***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: We report on parent outcomes from a r and omized clinical trial of parent training ( PT ) versus psychoeducation ( PEP ) in 180 children with autism spectrum disorder ( ASD ) and disruptive behavior . We compare the impact of PT and PEP on parent outcomes : Parenting Stress Index ( PSI ) , Parent Sense of Competence ( PSOC ) , and Caregiver Strain Question naire ( CGSQ ) . Mixed-effects linear models evaluated differences at weeks 12 and 24 , controlling for baseline scores . Parents in PT reported greater improvement than PEP on the PSOC ( ES = 0.34 ) , CGSQ ( ES = 0.50 ) , and difficult child subdomain of the PSI ( ES = 0.44 ) . This is the largest trial assessing PT in ASD on parent outcomes . PT  reduces disruptive behavior in children , and improves parental competence while reducing parental stress and parental strain BACKGROUND The quality of parenting a child receives has a major impact on development , wellbeing and future life opportunities . AIMS This study examined the efficacy of Triple P Online - Disability ( TPOL-D ) a telehealth intervention for parents of children with a disability . METHODS Ninety-eight parents and carers of children aged 2 - 12 years diagnosed with a range of developmental , intellectual and physical disabilities were r and omly assigned to either the intervention ( 51 ) or treatment-as-usual ( 47 ) control group . RESULTS At post-intervention parents receiving the TPOL-D intervention demonstrated significant improvements in parenting practice s and parenting self-efficacy , however a significant change in parent-reported child behavioral and emotional problems was not detected . At 3-month follow up intervention gains were maintained and /or enhanced . A significant decrease in parent-reported child behavioral and emotional problems was also detected at this time . CONCLUSIONS The results indicate that TPOL-D is a promising telehealth intervention for a mixed-disability group OBJECTIVES This study evaluated the effectiveness ( changes in health behaviors , health status , and health service utilization ) of a self-management program for chronic disease design ed for use with a heterogeneous group of chronic disease patients . It also explored the differential effectiveness of the intervention for subjects with specific diseases and comorbidities . METHODS The study was a six-month r and omized , controlled trial at community-based sites comparing treatment subjects with wait-list control subjects .  Participants were 952 patients 40 years of age or older with a physician-confirmed diagnosis of heart disease , lung disease , stroke , or arthritis .  Health behaviors , health status , and health service utilization , as determined by mailed , self-administered question naires , were measured . RESULTS Treatment subjects , when compared with control subjects , demonstrated improvements at 6 months in weekly minutes of exercise , frequency of cognitive symptom management , communication with physicians , self-reported health , health distress , fatigue , disability , and social/role activities limitations . They also had fewer hospitalizations and days in the hospital . No differences were found in pain/physical discomfort , shortness of breath , or psychological well-being . CONCLUSIONS An intervention design ed specifically to meet the needs of a heterogeneous group of chronic disease patients , including those with comorbid conditions , was feasible and beneficial beyond usual care in terms of improved health behaviors and health status . It also result ed in fewer hospitalizations and days of hospitalization BACKGROUND AND PURPOSE Systematic review s and meta-analyses often include an evaluation of the method ological quality of the individual studies that have been included , and are usually conducted by at least 2 individuals . The objective of this study was to assess the method ological quality and reliability of a series of r and omized controlled trials ( RCTs ) of both pharmacological and nonpharmacological interventions by use of the 10-item Physiotherapy Evidence -Based Data base ( PEDro ) Scale . METHODS Two abstract ors independently review ed 81 RCTs assessing a variety of interventions . The Cohen kappa statistic and the intraclass correlation coefficient ( ICC ) were used to assess agreement between abstract ors . RESULTS The average total PEDro scores were 5.94 ( SD=1.43 ) for all studies combined , 6.88 ( SD=1.2 ) for pharmacological studies , and 5.29 ( SD=1.26 ) for nonpharmacological studies . The median score for pharmacological studies was significantly higher than that for nonpharmacological studies ( 7 versus 5 ) . Pair-wise kappa scores ranged from a low of .452 for concealed allocation