***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: Objective : This study examined the role of demographic characteristics , psychological factors , and family functioning on attendance in a r and omized controlled trial of a family-based pediatric obesity program . Method : Participants included 155 children between the ages of 4 and 7 years ( M age = 5.77 , 57.4 % female , 73.6 % black , M body mass index = 25.5 ) and their primary caregivers who were r and omized to the treatment group . Three groups of participants were created based on their patterns of attendance during the program : ( 1 ) noncompleters , ( 2 ) partial completers , and ( 3 ) completers . Results : Results indicated no differences among the attendance groups in child gender , child body mass index , or child psychological functioning . Significant group differences were found with respect to race/ethnicity , parent marital status , and family income , such that noncompleters were more likely to be racial/ethnic minorities , to living in single parent households , and to have lower incomes than partial completers and completers . After controlling for the effects of these sociodemographic risk factors , noncompleters , and partial completers reported more family dysfunction characterized by high levels of disengagement than completers . Conclusion : Adapting existing weight management programs to include a focus on family engagement in the early stages of treatment may help to improve participation in family-based obesity interventions targeting high risk , socioeconomically disadvantaged youth Background When implemented at scale , the impact on health and health inequalities of public health interventions depends on who receives them in addition to intervention effectiveness . Methods The MEND 7–13 ( Mind , Exercise , Nutrition … Do it ! ) programme is a family-based weight management intervention for childhood overweight and obesity implemented at scale in the community . We compare the characteristics of children referred to the MEND programme ( N=18 289 referred to 1940 programmes ) with those of the population eligible for the intervention , and assess what predicts completion of the intervention . Results Compared to the MEND-eligible population , proportionally more children who started  MEND  were : obese rather than overweight excluding obese ; girls ; Asian ; from families with a lone parent ; living in less favourable socioeconomic circumstances ; and living in urban rather than rural or suburban areas . Having started the programme , children were relatively less likely to complete it if they : reported ‘ abnormal ’ compared to ‘ normal ’ levels of psychological distress ; were boys ; were from lone parent families ; lived in less favourable socioeconomic circumstances ; and had participated in a relatively large MEND programme group ; or where managers had run more programmes . Conclusions The provision and /or uptake of MEND did not appear to compromise and , if anything , promoted participation of those from disadvantaged circumstances and ethnic minority groups . However , this tendency was diminished because programme completion was less likely for those living in less favourable socioeconomic circumstances . Further research should explore how completion rates of this intervention could be improved for particular groups General Practitioners ( GPs ) have an important role to play in recognition of and intervention against childhood obesity in Irel and . Data were collected prospect ively on a cohort of children aged 4 - 14 and their parents ( n = 101 pairs ) who attended consecutively to a semi-rural group general practice . Parents estimated their child 's weight status . Actual weight status was determined for both parent and child using the United States Centres ' for Disease Control 's BMI -for-age references . 15 ( 14.9 % ) of the children and 49 ( 51.6 % ) of the parents were overweight or obese . While 71 ( 95.5 % ) of normal weight status children were correctly identified , parents showed poor concordance in identifying their children as overweight 2 ( 18.2 % ) or obese 0 ( 0 % ) . BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified . With parents failing to recognise childhood obesity , GPs have a responsibility in tackling this problem at a family level BACKGROUND The primary care setting offers the opportunity to reach children and parents to encourage healthy lifestyle behaviours , and improve weight status among children . OBJECTIVE Test the feasibility of Helping H AND ( Healthy Activity and Nutrition Directions ) , an obesity intervention for 5- to 8-year-old children in primary care clinics . METHODS A r and omized controlled pilot study of Helping H AND , a 6-month intervention , targeted children with body mass index 85 - 99%tile and their parents . Intervention group attended monthly sessions and self-selected child behaviours and parenting practice s to change . Control group received regular paediatric care and was wait-listed for Helping H AND . Session completion , participant satisfaction , child anthropometrics , dietary intake , physical activity , TV viewing and behaviour-specific parenting practice s were measured pre and post intervention . RESULTS Forty parent-child dyads enrolled : 82.5 % were Hispanic , 80 % had a girl and 65 % reported income ≤ $ 30 , 000/year . There was 20 % attrition from Helping H AND ( attended < 4/6 sessions ) . Families self-selected 4.35 ( SD 1.75 ) behaviours to target during the 6-month programme and each of the seven behaviours was selected by 45 - 80 % of the families . There were no between group differences in the child 's body mass index z-score , dietary intake or physical activity post intervention . Intervention group viewed 14.9 ( SE 2.3 ) h/week of TV post intervention versus control group 23.3 ( SE 2.4 ) h/week ( P < 0.05 ) . CONCLUSION Helping H AND is feasible , due to low attrition , good programme attendance , and clinical ly relevant improvements in some child and parenting behaviours OBJECTIVE To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children . DESIGN Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme . SETTING New Zeal and . SUBJECTS Forty-two parents/ primary caregivers of obese children who were r and omised in the intervention weight-management programme .  RESULTS Programmatic factors that enhanced retention included : simultaneous delivery to both children and parents as participants ; delivery of the programme in small group setting s at local community venues ; enabling trustworthy and accountable relationships ; providing re sources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals ; and day and time scheduling . Suggested programme improvements included having ethnic-specific Isl and - language delivery and practical sessions like cooking classes and shopping expeditions at local food stores . The research found that unpredictable external life crises like extended family deaths , a change in job shift , family illnesses ( both acute and those requiring chronic management ) and long-term family visitations affected participation and momentum . A loss of momentum through managing life crises was often difficult to overcome for participants , leading them to drop out of the weight-management programme . Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time . CONCLUSIONS In order for weight-management programmes to be effective , participants must be able to complete them . Identifying factors that predict participation and attrition may serve as a basis for programme improvement OBJECTIVE The purpose of the current study is to describe the development , implementation , and success of recruitment and adherence strategies  of 303 African American preadolescent girls and their primary caregiver in the Girls health Enrichment Multi-site Studies ( GEMS ) program .  METHODS A socio-ecologic model was used to guide selection and implementation of recruitment and retention strategies which were continuously monitored and revised in response . Strategy mode and frequency associated with program enrollment , engagement , and retention were analyzed . RESULTS Successful recruitment approaches included radio messages ( 23.1 % ) , school fliers ( 20.1 % ) , and friend referral ( 15 % ) . Initially 463 potential participants responded , 320 girls were screened , and 303 enrolled . Significant increases in participant accrual were observed between Wave 4 ( n=28 ) and Wave 5 ( n=91 ) after using a team recruitment approach . Implementing case management strategies and providing make-up sessions also served to keep participants current and engaged in the program . In year 2 , community field trips replaced the more structured sessions providing participants with experiential learning opportunities . Overall intervention attendance rates ranged from 79.7 % to 90.5 % among waves . Further , 75.9 % and 80.2 % , respectively , of participants attended 1-year and 2-year follow-ups . CONCLUSION Multiple recruitment strategies and flexible , responsive approaches to recruitment and retention guided by the socio-ecologic model facilitated optimal implementation of an intervention for preadolescent girls . Through the application of the socio-ecologic model research ers and program leaders will be able to identify strategies to enhance the probability of successful outcomes 
    Output:
    
Results suggest that parents provided the impetus for programme initiation , and this was driven largely by a concern for their child 's psychological health and wellbeing .
More often than not , children went along without any real reason or interest in attending .
Over the course of the programme , however , children 's positive social experiences such as having fun and making friends fostered the desire to continue .