***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: This study investigated whether a psycho-educational program with modest dosage ( eight sessions ) , delivered in a universal framework through childbirth education programs and targeting the coparenting relationship would have a positive impact on observed family interaction and child behavior at 6-month follow-up ( child age 1 year ) . One hundred sixty-nine couples , r and omized to intervention and control conditions , participated in videotaped family observation tasks at pretest ( during pregnancy ) and at child age 1 year ( 2003–2007 ) . Coparenting , parenting , couple relationship , and child self-regulatory behaviors were coded by teams of raters . Intent-to-treat analyses of program effects controlled for age , education , and social desirability . Evidence of significant ( p < 0.05 ) program effects at follow-up emerged in all four domains . Effect sizes ranged from 0.28 to 1.01 . Targeting the coparenting relationship at the transition to parenthood represents an effective , non-stigmatizing means of promoting parenting quality and child adjustment We examined the impact of father involvement on treatment . Participants were 107 families enrolled in parent-child interaction therapy ( PCIT ) , including 56 involved-father ( IF ) families , 16 uninvolved-father ( UF ) families , and 35 absent-father ( AF ) families . All groups showed improvements during treatment to within the average range on the Eyberg Child Behavior Inventory ( ECBI ) , although mothers from AF families reported better treatment outcome than mothers from IF families . Improvements occurred on the Beck Depression Inventory ( BDI ) and the Parenting Stress Index ( PSI ) as well , but there were no group differences . At a 4-month follow-up , mothers in IF families maintained treatment gains on the ECBI . In contrast , mothers in AF families reported significant decline at follow-up , although their scores remained within the normal range . Results suggest that father participation in treatment may not affect immediate treatment outcome but may help to maintain the beneficial effects of PCIT Objective To identify prospect i ve predictors of mental health in Kabul , Afghanistan . Method Using stratified r and om-sampling in schools , mental health and life events for 11-to 16-year-old students and their caregivers were assessed . In 2007 , 1 year after baseline , the retention rate was 64 % ( n = 115 boys , 119 girls , 234 adults ) with no evidence of selection bias .  Self- and caregiver-rated child mental health ( Strengths and Difficulties Question naire ) , depressive ( Depression Self-Rating Scale ) , and posttraumatic stress ( Child Revised Impact of Events Scale ) symptoms and caregiver mental health ( Self-Report Question naire ) were assessed . Lifetime trauma and past-year traumatic , stressful , and protective experiences were assessed . Results With the exception of posttraumatic stress , one-year trajectories for all mental health outcomes showed significant improvement ( p < .001 ) . Family violence had a striking impact on the Strengths and Difficulties Question naire data , raising caregiver-rated scores by 3.14 points ( confidence interval [ CI ] 2.21–4.08 ) or half a st and ard deviation , and self-rated scores by 1.26 points ( CI 0.50–2.03 ) ; past-year traumatic beatings independently raised self-rated scores by 1.85 points ( CI 0.03–3.66 ) . A major family conflict raised depression scores by 2.75 points ( CI 0.89–4.61 ) , two thirds of a st and ard deviation , whereas improved family life had protective effects . Posttraumatic stress symptom scores , however , were solely contingent on lifetime trauma , with more than three events raising scores by 5.38 points ( CI 1.76–9.00 ) . Conclusions Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors . The importance of prospect ively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war-affected population In the context of current concern about levels of marital distress , family violence , and divorce , the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children , in part by strengthening the men 's relationships with their children 's mothers . The study design involves a r and omized clinical trial that includes assignment to a 16-week couples group , a 16-week fathers group , or a single-session control group . Couples in both group interventions and the control condition include partners who are married , cohabiting , and living separately but raising a young child together . This article presents the rationale , design , and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives , many of whom are manifesting some degree of individual or relationship distress . We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest , and the first 160 who completed one postintervention assessment 9 months after entering the study . Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families Objective . Abusive head injuries among infants ( shaken infant or shaken impact syndrome ) represent a devastating form of child abuse ; an effective prevention program that reduces the incidence of abusive head injuries could save both lives and the costs of caring for victims . We wished to determine whether a comprehensive , regional , hospital-based , parent education program , administered at the time of the child 's birth , could be successfully implemented and to examine its impact on the incidence of abusive head injuries among infants < 36 months of age . Methods . All hospitals that provide maternity care in an 8-county region of western New York State participated in a comprehensive regional program of  parent education about violent infant shaking . The program was administered to parents of all newborn infants before the infant 's discharge from the hospital . The hospitals were asked to provide both parents ( mothers and , whenever possible , fathers or father figures ) with information describing the dangers of violent infant