among drug trials to perfect agreement ( 1.00 ) for r and omization and reporting of results from between-group comparisons . The ICCs associated with the cumulative PEDro score were .91 ( 95 % confidence interval [CI]=.83-.94 ) for all studies , .89 ( 95 % CI=.78-.95 ) for pharmacological studies , and .91 ( 95 % CI=.84-.952 ) for nonpharmacological studies . DISCUSSION AND CONCLUSION The method ological quality for pharmacological interventions was significantly higher than that for nonpharmacological interventions . There was good agreement between raters at an individual item level and in total PEDro scores . A lack of reporting clarity , poor organization of the report , or the failure to include salient details contributed to less-than-perfect agreement between raters OBJECTIVE To compare the efficacy of an outreach program for young children with cerebral palsy with center-based and " minimal intervention " control groups . DESIGN R and omized controlled trial conducted in a group of 85 children between the ages of 1.5 and 5 years . Urban children were allocated to a daily center-based mother-child group or to monthly training of their parents along with a pictorial guidance manual .  Rural children were allocated either to parent training or health advice . Outcome measures were changes in children 's adaptive skills , maternal stress and adaptation to the child , satisfaction with social support , and knowledge of h and ling a physically disabled child . RESULTS Fifty-eight children were successfully followed up . The pattern of change in children 's adaptive skills was as predicted ( ie , least progress in the health advice group ) . Positive effects of intervention also included increased maternal knowledge and perceived helpfulness of support from formal sources . However , maternal adaptation increased most in the health advice group with minimal intervention . When children had attended a program at least 4 times , their skills improved , and mothers ' adaptation did increase . CONCLUSIONS Outreach training for mothers in Bangladesh can help them to improve the skills of their young children with cerebral palsy and is perceived as helpful UNLABELLED Despite their popularity , empirical support for health coaches is limited . OBJECTIVE This study examined the feasibility and preliminary efficacy of three types of coaching models for obesity treatment . DESIGN AND METHODS Participants ( N = 44 ) were r and omized to 6 months of reduced intensity group behavioral weight loss ( rBWL ) plus one of three types of health coaches : ( i ) Professional ( rBWL interventionist ) , ( ii ) Peer ( group members r and omly paired and coached one another ) , or ( iii ) Mentor ( successful weight loser ) . Groups met weekly for the first 6 weeks , biweekly for the next 6 weeks , and monthly thereafter , for a total of 12 meetings . During weeks that group did not meet , participants emailed their weight loss information to their coach and received feedback . Coaches were trained on appropriate coaching strategies and feedback delivery . RESULTS Retention was 95 % . Participants emailed their progress to their coach 10.8 ± 1.9 of the 12 weeks that there were no group meetings . Coaches responded with feedback 94 % of the time . Percent weight losses at 6 months were 9.6 ± 8.1 , 9.1 ± 5.0 , and 5.7 ± 5.6 for the Professional , Peer , and Mentor conditions , respectively . More participants in the Professional and Peer conditions lost 10 % of their initial body weight ( Professional : 56 % Peer : 50 % and Mentor : 17 % ) , with a statistically significant difference between the Professional and Mentor conditions ( P = 0.03 ) . CONCLUSION These preliminary data suggest that combining a rBWL program with health coaching may hold significant promise as a cost-effective obesity treatment paradigm . Larger trials are needed to conclusively determine whether adding coaches improves weight loss outcomes in reduced intensity treatments and to examine which type of coach is most effective Objective The purpose of this study was to examine the effectiveness of group psychoeducation to relieve the psychological distress of mothers of children with high-functioning pervasive developmental disorders ( HFPDD ) and to improve the behaviors of the children . Methods Seventy-two mothers of preschool out patients with HFPDD were r and omly assigned to a four-session brief group psychoeducational program ( GP ) . The sessions were held every second week in addition to the usual treatment ( GP + treatment as usual [ TAU ] group ) , or to a TAU-alone group . The primary outcome was self-reported symptoms of maternal mental health as assessed using the 28-item General Health Question naire ( GHQ-28 ) at 21 weeks post-r and omization ( week 