***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: Findings are presented from an Icel and ic r and omized control trial ( RCT ) evaluating parent management training - Oregon model ( PMTO ™ ) , a parent training intervention design ed to improve parenting practice s and reduce child behavior problems . In a prior report from this effectiveness study that focused on child outcomes , children in the PMTO condition showed greater reductions in reported child adjustment problems relative to the comparison group . The present report focuses on observed parenting practice s as the targeted outcome , with risk by treatment moderators also tested . It was hypothesized that mothers assigned to the PMTO condition would show greater gains in pre-post parenting practice s relative to controls . The sample was recruited from five municipalities throughout Icel and and included 102 participating families of children with behavior problems . Cases were referred by community professionals and r and omly assigned to either PMTO ( n = 51 ) or community services usually offered ( n = 51 ) . Child age ranged from 5 to 12 years ; 73 % were boys . Contrary to expectations , findings showed no main effects for changes in maternal parenting . However , evaluation of risk by treatment moderators showed greater gains in parenting practice s for mothers who increased in depressed mood within the PMTO group relative to their counterparts in the comparison group . This finding suggests that PMTO prevented the expected damaging effects of depression on maternal parenting . Failure to find hypothesized main effects may indicate that there were some unobserved factors regarding the measurement and a need to further adapt the global observational procedures to Icel and ic culture 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 Structured parent training has been proven to be effective in reducing  disruptive behavior problems ( DBP ) in children . Most of the programs that are used in Sweden have their origin in North America , and there is an ongoing debate over the transferability to Sweden of manual-based programs developed in other context s. The goal of the present study was to study effectiveness of the Incredible Years parent-training program ( IY ) , developed in the US , in regular clinical work in Sweden , using a r and omized controlled design . Parents of 62 four to eight-year-old children diagnosed with Oppositional Defiant Disorder participated in the study . Parents of 38 children were assigned to  parent training ( PT ) and 24 to a waiting list ( WL ) .  The results indicate that the IYS retains the positive effects on children 's disruptive behavior problems when translated and transferred to Swedish . There was a statistically significant difference in reduction of DBP in children between the groups in favor of the PT . The improvement in the PT group was sustained at the one-year follow-up . The improvement also , at least to some extent , generalized over time to the school context . There was also a statistically significant difference in mothers ' report of pre to post change in parenting alliance between the PT and WL groups . The IYS program was appreciated and well received by the participating mothers This study was a r and omized control trial ( RCT ) of Parent Management Training -- The Oregon Model ( PMTO )  in Norway . A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study . Families were r and omly assigned to either PMTO or a regular services comparison group . PMTO was delivered via existing children 's services , and families were recruited using the agencies ' regular referral procedures , making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States . Using a multiagent-multi method approach , results showed that PMTO was effective in reducing parent-reported child externalizing problems , improving teacher-reported social competence , and enhancing parental discipline . Age level and gender modified the effects of PMTO treatment on other outcomes . In a path model , participation in PMTO was associated with improved parental discipline , and effective discipline predicted greater child compliance , fewer child-initiated negative chains , and lower levels of child externalizing problems . Findings are presented along with a discussion of the implication s for practice and research and the challenges accompanying effectiveness trials The present study evaluated the effectiveness of the Positive Parenting Program ( Triple P ) with a sample of Chinese parents of children with early onset conduct-related problems in Hong Kong . The participants consisted of 91 parents whose children attended maternal and child health centers and child assessment centers for service , and were between three to seven years old . Participants were r and omly assigned to the intervention ( TP ) and a waitlist control group ( WL ) . There was no significant difference in pre-intervention measures between the two groups . However , at post intervention , participants in the TP group reported significantly lower levels of child behavior problems , lower dysfunctional parenting styles , and higher parent sense of competence , compared to the WL group . Implication s of these findings for the use of Triple P with families of Chinese descent are discussed BACKGROUND To test effectiveness of a parenting intervention , delivered in a community-based voluntary-sector organisation , for reducing conduct problems in clinical ly-referred children . METHODS R and omised controlled trial , follow-up at 6 , 18 months , assessors blind to treatment status . Participants --76 children referred for conduct problems , aged 2 - 9 , primarily low-income families , r and omised to treatment vs. 6-month wait-list group .  Retention was 93 % at 6 months , 90 % at 18 months . Interventions --Webster-Stratton Incredible Years video-based 14-week group programme , teaches cognitive-behavioural principles for managing behaviour , using a collaborative , practical , problem-solving approach . Primary outcomes --child problem behaviour by parent-report ( Eyberg ) and home-based direct observation ; secondary outcomes --observed positive and negative parenting ; parent-reported parenting skill , confidence and depression . RESULTS Post-treatment improvements were found in child problem behaviour , by parent-report ( effect size ( ES ) .48 , p = .05 ) and direct observation ( ES .78 , p = .02 ) ; child independent play ( ES .77 , p = .003 ) ; observed negative ( ES .74 , p = .003 ) and positive ( ES .38 , p = .04 ) parenting ; parent-reported confidence ( ES .40 , p = .03 ) and skill ( ES .65 , p = .01 ) , using ANCOVA to control for baseline scores . Maternal depression did not change . Consumer satisfaction was high . At 18-month follow-up , although