***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: The research design of the r and omised controlled trial is primarily associated today with medicine . It tends either to be ignored or regarded with suspicion by many in such disciplines as health promotion , public policy , social welfare , criminal justice , and education . However , all professional interventions in people 's lives are subject to essentially the same questions about acceptability and effectiveness . As the social reformers Sidney and Beatrice Webb pointed out in 1932 , there is far more experimentation going on in “ the world sociological laboratory in which we all live ” than in any other kind of laboratory , but most of this social experimentation is “ wrapped in secrecy ” and thus yields “ nothing to science.”1 # # # Summary points Many social scientists argue that r and omised controlled trials are inappropriate for evaluating social interventions , but they ignore a considerable history , mainly in the United States , of the use of r and omised controlled trials to assess different approaches to public policy and health promotion A tradition of experimental sociology was well established by the 1930s , built on the early use of controlled experiments in psychology and education From the early 1960s to early 1980s r and omised experiments were considered the optimal design for evaluating public policy interventions in the United States , and major evaluations using this design were carried out This approach became less popular as policy makers reacted negatively to evidence of “ near zero ” effects Lessons to be learnt about implementing r and omised controlled trials in real life setting s include the difficulty of assessing complex multi-level interventions and the challenge of integrating qualitative data The Webbs argued for a more “ scientific ” social policy , with social scientists being trained in experimental methods and evaluations of social interventions being carried out by independent investigators . They were apparently unaware that a strong tradition in experimental sociology had already been established , mainly in the United States . Reductions in the generosity of fee-for-service insurance lower the use of general medical and mental health services , but do they lead to lower mental health status for the covered population ? We addressed this question using data from the R AND Corporation Health Insurance Experiment . Families in six sites in the United States were r and omly assigned to one of 14 insurance plans for three- or five-year periods . On average , there were no significant adverse effects of cost-sharing plans , relative to a free-care plan , on either psychological well-being or psychological distress , when the cost-sharing plans included full catastrophic coverage . Those with high mental health status but low income at baseline had significantly more favorable mental health outcomes on the cost-sharing plans than on the free-care plan . We can not definitively comment on the effects of insurance generosity for the sick poor . Our findings apply in the context of m and ated comprehensive mental and general health coverage for a general nonelderly , nondisabled household population We assess the impact of the New Hope Project , an antipoverty program tested in a r and om assignment experimental design , on family functioning and developmental outcomes for preschool- and school-aged children ( N = 913 ) .  New Hope offered wage supplements sufficient to raise family income above the poverty threshold and subsidies for child care and health insurance to adults who worked full-time .  New Hope had strong positive effects on boys ' academic achievement , classroom behavior skills , positive social behavior , and problem behaviors , as reported by teachers , and on boys ' own expectations for advanced education and occupational aspirations . There were not corresponding program effects for girls . The child outcomes may have result ed from a combination of the following : Children in New Hope families spent more time in formal child care programs and other structured activities away from home than did children in control families . New Hope parents were employed more , had more material re sources , reported more social support , and expressed less stress and more optimism about achieving their goals than did parents in the control sample . The results suggest that an anti-poverty program that provides support for combining work and family responsibilities can have beneficial effects on the development of school-age children The present study examined the effectiveness and cost efficiency of three different techniques to encourage low-income rural parents to seek dental care for their children . The families of 51 children who needed immediate dental care ( determined by dental screening at a local school ) were placed into three matched groups and r and omly assigned to the treatment conditions : One Prompt ( Note Only ) , Three Prompt ( Note , Telephone Contact , Home Visit ) , and One Prompt plus $ 5 Incentive- The Three Prompt and One Prompt plus $ 5 Incentive were significantly more effective in initiating dental visits than the Note-Only procedure . Not only was the One Prompt plus $ 5 Incentive technique effective in producing a slightly larger percentage of initial dental visits compared to the Three-Prompt technique , it also produced a significantly larger number of followup visits . Furthermore , the cost-effectiveness analysis showed the Incentive condition to be less costly than the Three-Prompt condition in encouraging initial dental visits This study examined the effect of a time-limited welfare program on school-age children using data on almost 3,000 children ( ages 5 - 17 at the four year follow up-point ) from the r and om assignment evaluation of Florida 's Family Transition Program ( FTP ) .  