***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 long-term effect of two parent training programs for conduct problem preschoolers is reported . Families of 54 behaviorally disturbed preschool-aged children were r and omly assigned to 1 of 3 treatment conditions : st and ard Parent – Child Interaction Therapy ( STD ) , an abbreviated form of PCIT ( ABB ) , and a no-treatment waitlist control group ( WL ) . Of the families who completed treatment ( STD and ABB ) , data were collected on 97 % and 94 % of families at 1- and 2-year follow-up , respectively . Follow-up assessment of parent report and independent observations indicated that treatment gains were largely maintained for both treatment conditions with little difference between the two treatments . The findings suggest that an abbreviated form of PCIT has long-term benefits for families with young children displaying early conduct problems Objective To present the design , methods , and rationale of the Child/Adolescent Anxiety Multimodal Study ( CAMS ) , a recently completed federally-funded , multi-site , r and omized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy ( CBT ) , sertraline ( SRT ) , and their combination ( COMB ) against pill placebo ( PBO ) for the treatment of separation anxiety disorder ( SAD ) , generalized anxiety disorder ( GAD ) and social phobia ( SoP ) in children and adolescents . Methods Following a brief review of the acute outcomes of the CAMS trial , as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders , the design and methods of the CAMS trial are described . Results CAMS was a six-year , six-site , r and omized controlled trial . Four hundred eighty-eight ( N = 488 ) children and adolescents ( ages 7 - 17 years ) with DSM-IV-TR diagnoses of SAD , GAD , or SoP were r and omly assigned to one of four treatment conditions : CBT , SRT , COMB , or PBO . Assessment s of anxiety symptoms , safety , and functional outcomes , as well as putative mediators and moderators of treatment response were completed in a multi-measure , multi-informant fashion . Manual-based therapies , trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity . A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial , study protocol s and quality assurance . Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls . CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidence d-based psychosocial ( CBT ) and pharmacologic ( SSRI ) treatments to date for the most commonly occurring pediatric anxiety disorders . Primary and secondary results of CAMS will hold important implication s for informing practice -relevant decisions regarding the initial treatment of youth with anxiety disorders . Trial registration Clinical Trials.gov NCT00052078 BACKGROUND Despite a wealth of evidence showing that behavioural family intervention is an effective intervention for parents of children with behavioural and emotional problems , little attention has been given to the relationship between parents functioning at work and their capacity to manage parenting and other home responsibilities . This study evaluated the effects of a group version of the Triple-P Positive Parenting Program ( WPTP ) design ed specifically for delivery in the workplace . METHOD Participants were 42 general and academic staff from a major metropolitan university who were reporting difficulties managing home and work responsibilities and behavioural difficulties with their children . Participants were r and omly assigned to WPTP , or to a waitlist control ( WL ) condition . RESULTS Following intervention , parents in WPTP reported significantly lower levels of disruptive child behaviour , dysfunctional parenting practice s , and higher levels of parental self-efficacy in managing both home and work responsibilities , than parents in the WL condition . These short-term improvements were maintained at 4-months follow-up . There were also additional improvements in reported levels of work stress and parental distress at follow-up in the WPTP group compared to post-intervention . CONCLUSIONS Implication s for the development of ' family-friendly ' work environments and the prevention of child behaviour problems are discussed BACKGROUND There is a pressing need for cost-effective population -based interventions to tackle early-onset antisocial behaviour . As this is determined by many factors , it would seem logical to devise interventions that address several influences while using an efficient means of delivery . The aim of this trial was to change four risk factors that predict poor outcome : ineffective parenting , conduct problems , attention deficit/hyperactivity disorder ( ADHD ) symptoms , and low reading ability . METHODS A r and omised controlled trial was carried out in eight schools in London , Engl and . Nine hundred and thirty-six ( 936 ) 6-year-old children were screened for antisocial behaviour , then parents of 112 high scorers were r and omised to parenting groups held in schools or control ; 109 were followed