no r and omised comparison was possible , changes appeared to maintain , with no significant change toward baseline level on any measure . Change in observed positive parenting appeared to mediate change in child problem behaviour ( p < .025 ) . CONCLUSIONS Findings suggest that a group-based cognitive-behavioural parenting programme , delivered by well-trained and supervised staff , can be effective in a community voluntary-sector setting , for reducing conduct problems and enhancing parenting skills . Change in parenting skill appears to be a key mechanism for change in child behaviour . Findings have implication s for feasibility of translating evidence -based programmes , even for clinical ly-referred conduct problems , into less specialised community setting s , likely to have lower costs and be more accessible for families Objective To evaluate the effectiveness of a parenting programme as a preventive intervention with parents of preschool children considered to be at risk of developing conduct disorder . Design Pragmatic r and omised controlled trial using a block design with allocation by area . Setting Eleven Sure Start areas in north and mid-Wales . Participants 153 parents from socially disadvantaged areas , with children aged 36 - 59 months at risk of conduct disorder defined by scoring over the clinical cut off on the Eyberg child behaviour inventory . Participants were r and omised on a 2:1 basis , 104 to intervention and 49 to remaining on the  wait  listing ( control ) . Twenty ( 13 % ) were lost to follow-up six months later , 18 from the intervention group . Intervention The Webster-Stratton Incredible Years basic parenting programme , a 12 week group based intervention . Main outcome measures Problem behaviour in children and parenting skills assessed by self reports from parents and by direct observation in the home . Parents ' self reported parenting competence , stress , and depression . St and ardised and well vali date d instruments were used throughout . Results At follow-up , most of the measures of parenting and problem behaviour in children showed significant improvement in the intervention group . The intention to treat analysis for the primary outcome measure , the Eyberg child behaviour inventory , showed a mean difference between groups of 4.4 points ( 95 % confidence interval 2.0 to 6.9 , P<0.001 ) on the problem scale with an effect size of 0.63 , and a mean difference of 25.1 ( 14.9 to 35.2 , P<0.001 ) on the intensity scale with an effect size of 0.89 . Conclusion This community based study showed the effectiveness of an evidence based parenting intervention delivered with fidelity by regular Sure Start staff . It has influenced policy within Wales and provides lessons for Engl and where , to date , Sure Start programmes have not been effective . Trial registration IS RCT This article reports the effectiveness of two universal prevention programs in reducing externalizing behavior in elementary school children . A sample of 1,675 first grade rs in 56 Swiss elementary schools was r and omly assigned to a school-based social competence intervention , a parental training intervention , both , or control . Externalizing psychopathology and social competence ratings were provided by the children , primary caregivers , and teachers at the beginning and end of the 2-year program , with a follow-up 2 years later . Intention-to-treat analyses revealed that long-term effects on teacher- and parent-rated externalizing behavior were greater for the social competence intervention than for the control . However , for most outcomes , no statistically significant positive effects were observed This r and omized clinical trial assessed the effectiveness of  multisystemic therapy ( MST ) for 156 youths who met the diagnostic criteria for conduct disorder . Sweden 's 3 largest cities and 1 small town served as the recruiting area for the study . A mixed factorial design was used , with r and om allocation between MST and treatment as usual groups . Assessment s were conducted at intake and 7 months after referral . With an intention-to-treat approach , results from multiagent and multi method assessment batteries showed a general decrease in psychiatric problems and antisocial behaviors among participants across treatments . There were no significant differences in treatment effects between the 2 groups . The lack of treatment effect did not appear to be caused by site differences or variations in program maturity . MST treatment fidelity was lower than that of other studies , although not clearly related to treatment outcomes in this study . The results are discussed in terms of differences between Sweden and the United States . One difference is the way in which young offenders are processed ( a child welfare approach vs. a juvenile justice system approach ) . Sociodemographic differences ( e.g. , rates of poverty , crime , and substance abuse ) between the 2 countries may also have moderating effects on the rates of rehabilitation among young offenders . ( PsycINFO Data base Record ( c ) 2008 APA , all rights reserved ) This study evaluates the initial efficacy of the Parent-Child Interaction Therapy ( PCIT ) for Puerto Rican preschool children aged 4 - 6 years with a diagnosis of attention-deficit/hyperactivity disorder ( ADHD ) , combined or predominantly hyperactive type , and significant behavior problems . Thirty-two families were r and omly assigned to PCIT ( n = 20 ) or a 3.5-month waiting-list condition ( WL ; n = 12 ) . Participants from both groups completed pretreatment and posttreatment assessment s. Outcome measures included child 's ADHD symptoms and behavior problems , parent or family functioning , and parents ' satisfaction with treatment . ANCOVAs with pretreatment measures entered as covariates were significant for all posttreatment outcomes , except mother 's depression , and in the expected direction ( p < .01 ) . Mothers reported a highly significant reduction in pretreatment hyperactivity and inattention and less aggressive and oppositional-defiant behaviors 
    Output:
    
Interventions transported to “ western ” countries showed comparable effects to trials in origin countries ; however , effects were stronger when interventions were transported to culturally more distant regions .
Effects were higher in countries with survival-focused family/childrearing values than those ranked more individualistic .
There were no differences in effects by country-level policy or re source factors .
Contrary to common belief , parenting interventions appear to be at least as effective when transported to countries that are more different culturally , and in service provision , than those in which they were developed .
Extensive adaptation did not appear necessary for successful transportation