***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: In Mexico , the potential impact on child malnutrition from a nutritional supplement ( papilla ) delivered through a conditional transfer program ( Oportunidades ) was attenuated by problems of household utilization . A behavioral change through communication intervention was developed to improve supplement utilization . Our study assessed the efficacy of this intervention through the results of a r and omized trial . In 2 states ( Veracruz and Chiapas ) 2 clusters of communities were r and omly assigned to intervention or control groups . Data were obtained from 176 - 198 mothers in intervention and control communities using a survey question naire at preintervention baseline and at a 5-mo follow-up . Concordance between reported and observed behaviors was examined through an observational sub study . The 4 behavioral recommendations were : 1 ) prepare papilla as a pap ; 2 ) administer the preparation every day ; 3 ) administer it between breakfast and dinner ; and 4 ) administer it only to target children . The intervention result ed in a significant increase ( P<0.05 ) in the prevalence of reported correct behaviors in the intervention group compared with the control for 3 of the behaviors : a mean increase of 42.5 % for preparing papilla as pap , 64.4 % for daily administration , and 61.5 % for giving papilla between breakfast and dinner . Administering to a target child increased significantly in Veracruz ( from 51.5 % to 90.6 % ) , but not in Chiapas ( 20.6 % to 33.3 % ) . Reported behaviors agreed with observed behaviors in the sub study . With the exception of the target-child administration in Chiapas , adopting the recommendations was culturally acceptable and feasible . The results indicate that improvements in household utilization of the supplement can be achieved with a communication intervention that is potentially feasible for implementation on a large scale within the Oportunidades Program Background In 2011 , Cameroon and its health partners distributed over eight million free long-lasting insecticide treated nets ( LLINs ) in an effort to reduce the significant morbidity and mortality burden of malaria in the country . A national communications campaign was launched in July 2011 to ensure that as the nets were delivered , they would be used consistently to close a net use gap : only 51.6 % of adults and 63.4 % of their children in households with at least one net were sleeping under nets before the distribution . Even in households with at least one net for every two people , over 35 % of adults were not sleeping under a net . Malaria No More ( MNM ) adapted its signature NightWatch communications programme to fit within the coordinated “ KO Palu ” ( Knock Out Malaria ) national campaign . This study evaluates the impact of KO Palu NightWatch activities ( that is , the subset of KO Palu-br and ed communications that were funded by MNM ’s NightWatch program ) on bed net use . Methods Using national survey data collected at baseline ( in March/April 2011 , before the national LLIN distribution and KO Palu NightWatch launch ) and post-intervention ( March/April 2012 ) , this study evaluates the impact of exposure to KO Palu NightWatch activities on last-night net use by Cameroonian adults and their children under five . First , a plausible case for causality was established by comparing net use in 2011 and 2012 and measuring exposure to KO Palu NightWatch ; next , a propensity score matching ( PSM ) model was used to estimate the impact of exposure on net use by simulating a r and omized control trial ; finally , the model was tested for sensitivity to unmeasured factors . Results The PSM model estimated that among Cameroonians with at least one net in their household , exposure to KO Palu NightWatch activities was associated with a 6.6 percentage point increase in last-night net use among respondents ( 65.7 % vs 59.1 % , p < 0.05 ) and a 12.0 percentage point increase in last-night net use among respondents ’ children under five ( 79.6 % vs 67.6 % , p < 0.025 ) . Sensitivity analysis suggests only a very small risk of bias from omitted factors influencing exposure and net use . Conclusions Extrapolating the results of the PSM model to the population of Cameroonians with access to at least one mosquito net , this analysis estimates that approximately 298,000 adults and over 221,000 of their children under five slept under a bed net because of the knowledge , motivation , and /or timely reminder provided by KO Palu NightWatch activities . The programme cost less than $ 0.16 per adult reached , and less than $ 1.62 per additional person protected by a net . The results suggest a strong role for mass media communication interventions in support of investments in malaria control commodities such as LLINs In this article we examine the cost-effectiveness of the Smiling Sun multichannel media campaign , which was undertaken in Bangladesh from 2001 to 2003 and involved a nationally broadcast television serial drama supported by radio , television , newspaper , and billboard advertisements and local promotion activities . The goal was to encourage the use of a package of family health services at NGO ( nongovernmental organization ) Service Delivery Program ( NSDP ) providers . This analysis relates the costs of the Smiling Sun campaign at the national and local level to measures of change in the use of health services , namely , antenatal care and childhood immunizations . Effectiveness is measured using data from cross-sectional surveys conducted in 2001 and 2003 in NSDP catchment areas in rural Bangladesh . The statistical approach , bivariate probit estimation , controls for nonr and om exposure to the program 's media messages , advertisements , and signs . Using national-level data , we find that the Smiling Sun campaign was both effective and cost-effective , inducing higher levels of service utilization for only $ 0.05 per additional antenatal care ( ANC ) user and only $ 0.30 and $ 0.36 for each additional child vaccinated for measles and DPT3 , respectively . With respect to local promotion activities , the cost per attributable behavior change was considerably higher — nearly $ 8 per new ANC user , $ 37 per new DPT3 vaccination , and $ 32 per new measles vaccination Evaluations of national  family planning communication campaigns are often complicated by nonr and omized research design s and self-reported measures of exposure to media messages , both of which can bias estimates of campaign effectiveness if suitable analytical methods are not employed . This study uses three methods to address these problems : ( 1 ) single-equation multiple regression analysis ; ( 2 ) propensity score matching ( PSM ) ; and ( 3 ) maximum-likelihood simultaneous equation models ( SEM ) , namely bivariate probit . We use these methods to evaluate the impact of  family planning health-communication campaigns  on the use of modern family planning methods , focusing primarily on the radio drama Zinduka ! in Tanzania and Ghanti Heri Haad Nilaun in Nepal . We find that these methods led to substantially different estimates of the magnitude of the impact of these communication campaigns . Specifically , we found that self-reported exposure to each radio program was exogenously related to family planning use and that PSM and multiple regression analysis gave similar estimates in those situations . An indicator of exposure to any type of family planning message was found to be endogenous , in which case bivariate probit and PSM gave different estimates of program impact . Research ers should , therefore , pay close attention to the results of tests for endogeneity and identification that guide the appropriate use of the different methods Cost-effectiveness analysis is based on a simple formula . A dollar estimate of the total cost to conduct a program is divided by the number of people estimated to have been affected by it in terms of some intended outcome . The direct , total costs of most communication campaigns are usually available . Estimating the amount of effect that can be attributed to the communication alone , however is problematical in full-coverage , mass media campaigns where the r and omized control group design is not feasible . Single-equation , multiple regression analysis controls for confounding variables but does not adequately address the issue of causal attribution . In this article , multivariate causal attribution ( MCA ) methods are applied to data from a sample survey of 1,516 married women in the Philippines to obtain a valid measure of the number of new adopters of modern contraceptives that can be causally attributed to a national mass media campaign and to calculate its cost-effectiveness . The MCA analysis uses structural equation modeling to test the causal pathways and to test for endogeneity , biprobit analysis to test for direct effects of the campaign and endogeneity , and propensity score matching to create a statistically equivalent , matched control group that approximates the results that would have been obtained from a r and omized control group design . The MCA results support the conclusion that the observed , 6.4 percentage point increase in modern contraceptive use can be attributed to the national mass media campaign and to its indirect effects on attitudes toward contraceptives . This net increase represented 348,695 new adopters in the population of married women at a cost of U.S. $ 1.57 per new adopter OBJECTIVE To study the impact of an intensive IEC campaign regarding the Revised National Tuberculosis Control Programme launched by the Government of Delhi on awareness generation among the general population and improvement in self-reporting by symptomatic cases in Delhi , India . DESIGN Cross-sectional study . RESULTS A pilot study wherein 