up a year later . The intervention lasted 28 weeks and was novel as it had components to address both child behaviour ( through the Incredible Years programme ) and child literacy ( through a new ' SPOKES ' programme to help parents read with their children ) . Fidelity of implementation was emphasised by careful training of therapists and weekly supervision . Controls received an information helpline . Assessment of conduct problems was by parent interview , parenting by direct observation and child reading by psychometric testing . RESULTS At follow-up parents allocated to the intervention used play , praise and rewards , and time out more often than controls , and harsh discipline less ; effect sizes ranged from .31 to .59 sd ( p-values .046 to .005 ) . Compared to control children , whose behaviour did n't change , intervention children 's conduct problems reduced by .52sd , ( p < .001 ) , dropping from the 80th to the 61st percentile ; oppositional-defiant disorder ( ODD ) halved from 60 % to 31 % ( p = .003 ) . ADHD symptoms reduced by .44sd ( p = .002 ) , and reading age improved by six months ( .36sd , p = .027 ) . Teacher-rated behaviour did n't change . The programme cost pound2,380 ( $ 3,800 ) per child . CONCLUSIONS Effective population -based early intervention to improve the functioning of with antisocial behaviour is practically feasible by targeting multiple risk factors and emphasising implementation fidelity OBJECTIVE A community-based r and omized controlled trial ( RCT ) was conducted in urban areas characterized by high levels of disadvantage to test the effectiveness of the Incredible Years BASIC parent training program ( IYBP ) for children with behavioral problems . Potential moderators of intervention effects on child behavioral outcomes were also explored . METHOD Families were included if the child ( aged 32 - 88 months ) scored above a clinical cutoff on the Eyberg Child Behavior Inventory ( ECBI ) . Participants ( n = 149 ) were r and omly allocated on a 2:1 ratio to an intervention group ( n = 103 ) or a waiting-list control group ( n = 46 ) . Child behavior , parenting skills , and parent well-being were assessed at baseline and 6 months later using parent-report and independent observations . An intention-to-treat analysis of covariance was used to examine postintervention differences between groups . RESULTS Statistically significant differences in child disordered behavior favored the intervention group on the ECBI Intensity ( effect size = 0.7 , p < .001 ) and Problem subscales ( effect size = 0.75 , p < .001 ) . Intervention effects on child hyperactive-inattentive behaviors and social competence , as well as parent competencies and well-being , were also found . Moderator analyses showed that the effects of the IYBP intervention on the primary child outcomes were not moderated by child or family demographic characteristics or risk factors . CONCLUSION The results demonstrate the effectiveness of the IYBP in alleviating problem behavior among children and in improving well-being among families living in disadvantaged areas . The findings also highlight the importance of parental intervention in early childhood for parents and children most in need of support Objective To investigate the cost effectiveness of a parenting programme . Design An incremental cost effectiveness analysis alongside a pragmatic r and omised controlled trial of the effectiveness of a group parenting programme delivered through Sure Start in the community . Setting Sure Start areas in north and mid Wales . Participants Parents of 116 children aged 36 - 59 months ( 87 % of the clinical sample ) at risk of developing conduct disorders defined by scoring over the clinical cut off on the Eyberg child behaviour inventory ) . Children were identified by health visitors and recruited by the research team . Intervention The Webster-Stratton Incredible Years basic parenting programme or a six month waiting list control . Main outcome measure Incremental cost per unit of improvement on the intensity score of the Eyberg child behaviour inventory . Results The bootstrapped incremental cost effectiveness ratio point estimate was � 73 ( € 109 , $ 142 ) per one point improvement on the intensity score ( 95 % confidence interval � 42 to � 140 ) . It would cost � 5486 ( € 8190 , $ 10 666 ) to bring the child with the highest intensity score to below the clinical cut-off point and � 1344 ( € 2006 , $ 2618 ) to bring the average child in the intervention group within the non- clinical limits on the intensity score ( below 127 ) . For a ceiling ratio of � 100 ( € 149 , $ 194 ) per point increase in intensity score , there is an 83.9 % chance of the intervention being cost effective . The mean cost per child attending the parenting group was � 1934 ( € 2887 , $ 3760 ) for eight children and � 1289 ( € 1924 , $ 2506 ) for 12 children , including initial costs and material s for training group leaders . When we categorised the sample into relatively mild , moderate , and severe behaviour groups based on intensity scores at baseline the intervention seemed more cost effective in those with the highest risk of developing conduct disorder . Conclusion This parenting programme improves child behaviour as measured by the intensity score of the Eyberg child behaviour inventory at a relatively low cost and was cost effective  compared with the waiting list control . This parenting programme involves modest costs and demonstrates strong clinical effect , suggesting it would represent good value for money for public spending OBJECTIVE This study aims to evaluate the effectiveness of a parent training program in improving parenting practice s , parents ' feeling of self-efficacy and parents ' perception of their child 's behavior , implemented in a child protection service , with trained professionals from the agency acting as facilitators . METHOD Thirty-five parents monitored in a child protection service for child neglecting behaviors participated either in the  intervention group  ( n=26 ) or were on the waiting list ( n=9 ) . The program implemented ( Incredible Years ) lasted 16 weeks , was in a group format , and aim ed : ( 1 ) to develop a harmonious parent-child relationship ; ( 2 ) to support parents in learning and consistently applying effective practice s ; ( 3 ) to improve problem solving and communication skills within families and with teachers . A repeated measures design was used to test the program 's effects on parenting practice s , parents ' feeling of self-efficacy , parents ' perception of their child 's behavior , and parents ' satisfaction .  Parents were tested twice , during a 19-week interval , before and after the parent training program . RESULTS Analyses of variance comparing Intervention and Control groups with repeated measures ( pre- and post-test measures ) revealed that the program has a positive impact on parenting practice s ( harsh discipline , physical punishment , praise/incentive , appropriate discipline and positive verbal discipline ) and parents ' perception of their child 's behavior ( frequency of behavioral problems and number of problematic behaviors ) . No change on clear expectations from parents , or on parents ' self-efficacy was observed . CONCLUSION Though the implementation of an evidence -based parent training program by professionals in a child protection service presents specific challenges , results suggest that it can contribute to improvements in parenting practice s and in parents ' perception of their child 's behavior BACKGROUND Parenting programs have been shown to work when delivered to motivated ethnic majority parents in demonstration projects , but comparatively little is known about their impact when delivered to high-risk , multi-ethnic population s by routine local services . METHODS The Primary Age Learning Skills ( PALS ) trial was a r and omized controlled trial of an evidence -based parenting-group program that targeted the parent-child relationship and child literacy . Parents of 174 children were selected from a population of 672 5- and 6-year-olds attending four primary schools in a high-risk , ethnically diverse , inner-city area . Eighty-eight children were allocated to the Incredible Years preventive program plus a shortened six-week version of the SPOKES literacy program , delivered by local services ; 86 to usual community services ; 152/174 ( 87 % ) of families were successfully followed up . Parent-child relationship quality and child behavior were measured using direct observation and parent interview ; child reading was assessed psychometrically . RESULTS Two-thirds ( 58/89 ) of those offered the parenting program attended at least one session , with similar enrollment rates across the Black African , African-Caribbean , White-British and Other ethnic groups . Mean attendance was four relationship-building sessions and one literacy-development session . Satisfaction question naires were completed by 43/58 starters ; 93 % said they were well or extremely satisfied , with equally high rates across ethnic groups . At follow-up after one year , those allocated to the intervention showed significant improvements in the parent-child relationship on observation and at interview compared to controls ; effects were similar across all ethnic groups . However , child behavior problems and reading did not improve . 
    Output:
    
Moreover , the intervention demonstrated evidence of cost-effectiveness .
These costs of programme delivery are modest when compared with the long-term health , social , educational and legal costs associated with childhood conduct problems .
Behavioural and cognitive-behavioural group-based parenting interventions are effective and cost-effective for improving child conduct problems , parental mental health and parenting skills in the short term .
The cost of programme delivery was modest when compared with the long-term health , social , educational and legal costs associated with childhood conduct problems .