group were more likely to have received all of their primary immunisations , to be read to , and to be read to daily , played more cognitive games ; and were exposed to more nursery rhymes . They were less likely to begin cows ' milk before 26 weeks and to receive an inappropriate energy intake and inappropriate amounts of animal protein , non-animal protein , wholefoods , vegetables , fruit , and milk . Mothers in the intervention group also had a better diet than controls . At the end of the study they were less likely to be tired , feel miserable , and want to stay indoors ; had more positive feelings ; and were less likely to display negative feelings . CONCLUSION --Non-professionals can deliver a health promotion programme on child development effectively . Whether they can do so as effectively as professionals requires further study The  Parents as Teachers ( PAT ) program is a parent-education program that includes home visiting and is design ed to begin prenatally or at birth . Through home visits , visitors called parent educators help parents to strengthen their parenting skills and knowledge of child development and to prepare young children for school . This article describes the PAT program and reports the results of evaluations of two r and omized trials of PAT  : ( 1 ) the Northern California ( Salinas Valley ) Parents as Teachers Demonstration , which served primarily Latino parents in the Salinas Valley of California 's Monterey County ; and ( 2 ) the Teen Parents as Teachers Demonstration , which served adolescent parents in four counties in Southern California . The two evaluations revealed small and inconsistent positive effects on parent knowledge , attitudes , and behavior , and no gains in child development or health , when analyses compared the experimental and control groups overall . However , subgroup analyses in the Salinas Valley program indicated that children in primarily Spanish-speaking Latino families benefitted more than either non-Latino or English-speaking Latino families , with significant gains in cognitive , communication , social , and self-help development . Subgroup analyses in the Teen PAT Demonstration indicated that families that received both PAT services and comprehensive case management services design ed to help mothers improve their life course benefitted most . Subgroup analyses in the Salinas Valley study suggested that children in families that received more intensive services benefitted more than children whose families received less intensive services . Results from that study suggested that home visits produced about a one-month developmental advantage per 10 visits for participating children Pregnancy and the early years of the child 's life offer an opportune time to prevent a host of adverse maternal and child outcomes that are important in their own right , but that also have significant implication s for the development of criminal behaviour . This paper summarizes a 30‐year programme of research that has attempted to improve the health and development of mothers and infants and their future life prospect s with prenatal and infancy home visiting by nurses . The programme , known today as the Nurse‐Family Partnership , is design ed for low‐income mothers who have had no previous live births .  The home visiting nurses have three major goals : to improve the outcomes of pregnancy by helping women improve their prenatal health ; to improve the child 's health and development by helping parents provide more sensitive and competent care of the child ; and to improve parental life‐course by helping parents plan future pregnancies , complete their educations , and find work . Given consistent effects on prenatal health behaviours , parental care of the child , child abuse and neglect , child health and development , maternal life‐course , and criminal involvement of the mothers and children , the programme is now being offered for public investment throughout the United States , where careful attention is being given to ensuring that the programme is being conducted in accordance with the programme model tested in the r and omized trials . The programme also is being adapted , developed , and tested in five countries outside of the US : the Netherl and s , Germany , Engl and , Australia , and Canada , where programmatic adjustments are being made to accommo date different population s served and health and human service context s. We believe it is important to test this programme in r and omized controlled trials in these new setting s before it is offered for public investment Socioeconomic inequalities in the health of adults have been largely attributed to lifestyle inequalities . The cognitive development ( CD ) and emotional health ( EH ) of the child provides a basis for many of the health-related behaviours which are observed in adulthood . There has been relatively little attention paid to the way CD and EH are transmitted in the foetal and childhood periods , even though these provide a foundation for subsequent socioeconomic inequalities in adult health . The Mater-University of Queensl and Study of Pregnancy ( MUSP ) is a large , prospect i ve , pre-birth cohort study which enrolled 8556 pregnant women at their first clinic visit over the period 1981 - 1983 . These mothers ( and their children ) have been followed up at intervals until 14 years after the birth . The socioeconomic status of the child was measured using maternal age , family income , and marital status and the gr and fathers ' occupational status . Measures of child CD and child EH were obtained at 5 and 14 years of age . Child smoking at 14 years of age was also determined . Family income was related to all measures of child CD and EH and smoking , independently of all other indicators of the socioeconomic status of the child . In addition , the gr and fathers ' occupational status was independently related to child CD ( at 5 and 14 years of age ) . Children from socioeconomically disadvantaged families ( previous generations ' socioeconomic status as well as current socioeconomic status ) begin their lives with a poorer platform of health and