***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 : To develop a short instrument , called DISCERN , which will enable patients and information providers to judge the quality of written information about treatment choices . DISCERN will also facilitate the production of new , high quality , evidence -based consumer health information . DESIGN : An expert panel , representing a range of expertise in consumer health information , generated criteria from a r and om sample of information for three medical conditions with varying degrees of evidence : myocardial infa rct ion , endometriosis , and chronic fatigue syndrome . A graft instrument , based on this analysis , was tested by the panel on a r and om sample of new material for the same three conditions . The panel re-drafted the instrument to take account of the results of the test . The DISCERN instrument was finally tested by a national sample of 15 information providers and 13 self help group members on a r and om sample of leaflets from 19 major national self help organisations . Participants also completed an 8 item question naire concerning the face and content validity of the instrument . RESULTS : Chance corrected agreement ( weighted kappa ) for the overall quality rating was kappa = 0.53 ( 95 % CI kappa = 0.48 to kappa = 0.59 ) among the expert panel , kappa = 0.40 ( 95 % CI kappa = 0.36 to kappa = 0.43 ) among information providers , and kappa = 0.23 ( 95 % CI kappa = 0.19 to kappa = 0.27 ) among self help group members . Higher agreement levels were associated with experience of using the instrument and with professional knowledge of consumer health information . Levels of agreement varied across individual items on the instrument , reflecting the need for subjectivity in rating certain criteria . The trends in levels of agreement were similar among all groups . The final instrument consisted of 15 questions plus an overall quality rating . Responses to the question naire after the final testing revealed the instrument to have good face and content validity and to be generally applicable . CONCLUSIONS : DISCERN is a reliable and valid instrument for judging the quality of written consumer health information . While some subjectivity is required for rating certain criteria , the findings demonstrate that the instrument can be applied by experienced users and providers of health information to discriminate between publications of high and low quality . The instrument will also be of benefit to patients , though its use will be improved by training Families of 54 behaviorally disturbed preschool-aged children ( 3 to 5 years ) were r and omly assigned to 1 of 3 treatment conditions : st and ard parent-child interaction therapy ( PCIT ; STD ) ; modified PCIT that used didactic videotapes , telephone consultations , and face-to-face sessions to abbreviate treatment ; and a no-treatment waitlist control group ( WL ) .  Twenty-one nondisturbed preschoolers were recruited as a social validation comparison condition . Posttreatment assessment indicated significant differences in parent-reported externalizing behavior in children , and parental stress and discipline practice s from both treatment groups on most measures compared with the WL group . Clinical significance testing suggested a superior effect for the STD immediately after intervention , but by 6-month follow-up , the two groups were comparable . The findings indicate that abbreviated PCIT may be of benefit for families with young conduct problem children The effectiveness of an advice package design ed to restructure the restaurant environment and encourage parent praise was examined . Experiment 1 assessed the usefulness of the package when used with experimenter assistance . Videotapes were used to record the target child 's behavior . Pre-meal inappropriate behavior decreased an average of 51 % across target children . Mealtime inappropriate behavior and parent praise and disapproval were also measured . Experiment 2 was design ed to determine whether families could implement the package without experimenter assistance and whether effects obtained would generalize to a different restaurant . Data were taken in vivo . Nine families were r and omly assigned to one of three groups . Group assignment determined the order in which families went to two restaurants , the number of dinners each family participated in , and the point at which parents received the advice package . The order in which the families went to the two restaurants as well as the number of baseline meals was counterbalanced . Results of Experiment 2 showed that , when using the advice package , parents in all sequences were able to decrease pre-meal inappropriate behavior of their children , and that these effects generalized to a second restaurant Parents of 114 conduct-problem children , aged 3 - 8 years , were r and omly assigned to one of four groups : an individually administered videotape modeling treatment ( IVM ) , a group discussion videotape modeling treatment ( GDVM ) . a group discussion treatment ( GD ) , and a waiting-list control group . Compared ~4th the control group , all three treatment groups of mothers reported significantly fewer child behavior problems , more prosocial behaviors , and less spanking . Fathers in the GDVM and IVM conditions and teachers of children whose parents were in the GDVM and GD conditions also reported significant reductions in behavior problems compared ~4th control subjects . Home visit data indicated that all treatment groups of mothers , fathers , and children exhibited significant behavioral changes . There were relatively few differences between treatment groups on most outcome measures , although the differences found consistently favored the GDVM treatment . However , cost effectiveness was the major advantage of the IVM treatment Department of Parent and Child NursingUniversity of WashingtonClinic mothers of 35 conduct-disordered children were r and omly assigned to awaiting list  control group  , 9 weeks of individual therapy , or 9 weeks of therapist-led group therapy based on a st and ardized videotape modeling program .  