1008 persons selected by systematic r and om sampling from the general population and 1012 patients selected from symptomatic cases reporting to DOTS centres were interviewed . Among the general population , 716 ( 71.0 % ) had been exposed to one or more IEC message through the media . The core message regarding symptoms , diagnosis , treatment centre and free treatment was recalled correctly by 144 ( 14.3 % ) , 449 ( 44.5 % ) , 659 ( 65.4 % ) and 900 ( 89.2 % ) , respectively . In the post IEC period , a significant increase ( P < 0.01 ) was seen in individuals self-reporting with symptoms to DOTS centres : the media message reportedly encouraged 36.3 % of these to self-report . Prior to the IEC campaign only 49 ( 9.8 % ) patients had chosen a DOTS centre as first source of treatment , which increased significantly ( P < 0.0001 ) to 104 ( 20.4 % ) post IEC . CONCLUSION The IEC campaign launched by the Government of Delhi has been effective in raising awareness and improving self-reporting , but it requires intensification with suitable modification to reach all sectors Objective The study aim was to assess the effects of a multi-component communication campaign that promoted contraceptive use in Burkina Faso . Methods This was a cross-sectional survey conducted in 2001 involving 1421 women of reproductive age from Ouagadougou and Bobo-Dioulasso . Participants during the 2001 survey were r and omly selected from 54 enumeration areas that were covered during the 1999 Demographic and Health Survey . The propensity score matching ( PSM ) technique was the analytical method used to assess the effects of the campaign . Results More than three-quarters of the respondents reported exposure to at least one example of campaign material . Compared with no exposure , high campaign exposure is associated with an adjusted increase of 21.8 percentage points in the proportion of women currently using modern contraceptive methods . Similarly , low exposure is associated with a 7.3 percentage point increase over no exposure . The campaign is also associated with increased knowledge about contraceptives and more favourable attitudes towards family planning . Conclusions The multiple-component nature of the campaign makes it easy for many members of the target audience to hear consistent messages from a variety of sources . This is a key element responsible for the documented effectiveness of the campaign . Despite its limitations , the PSM technique is a straightforward method that should be used more often to assess the effects of communication programmes Scalable interventions are needed to improve infant and young child feeding ( IYCF ) . We evaluated whether an IYCF nutrition communication strategy using radio and nurses changed beliefs , attitudes , social norms , intentions , and behaviors related to breastfeeding ( BF ) , dietary diversity , and food consistency .  Women with children 6 - 24 mo were r and omly selected from 6 semi-urban , low-income communities in the Mexican state of Morelos ( intervention , n = 266 ) and from 3 comparable communities in Puebla ( control , n = 201 ) .  Nurses delivered only once 5 scripted messages : BF , food consistency , flesh-food and vegetable consumption , and feed again if food was rejected ; these same messages aired 7 times each day on 3 radio stations for 21 d. The control communities were not exposed to scripted messages via nurse and radio . We used a pre-/post-test design to evaluate changes in beliefs , attitudes , norms , and intentions as well as change in behavior with 7-d food frequency questions . Mixed models were used to examine intervention-control differences in pre-/post changes . Coverage was 87 % for the nurse component and 34 % for radio . Beliefs , attitudes , and intention , but not social norms , about IYCF significantly improved in the intervention communities compared with control . Significant pre-/post changes in the intervention communities compared with control were reported for BF frequency ( 3.7 ± 0.6 times/d ) , and consumption of vegetables ( 0.6 ± 0.2 d ) and beef ( 0.2 ± 0.1 d ) and thicker consistency of chicken ( 0.6 ± 0.2 d ) and vegetable broths ( 0.8 ± 0.4 d ) . This study provides evidence that a targeted communication strategy using a scalable model significantly improves IYCF In just a few years , oral rehydration therapy ( ORT ) has become the st and ard treatment to reduce infant diarrhoeal disease mortality in the developing world . The paper describes an ORT intervention campaign in a rural area in Western Kenya ( Kakamega District ) . After about a year of careful preparation , the campaign was launched in January 1986 and compared the use of a value-added product ( flavoured sachets ) sold through private outlets in 
    Output:
    
The moderate and stronger evaluations provide evidence that mass media-centric campaigns can positively impact a wide range of child survival health behaviors