21 ) . The GHQ-28 at the end of the intervention ( week 7 ) , Aberrant Behavior Checklist ( ABC ) for the behavior of the children , the Zarit Burden Interview ( ZBI ) , and the Medical Outcomes Study 36-item Short Form Health Survey ( SF-36 ) were carried out at weeks 7 and 21 . We tested the group effects with the interaction between the intervention and the evaluation points . Results The GHQ-28 score at week 21 was significantly higher in the GP + TAU group as compared to that in the TAU-alone group , indicating a greater improvement in the TAU-alone group . There was no evidence that GP + TAU led to a greater improvement of maternal mental health than TAU-alone at week 7 . Similarly , no evidence was obtained to indicate that GP + TAU led to a reduction in the ABC or ZBI scores by week 7 or 21 . The adjusted scores for the RF ( role emotional ) and MH ( mental health ) subscales of the SF-36 at week 21 were also significantly lower in the GP + TAU group , indicating a similar tendency to that of the change of the GHQ-28 score at week 21 . Conclusion The psychoeducational program did not alleviate maternal distress , aberrant behaviors of the children , or caregiver burden Background Children with borderline to mild intellectual disability ( BMI D ) have been shown to be at increased risk for psychosocial problems . The presence of these psychosocial problems leads to parenting stress . Stepping Stones Triple P ( SSTP ) is a parenting support program to support parents with children with BMI D and psychosocial problems . The aim of this study was to evaluate the effectiveness of SSTP compared to Care as Usual ( CAU ) in reducing psychosocial problems in children with BMI D. Method We conducted a r and omized controlled trial in the Northern provinces of the Netherl and s. Parents of children aged 5 to 12 with borderline ( IQ 70 to 85 ) or mild ( IQ 70 to 50 ) ID and psychosocial problems were invited . Psychosocial problems were identified using the Strengths and Difficulties Question naire ( SDQ ) parent report ( ≥14 ) . Measurements were assessed before the intervention ( T0 ) , immediately after the intervention ( T1 ) and after a follow-up of six months ( T2 ) . SSTP takes 8 to 10 individual sessions of 40 - 90 minutes , provided over 10 to 12 weeks . CAU concerned any service , except SSTP . Primary outcomes were the child ’s psychosocial problems ( SDQ parent and teacher forms and the Eyberg Child Behavior Inventory , ECBI ) . Secondary outcomes were parenting stress ( Parenting Stress Index , PSI ) and parenting skills ( Alabama Parenting Question naire , APQ ) . Results In total 209 parents of children aged 5 to 12 with BMI D were allocated blindly to either SSTP ( n = 111 ) or CAU ( n = 98 ) . In the intention to treat analyses , SSTP achieved no significantly better effect than CAU  for the SDQ parent report , the ECBI and the APQ on the short- and long- term . In the short term , SSTP was significantly more effective than CAU  for the SDQ teacher report ( B = -2.25 , 95 % CI -3.79 to -0.71 ) and the PSI ( B = -7.06 , 95 % CI -12.11 to -2.01 ) . For both SDQ teacher report and PSI , there was no statistically significant effect in the long term . Dropout from SSTP was considerable ( 49 % ) , with the effects being solely found in the adherent SSTP subgroup . Conclusions SSTP had some short-term advantages over CAU , but not in the longer term . Trial registration Dutch Trial Register NTR2624 . Registered 26 November AIM This study aim ed to evaluate the efficacy of a parent education program , the Happy Parenting program , for Chinese preschool children with developmental disabilities . METHODS This study adopted r and omized controlled trial design without blinding . Participants were r and omized into intervention group ( n=62 ) who were offered the Happy Parenting program delivered by educational psychologists and trainee educational psychologists , and a control group ( n=57 ) who were offered a parent talk after the intervention group had completed treatment .  Parent participants were requested to complete question naires on their children 's behavior , their parenting stress , and discipline strategies . RESULTS Analysis was by intention-to-treat . The results indicated significant decrease in child problem behaviors , parenting stress and dysfunctional discipline strategies in the intervention group at post-intervention . CONCLUSION This study provided promising evidence on the effectiveness of a parent 
    Output:
    
Overall , there is an insufficient-to-limited level of evidence regarding the effectiveness of these approaches .
The child-targeted health coaching approach is currently most applied .
Parents of children with autism spectrum disorder are the most common recipients