a reduced capacity to benefit from the economic and social advances experienced by the rest of society OBJECTIVE Improve pregnancy outcomes in first-time Hispanic adolescent mothers and their infants . SETTING Urban communities in Orange County , California . DESIGN AND METHODS A comparison of the Nurse-Family Partnership pilot study home visitation program with traditional Public Health Field Nursing ( PHFN ) home visitation . PARTICIPANTS Two hundred twenty-five Hispanic adolescent mothers and their infants . INTERVENTIONS Participants in the control group received the traditional PHFN services ; the intervention group received interventions from advanced trained public health nurses The control group received a minimum of three home visits : one initial client assessment and family profile , one antepartum visit , and one postpartum visit , including newborn assessment . Participants in the intervention group received weekly home visits for the first 4 weeks , followed by visits every other week until delivery , weekly visits for the next 6 weeks , visits every other week until the child was 20 months , and monthly visits until the child was 24 months of age . RESULTS Preliminary results indicate that home visitation by public health nurses ( PHNs ) positively affected the health of adolescents mothers and their infants . The incidence of premature births to adolescent mothers in the intervention group was lower than that found in the California population of adolescent mothers . CONCLUSION Preliminary results from this program showed that PHN home visitation ( control and intervention groups ) positively affects the birth outcomes of adolescent mothers and their infants The aim of this investigation was to follow up a sample of exceptionally short but medically healthy children , and a normal comparison group , previously studied at 4 years of age . They lived in an inner-city area which was , on objective criteria , seriously disadvantaged in socioeconomic terms . When first seen at 4 years , cases were significantly impaired in cognitive abilities relative to comparisons , although firstborns were much less severely affected . Of the original 46 cases , 45 were assessed again at 11 years . Most continued to live in the same geographical area . Case children remained exceptionally short , even when parental stature was taken into account , although a degree of catch-up had occurred . One third had special educational needs , and a similar proportion had been referred for  speech therapy . Verbal and nonverbal cognitive skills of both case and comparison children had , on the whole , changed little and group differences persisted . In conclusion , short normal children from socioeconomically disadvantaged background s are at high risk of educational failure at elementary school Two studies were made of home visiting and psychosocial stimulation with deprived urban children in Jamaica . The aim was to determine the relative effectiveness of different frequencies of visiting on the children 's developmental levels and the feasibility of integrating the model into government primary health care services . Health paraprofessionals supervised by a nurse from a local health center conducted the intervention . In the first study , 152 children aged 6 to 30 months were assigned to groups visited biweekly , monthly , or not at all by area of residence . The biweekly group showed small but significant increases in scores on the Griffiths Mental Development Scales ( developmental quotient ) and performance subscale compared with the monthly and control groups , whereas no benefit was shown in the Griffiths scores of the monthly group . In the second study , 58 children aged 16 to 30 months from the same neighborhoods were r and omly assigned to weekly visited and control groups . The group visited weekly showed marked improvements in the performance and hearing and speech subscales as well as the developmental quotient scores . The results indicate that as the frequency of visiting increases from none through monthly and biweekly to weekly , the benefits increase as well BACKGROUND School readiness , conceptualized as three components including emotional self-regulation , social competence , and family/school involvement , as well as absence of conduct problems play a key role in young children 's future interpersonal adjustment and academic success . Unfortunately , exposure to multiple poverty-related risks increases the odds that children will demonstrate increased emotional dysregulation , fewer social skills , less teacher/parent involvement and more conduct problems . Consequently intervention offered to socio-economically disadvantaged population s that includes a social and emotional school curriculum and trains teachers in effective classroom management skills and in promotion of parent-school involvement would seem to be a strategic strategy for improving young children 's school readiness , leading to later academic success and prevention of the development of conduct disorders . METHODS This r and omized trial evaluated the Incredible Years ( IY ) Teacher Classroom Management and Child Social and Emotion curriculum ( Dinosaur School ) as a universal prevention program for children enrolled in Head Start , kindergarten , or first grade classrooms in schools selected because of high rates of poverty . Trained teachers offered the Dinosaur School curriculum to all their students in bi-weekly lessons throughout the year . They sent home weekly dinosaur homework to encourage parents ' involvement . Part of the curriculum involved promotion of lesson objectives through the teachers ' continual use of positive classroom management skills focused on building social competence and emotional self-regulation skills as well as decreasing conduct problems . Matched pairs of schools were r and omly assigned to intervention or control 
    Output:
    
AUTHORS ' CONCLUSIONS This review does not provide evidence of the effectiveness of home-based interventions that are specifically targeted at improving developmental outcomes for preschool children from socially disadvantaged families .