FTP was one of the first welfare reform initiatives to impose a time limit on the receipt of cash assistance , and it combined the time limit with a rich array of m and atory services . The effects of FTP on children were moderated by families ' risk of long-term welfare dependency . Contrary to predictions laid out at the outset , there were few effects of FTP on middle childhood and adolescent children for children of parents most likely to be long-term welfare dependent ( those most likely to hit the time limit ) . However , consistent negative effects on this same age group of children were found for children of parents least likely to be long-term welfare dependent -- parents who had the largest employment gains-- and effects of FTP  were most strongly negative for the oldest adolescent children . The findings suggest a different theoretical model for movements into employment than the one suggested in the previous literature for job loss . The findings are discussed in terms of their contribution to research and policy This study examined the effectiveness of short-term contingency management for eliminating cocaine use and increasing full day treatment attendance with pregnant methadone-maintained women r and omly assigned to either an escalating voucher incentive schedule  ( n=44 ) or non-incentive  ( n=36 ) conditions . Full day treatment attendance and urine toxicology for cocaine and heroin were assessed and consequated for 14 days . The escalating voucher incentive schedule significantly increased full day treatment attendance and drug abstinence compared to the non-incentive schedule . These results suggest that reinforcing the co-occurrence of two required behaviors ( treatment attendance and abstinence from illicit drug use ) is effective , and may be an important adjunct to methadone pharmacotherapy for treating pregnant drug dependent women Approximately 4,000 preschool black children from low-income families in South Memphis participated for three years in a supplementary food program sponsored by the US Department of Agriculture . Part of this group received additional benefit from food stamps , day-care centers , and an infant-feeding program . We evaluated the effects of this participation in 250 children selected r and omly from the enrollment list of the supplemetary program . Each child was examined for height , weight , head circumference , and levels of hemoglobin , serum iron , and vitamins A and C. The data were then compared with those from a similar survey in the same area conducted three years before . The results of this comparison indicate considerable improvements in height and weight and a reduction in the incidence of anemia and in the numbers of children with low plasma vitamin A levels . In the absence of other recognizable intervening factors , we conclude that federal food assistance programs were primarily responsible for the observed nutritional improvements Objective : To raise immunization coverage among children at risk for underimmunization , we evaluated the effectiveness and cost-effectiveness of immunization activities in the Special Supplemental Program for Women , Infants and Children ( WIC ) . Method : A controlled intervention trial was conducted in seven WIC sites in Chicago between October 1990 and March 1994 . At intervention sites , staff screened children for vaccination status at every visit , referred vaccine-eligible children to either an on-site WIC nurse , on-site clinic , or off-site community provider , and issued either a 3-month supply of food vouchers to up-to- date children or a 1-month supply to children not up-to- date —a usual practice for high-risk WIC children . Our primary measure of effectiveness was the change in the baseline percentage of up-to- date children at the second birthday ; cost-effectiveness was approximated for each of the three referral interventions . Results : After one year , up-to- date vaccination coverage increased 23 % above baseline for intervention groups and decreased 9 % in the control group . After the second year , up-to- date vaccination further increased to 38 % above baseline in intervention groups and did not change in the control group . The total cost per additional up-to- date child ranged from $ 30 for sites referring children off-site to $ 73 for sites referring children on-site to a nurse . Conclusion : This controlled intervention trial of screening , referral , and a voucher incentive in the WIC program demonstrated a substantial increase in immunization coverage at a low cost . Continuing to design linkages between WIC and immunization programs by building on WIC 's access to at-risk population s is worth the investment Inner-city infants ( n = 565 ) enrolled in the WIC program were r and omly assigned at 6 months of age to either of 2 groups : ( 1 ) voucher incentive ( frequency of issuance of food vouchers based on immunization status ) plus reminder-recall ( calls and /or letters to families of under-vaccinated children ) or ( 2 ) voucher incentive alone . At 12 months , both