Mothers and their children were assessed at baseline , immediately after treatment , and 1year later by home visits , twice-per-week telephone reports , and question naires . One month after treatment , both groups of treated mothers showed significantattitudinal and behavioral improvements compared with untreated controls . Ad-ditionally , the children in the two treatment groups showed reductions in childnoncompliance compared with control children . At the 1-year follow-up , not onlywere most of the changes in mothers ' behaviors maintained , but both treatmentgroups of children continued to show significant reductions in noncompliant and deviant behaviors . There were no significant differences on any of the attitudinalor behavioral measures between individual and videotape modeling group discussion therapies at the immediate or 1-year follow-up . Total therapist time was approx-imately 251 hr for the entire individual group and 48 hr for the entire videotape discussion group . Although both treatments seem to offer equivalent and sustainedimprovements for parents and conduct-disordered children , the therapeutic efficiencyof the videotape modeling group format is more cost-effective . In response to the large numbers of childrenwith conduct disorders and the shortage ofprofessional personnel , there has been an in-creasing emphasis on training parents as ther-apists for their own children . Several excellent review s ( Berkowitz & Graziano , 1972 ; Gra-ziano , 1977 ; Johnson KMorel and , Schwebel , Beck , & Wells , 1982 ; Pawlicki Regular night waking of young children is one of the most common problems encountered by parents . This study compared a st and ardized night waking programme that involved organized bedtime routines , procedures for settling the child and for the h and ling of crying , calling out and getting out of bed , with a group which received written information only and a waiting list control group . The children receiving the st and ard programme and those receiving written information only showed significant improvement over children in the waiting list group . This result supports the use of written parent instructions with or without therapist support The effectiveness of bibliotherapy as an adjunct to stimulant medication in the treatment of children with attention-deficit hyperactivity disorder was investigated . Subjects were r and omly assigned to the experimental group , or the control group . Parents in the experimental group received a written protocol ( bibliotherapy ) outlining behavioral techniques for managing oppositional child behavior . Results indicated significant differences favoring the experimental group on st and ardized measures of the intensity of behavior problems in the home , parental knowledge of behavioral principles , and teacher ratings of behavior . This bibliotherapy approach appears to offer an inexpensive adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder when individual or group behavior management training is not feasible Background : Settling and night waking problems are particularly prevalent , persistent , and generally considered difficult to treat in children with a learning disability , although intervention trials are few . Scarce re sources , however , limit access to proven behavioural treatments . Aims : To investigate the efficacy of a media based brief behavioural treatment of sleep problems in such children by comparing ( 1 ) face-to-face delivered treatment versus control and ( 2 ) booklet delivered treatment versus controls . Methods : The parents of 66 severely learning disabled children aged 2–8 years with settling and /or night waking problems took part in a r and omised controlled trial with a wait-list control group . Behavioural treatments were presented either conventionally face-to-face or by means of a 14 page easy to read illustrated booklet . A composite sleep disturbance score was derived from sleep diaries kept by parents . Results : Both forms of treatment were almost equally effective compared with controls . Two thirds of children who were taking over 30 minutes to settle five or more times per week and waking at night for over 30 minutes four or more times per week improved on average to having such settling or night waking problems for only a few minutes or only once or twice per week ( H = 34.174 , df = 2 , p<0.001 ) . These improvements were maintained after six months . Conclusions : Booklet delivered behavioural treatments  for sleep problems were as effective as face-to-face treatment for most children in this population A preventive mental health intervention was tested with low income parent-child dyads . Parents who were having a problem with the behavior of their preschool child were recruited ; 89 parents , of 96 children , completed pre- and postintervention assessment s. Families were r and omly assigned to a " minimal treatment " control group or a more extensive treatment experimental group . Parent training was supervised by the authors and delivered by paraprofessionals using st