***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 study investigated whether a psycho-educational program with modest dosage ( eight sessions ) , delivered in a universal framework through childbirth education programs and targeting the coparenting relationship would have a positive impact on observed family interaction and child behavior at 6-month follow-up ( child age 1 year ) . One hundred sixty-nine couples , r and omized to intervention and control conditions , participated in videotaped family observation tasks at pretest ( during pregnancy ) and at child age 1 year ( 2003–2007 ) . Coparenting , parenting , couple relationship , and child self-regulatory behaviors were coded by teams of raters . Intent-to-treat analyses of program effects controlled for age , education , and social desirability . Evidence of significant ( p < 0.05 ) program effects at follow-up emerged in all four domains . Effect sizes ranged from 0.28 to 1.01 . Targeting the coparenting relationship at the transition to parenthood represents an effective , non-stigmatizing means of promoting parenting quality and child adjustment Behavioral and emotional problems are common in early childhood and put children at risk for developing more serious problems . This study tested the mediating mechanisms through which a universal coparenting intervention implemented during the transition to parenthood led to reduced child adjustment problems at age 3 and explored child gender as a potential moderator . One hundred sixty-nine heterosexual couples expecting their first child were r and omly assigned to a control condition or Family Foundations , a series of eight classes that targeted the coparenting relationship .  Data were collected through videotaped triadic mother – father – child interaction tasks when the child was 1 and 3 years of age . Separate longitudinal path analyses for mothers and fathers tested coparenting competition and positivity as mediators of program effects on child adjustment problems . Significant mediated effects for coparenting competition were found for fathers with both sons and daughters and for mothers with sons but not for mothers with daughters . These effects accounted for between 39 and 55 % of the intervention ’s impact on child adjustment problems . Coparenting positivity did not mediate program effects . These results support the use of a prevention approach to reduce coparenting competition and enhance child adjustment and provide information that can be used to refine theory This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship , parental mental health , the parent-child relationship , and child outcomes . A sample of 169 heterosexual , adult couples expecting their first child was r and omized to intervention and control conditions . The intervention families participated in Family Foundations , a series of eight classes delivered before and after birth , which was design ed as a universal prevention program ( i.e. , applicable to all couples , not just those at high risk ) . Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy , coparenting , harsh parenting , and children 's emotional adjustment among all families , and maternal depression among cohabiting couples . Among families of boys , program effects were found for child behavior problems and couple relationship quality . These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being Objective To determine whether a structured programme of parent anticipatory guidance ‘ Toddlers Without Tears  , ’ delivered in universal primary care , can prevent preschool child behaviour problems . Design Cluster r and omised controlled trial . Setting / participants 40 primary care nursing centres ( clusters ) in metropolitan Melbourne , Australia . 733 English-speaking mothers of 6- to 7-month-old infants consecutively recruited from well-child appointments ; 589 ( 80 % ) retained at age 3 years . Intervention Parenting programme from age 8 to 15 months , with two group sessions co-led by well-child providers and a parenting expert . The programme addressed normal behaviour development and offered strategies to increase desired and reduce unwanted behaviour . While 93 % of intervention parents received at least some of the programme , only 49 % completed all components . Control Usual primary care . Main outcome measures Maternal report of child externalising behaviour ( Child Behaviour Checklist ) , parenting ( Parent Behaviour Checklist ) and maternal mental health ( Depression Anxiety Stress Scales ) when children were aged 3 years . Results Behaviour scores in the intervention and control groups were similar ( mean ( SD ) ) 11.4 ( 7.1 ) versus 12.4 ( 7.6 ) ; adjusted mean difference −0.8 , 95 % CI −2.2 to 0.6 , p=0.26 ) . On the parenting subscale scores , intervention parents reported fewer unreasonable expectations of child development ( 37.3 ( 10.9 ) vs 39.9 ( 10.2 ) , adjusted mean difference −3.1 , 95 % CI −4.9 to −1.4 , p=0.001 ) . The mean scores for harsh/abusive and nurturing parenting , and maternal mental health , were similar between the two groups . Conclusions A brief universal parenting programme in primary care is insufficient to prevent development of preschool externalising problems . A new population trial targeting more intensive prevention to distressed parents with toddler behaviour problems is now under way , aim ing to prevent externalising and internalising problems before school entry . Trial registration number IS RCT Objective To determine whether a parenting programme , offered universally in primary care , can prevent behavioural problems in children and improve parenting and maternal mental health . Design Cluster r and omised trial . Setting 40 primary care nursing centres ( clusters ) in Victoria , Australia . Participants 733 English speaking mothers of 8 month old children sequentially recruited from well child appointments ; 656 retained at 24 months . Intervention Structured three session programme at age 8 - 15 months , co-led by well child providers and a parenting expert . The programme covered normal development and behaviour , strategies to increase desired behaviour , and strategies to reduce unwanted behaviour . Main outcome measures Maternal report of child externalising behaviour ( child behavior checklist 1½-5 year old ) , parenting ( parent behavior checklist ) , and maternal mental health ( depression anxiety stress scales ) at 18 and 24 months . Results At 18 months , child behaviour and parenting scores were similar in the two groups . At 24 months , externalising scores in the intervention and control groups were similar ( mean 11.9 ( SD 7.2 ) v 12.9 ( 7.4 ) ) ; however , on the parent behavior checklist subscale scores , intervention group parents were less likely to report harsh/abusive parenting ( mean 38.9 ( SD 7.7 ) v 40.5 ( 8.8 ) ; adjusted mean difference −1.83 , 95 % confidence interval −3.12 to −0.55 ) and unreasonable expectations of child development ( 40.9 ( 9.9 ) v 42.7 ( 9.6 ) ; −2.18 , −3.74 to −0.62 ) . Mean scores for nurturing parenting and maternal mental health were similar in the two groups at both times . Conclusions A universal parenting programme result ed in modest improvement in parenting factors that predict behavioural problems in children but did not reduce externalising behavioural problems or affect maternal mental health at 2 years . Trial registration IS RCT N 77531789 BACKGROUND The Copenhagen Child Cohort , CCC 2000 , was established to investigate developmental psychopathology prospect ively from birth in a general population . METHODS A r and om sample of 211 children from the CCC 2000 was investigated when the children were 1(1/2 ) years of age . The prevalence and associates of mental health problems and psychopathology were studied by clinical and st and ardised strategies , including videotape recordings , parent interviews and the following instruments : The Child Behavior Check List 1(1/2)-5 ( CBCL 1(1/2)-5 ) , The Infant Toddler Symptom Check List ( ITSCL ) , Checklist for Autism in Toddlers ( CHAT ) , Bayley Scales of Infant Development II ( BSID II ) , The Parent Child Early Relationship Assessment ( PC ERA ) and Parent Infant Relationship Global Assessment Scale  ( PIR-GAS ) . RESULTS Mental health problems according to International Classification of Diseases ( ICD-10 ) and Diagnostic Classification Zero to Three ( DC 0 - 3 ) diagnoses were found in 16 - 18 % of 1(1/2)-year-old children . Most common were disturbances of emotion , behaviour and eating and the DC 0 - 3 diagnosis of regulatory disorder . Parent-child relationship disturbances were found in 8 % . High psychosocial risk was significantly associated with emotional and behavioural disorders ( OR 3.1 95 % ( 1.2 - 8.1 ) ) and disturbed parent-child relationship ( OR 5.0 95 % ( 1.6 - 16.0 ) ) . The strongest association of risk was found between relationship disorders and emotional and behavioural disorders ( OR 11.6 95 % ( 3.8 - 37.5 ) ) . CONCLUSIONS The prevalence and distribution of psychopathology in 1(1/2)-year-old children seem to correspond to the distributions among older children . Disturbances in parent-child relationship have a key position in the risk mechanisms in early child psychopathology OBJECTIVE To evaluate the long-term effects of an early home-based intervention on the quantity and quality of psychiatric symptoms in adolescents . METHOD The material consisted of 160 families with a baby born in 1975 - 1976 . First , the families were classified with a weighted risk index into low- and high-risk families . Eighty families attended a 5-year-long family counseling program ( 10 times/year ) . The other half of the families served as a control group for the effects of counseling . The mental state of the adolescents was assessed at age 14 to 15 years by the Child Behavior Checklist and the Youth Self-Report . RESULTS The adolescents in the counseling families scored significantly fewer total symptoms on both the parent and the youth reports . The counseling reduced more effectively internalizing than externalizing symptoms . The counseling predicted better mental health in adolescence in both low- and high-risk families . CONCLUSIONS Home-based early intervention can have positive long-term effects on the mental state of adolescents . These results can be used when programs for primary prevention in families with small children are planned This study examined whether a group educational intervention during the transition to parenthood can enhance the quality of father-child interaction and increase father involvement with their children . A r and omized experimental design was used to evaluate an 8-session program with 165 couples who were first-time parents , beginning during the second trimester of pregnancy and ending at 5 months postpartum . Outcomes were assessed with time diaries , coded observations of parent-child play , and self-reports of fathers and mothers . The intervention had positive effects on fathers ' skills in interacting with their babies and their involvement on work days but not home days . It is concluded that a relatively brief intervention during the transition to parenthood can improve fathering , and possible reasons for differential effects on areas of parenting are explored The effects of a parent-training program design ed to increase parental competence to assess , predict , elicit , and contingently , respond to infant behavior and to increase the infant 's contingent responses to the parents ' behavior were assessed . 19 parent couples and their 4 - 12-month-old infants were r and omly assigned to the training group or the control group . Raters , unaware of the status of the parents , observed and rated the parents ' behavior during a 2-hour home observation . Separate raters , unaware of the hypothesis , then rated a 20-min videotape of the parent-infant interactions in the home . Parents independently completed a question naire . Training was found to increase both the parents ' and the infants ' competence in the parent-infant dyad . Most important , a reciprocal relationship between increases in the trained fathers ' interactions and decreases in the trained mothers ' interactions was found , indicating that the triad may be the crucial unit for studies of parental competence OBJECTIVE . We sought to determine whether Healthy Steps for Young Children has sustained treatment effects at 5.5 years , given early findings demonstrating enhanced quality of care and improvements in selected parenting practice s. METHODS . Healthy Steps was a clinical trial that incorporated developmental specialists and enhanced developmental services into pediatric care in the first 3 years of life . A total of 5565 children were enrolled at birth and followed through 5.5 years .  Healthy Steps was evaluated at 6 r and omization and 9 quasi-experimental sites .  Computer-assisted telephone interviews were conducted with mothers when Healthy Steps children were 5.5 years of age . Outcomes included experiences seeking care , parent response to child misbehavior , perception of child 's behavior , and parenting practice s to promote development and safety . Logistic regression was used to estimate overall effects of Healthy Steps , adjusting for site and baseline demographic characteristics . RESULTS . A total of 3165 ( 56.9 % ) families responded to interviews  ( usual care : n = 1441 ; Healthy Steps : n = 1724 ) . Families that had received Healthy Steps services were more satisfied with care ( agreed that pediatrician/nurse practitioner provided support , 82.0 % vs 79.0 % ; odds ratio : 1.25 [ 95 % confidence interval : 1.02–1.53 ] ) and more likely to receive needed anticipatory guidance ( 54.9 % vs 49.2 % ; odds ratio : 1.33 [ 95 % confidence interval : 1.13–1.57 ] ) ( all P < .05 ) . They also had increased odds of remaining at the original practice ( 65.1 
    Output:
    
There were no statistically significant effects of the intervention for the majority of the primary outcomes across the studies .
No clear conclusions can be drawn regarding the effects of universally offered parenting interventions  on child development and parent-child relationship for this age group