groups ' immunization levels were high and not significantly different : 80 % + /- 4 % versus 79 % + /- 5 % ( P = .749 ) Data from the Minnesota Family Investment  Program and the New Hope demonstration were used to determine whether experimental effects of antipoverty policies differ by parents ' risk for nonemployment . Using propensity score analysis , increases in employment and income were largest in the harder-to-employ halves of both sample s. However , only children in the moderately hard-to-employ quartiles ( 50th to 75th percentile ) consistently showed improvements in school and behavior outcomes . The very-hardest-to-employ 25 % experienced decreases in school engagement , and increases in aggressive behaviors , despite substantial increases in parental employment and income . In this group , increases in maternal depression , reductions in regular family routines , and smaller increases in job stability and center-based child care occurred . These factors may have counteracted the potential benefits of increased income on children Do Conditional Cash Transfers  Improve Child Health ? Evidence from PROGRESA 's Control R and omized Experiment Author(s ) : Paul Gertler Source : The American Economic Review , Vol . 94 , No. 2 , Papers and Proceedings of the One Hundred Sixteenth Annual Meeting of the American Economic Association San Diego , CA , January 3 - 5 , 2004 ( May , 2004 ) , pp . 336 - 341 Published by : American Economic Association Stable URL : http://www.jstor.org/stable/3592906 . Accessed : 13/03/2014 This study examined the age-specific pattern of effects of  welfare policies  on  child achievement .  Drawing from 7 r and om-assignment welfare and antipoverty evaluations that provided more than 30,000 observations of children 's achievement , this study found that times of developmental transition are the only periods sensitive to the changes in families brought about by these policies . More specifically , small positive effects of welfare and antipoverty policies  were found for children making the transition into middle childhood , and small negative effects of these same policies were found for children making the transition out of middle childhood and into early adolescence . Effects were robust across various program groupings and could not be attributed to family characteristics that differ for children of different ages . This research informs the underst and ing of how changes in employment and income for low-income parents  affect development across childhood This prospect i ve longitudinal study , using data from the National Longitudinal Survey of Youth ( NLSY ; N = 614 ) , addresses the gap in the research literature regarding the effects of welfare reform on children . Key questions addressed include whether welfare dynamics and support services relevant to welfare reform , both measured across the first 5 years of life , are associated with mothers ' earnings in the 6th year and three child cognitive outcomes in the 7th and 8th years : Peabody Individual Achievement Test ( PIAT ) math and reading scores , and the Peabody Picture Vocabulary Test ( PPVT ) . Welfare dynamics are represented by total time on welfare , degree of cycling on and off welfare , and degree to which welfare and work are combined . Support services measured include three forms of child care ( relative , babysitter , and center-based ) , as well as three forms of human capital supports ( child support , job training , and education ) . Controlling for a range of background factors and for different patterns of welfare use across the first 5 years , small positive associations with mother 's earnings were found for child support , education , and job training . Small positive associations also were found between child support and both math and reading scores . Finally positive associations of medium effect size were found between center care and both mothers ' earnings and child PPVT scores . Although effect sizes are generally small , the results suggest the potential value of welfare reform approaches that emphasize long-term human capital development . Interactions between welfare dynamics and support services suggest subgroup differences . Specifically , positive effects of support services on earnings are strongest among mothers with higher levels of human capital ( higher levels of work while on welfare , lower total time on welfare ) . Babysitter care appears to have negative effects on both reading and math scores of children whose mothers report low levels of work while on welfare . Implication s for welfare reform policy are discussed The goal of current national and state legislation on welfare reform is to decrease the number of people who are dependent on public assistance  , most of whom are mothers and their young children . M 
    Output:
    
No effect was observed on child health , measures of child mental health or emotional state .
Non-significant effects favouring the intervention group were seen for child cognitive development and educational achievement , and a non-significant effect favouring controls in rates of teenage pregnancy .
However , on the basis of current evidence we can not state unequivocally whether financial benefits delivered as an intervention are effective at improving child health or wellbeing in the short term .
We note particular concerns by some authors that sanctions and conditions ( such as working hours ) placed on families may increase family stress