and ard treatment manuals . The more extensive intervention produced significantly more improvement in parents ' ratings of children 's symptoms of attention deficit and internalizing symptoms than did the control intervention . A blind measure of videotaped interaction between parent and child also demonstrated significantly more improvement from the experimental intervention . Both groups improved with respect to parents ' ratings of children 's oppositional symptoms . Change in parent ratings of children 's behavior was correlated with change in blind observers ' ratings in parents ' behavior The Montréal Longitudinal Study of Disruptive Boys , an experimental study , was design ed to underst and boys who were considered disruptive in kindergarten . One part of the study involved assessing effects of a preventive treatment program carried out during the boys ' early years in primary school . This paper reports on the outcome of the r and omized treatment experiment 3 years after treatments ended . Disruptive boys were r and omly allocated to a treated group and two nontreated groups . Treatment consisted of parent training and training of boys for social skills , fantasy play and television viewing .  Results suggest that the treatment program had some positive effects . Some of the improvements were not evident immediately after treatment ended The study tested alternative intervention strategies to reduce escalation in problem behaviors among high-risk young adolescents ( 11 to 14 years old ) . A total of 158 families with young adolescents ( male and female ) participated in this study . Of these , 119 families were r and omly assigned to 1 of the following intervention conditions : ( a ) parent focus , ( b ) teen focus , ( c ) parent and teen focus , ( d ) self-directed change ( material s only ) . In addition , 39 families of young adolescents were recruited as a quasi-experimental control . Parent focus and teen focus interventions result ed in immediate beneficial effects in observed and reported family conflict . The parent intervention conditions showed immediate beneficial effects on behavior problems at school . Longitudinal trends suggest that the parent focus condition may reduce subsequent tobacco use , compared with all other approaches . Interventions that aggregated high-risk youths into groups , however , showed the highest escalations in tobacco use and problem behavior at school , beginning at termination and persisting to follow-up . These findings are discussed with respect to the need to re-evaluate strategies that aggregate high-risk youths into intervention programs and focus more on strategies to engage parents in prevention This study examines the specific effects of adding a broader based , videotape treatment component ( ADVANCE ) to a basic videotape parent skills training program ( GDVM ) . ADVANCE treatment trains parents to cope with interpersonal distress through improved communication , problem solving , and self-control skills . Seventy-eight families with a child diagnosed as oppositional-defiant or conduct-disordered were r and omly assigned to either GDVM alone or GDVM plus ADVANCE . Parent reports of child adjustment and parent distress , assessment of child 's knowledge of social skills , as well as independent observations of mother- and father-child interactions and communication and of problem solving between parents were obtained at pre- and post-GDVM and at post-ADVANCE . Both groups significantly improved at short-term follow-up . ADVANCE produced additional significant improvements in parents ' communication , problem-solving skills , and consumer satisfaction , as well as children 's increased knowledge of prosocial solutions . The clinical significance of these findings is discussed This paper examines the impact of a 12-episode television series , " Families " , on  disruptive child behavior and family adjustment .  This media intervention comprises the first of a five-level early intervention parenting and family support strategy , known as Triple P ( Positive Parenting Program ) . Fifty-six parents of children aged between 2 and 8 years were r and omly assigned to either watching the television series or to a waitlist control group . Compared to the control group , parents in the television viewing ( TV ) condition reported significantly lower levels of disruptive child behavior and higher levels of perceived parenting competence , immediately following intervention . Prior to intervention approximately 42.9 % of the children in the TV condition were in the clinical ly elevated range for disruptive child behavioral problems . This had reduced to 14.3 % following intervention . In addition , a high level of consumer acceptability was reported by parents in the TV condition . All post-intervention effects were maintained at 6-month follow-up . Implication s for public health approaches to family mental health are discussed BACKGROUND The treatment of 
    Output:
    
Media-based interventions may , in some cases , be enough to make clinical ly significant changes in a child 's behaviour , and may reduce the amount of time primary care workers have to devote to each case .
They can also be used as the first stage of a stepped care approach .
Consequently this would increase the number of families who could possibly benefit from these types of intervention , releasing clinician time that can be reallocated to more complex cases .
Media-based therapies would therefore appear to have both clinical and economic implication s as regards the treatment of children with behavioural problems