shaking and providing alternative responses to persistent infant crying and to have both parents sign voluntarily a commitment statement ( CS ) affirming their receipt and underst and ing of the material s. Program compliance was assessed by documenting the number of CSs signed by parents and returned by participating hospitals . Follow-up telephone interviews were conducted with a r and omized 10 % subset of parents , 7 months after the child 's birth , to assess parents ' recall of the information . Finally , the regional incidence of abusive head injuries among infants and children < 36 months of age during the program ( study group ) was contrasted with the incidence during the 6 preceding years ( historical control group ) and with statewide incidence rates for the Commonwealth of Pennsylvania during the control and study periods , using Poisson regression analyses with a type I error rate of 0.05 . Results . During the first 5.5 years of the program , 65 205 CSs were documented , representing 69 % of the 94 409 live births in the region during that time ; 96 % of CSs were signed by mothers and 76 % by fathers/father figures . Follow-up telephone surveys 7 months later suggested that > 95 % of parents remembered having received the information . The incidence of abusive head injuries decreased by 47 % , from 41.5 cases per 100 000 live births during the 6-year control period to 22.2 cases per 100000 live births during the 5.5-year study period . No comparable decrease was seen in the Commonwealth of Pennsylvania during the years 1996–2002 , which bracketed the control and study periods in western New York State . Conclusions . A coordinated , hospital-based , parent education program , targeting parents of all newborn infants , can reduce significantly the incidence of abusive head injuries among infants and children < 36 months of age OBJECTIVES To determine the utility of a parenting education program for fathers of infants , and to determine which fathers benefited . DESIGN Fathers ' perceptions of the program 's utility were captured in a brief , structured interview . Using secondary data analysis , pretest/posttest father-infant interaction scores of fathers who improved were compared with those of fathers who did not . Demographic predictors of improvement were identified using multiple regression . SAMPLE Community sample of 81 adult , English-speaking , primarily European Canadian , first-time fathers of 5-month-old infants , who participated in the intervention group of a r and omized controlled trial . INTERVENTION When infants were 5 and 6 months old , videotaped self-modeling and positive feedback about father-infant interaction were provided by specially trained nurses . MEASUREMENTS Father-infant interaction was assessed at baseline ( 5 months ) and outcome ( 8 months ) using the Nursing Child Assessment Teaching Scale . RESULTS Fathers found the program useful , indicating that their needs for educational programs are different from mothers . Controlling for baseline interactions , demographic variables did not significantly predict fathers ' outcome interactions . CONCLUSIONS The program may prove useful in public health setting s where implementing programs for fathers of infants is a priority . Future research needs to explore other predictors to identify fathers who will benefit from the program Look After the Child Investing in children has been demonstrated to improve their lives , both during the school-age years and afterward , as assessed by outcomes such as employment and income ; furthermore , these investments often help those in the most need . Campbell et al. ( p. 1478 ) report that these investments can also lead to improved adult health . Results from a r and omized and intensive intervention that involved 122 children in four cohorts recruited in the 1970s suggest that full-day child care for the first 5 years of life has produced adults in their 30s with better metabolic and cardiovascular health measures . Large investments in preschool children ’s education , health care , and nutrition provide long-term health benefits . High- quality early childhood programs have been shown to have substantial benefits in reducing crime , raising earnings , and promoting education . Much less is known about their benefits for adult health . We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of r and omization : the Carolina Abecedarian Project ( ABC ) . Using recently collected biomedical data , we find that disadvantaged children r and omly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s . The evidence is especially strong for males . The mean systolic blood pressure among the control males is 143 millimeters of mercury ( mm Hg ) , whereas it is only 126 mm Hg among the treated . One in four males in the control group is affected by metabolic syndrome , whereas none in the treatment group are affected . To reach these conclusions , we address several statistical challenges . We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis . We adjust inference to account for the multiple hypotheses tested and for nonr and om attrition . Our evidence shows the potential of early life interventions for preventing disease and promoting health This article reports pre – post intervention results from a r and omized controlled trial evaluating the initial efficacy of a  couples-based intervention aim ed at teaching skills for coping with stress and improving relationship skills in a sample of 173 ethnically diverse low-income co-resident mothers and fathers who were raising at least one child together . Couples were r and omly assigned to one of three interventions or to an assessment -only control condition . The Fatherhood , Relationship , and Marriage Education ( FRAME ) intervention is a 14-h psychoeducation intervention developed specifically to strengthen the ability of low-income mothers and fathers to reduce conflict , cope with stress , and co-parent effectively . Three versions of FRAME were assessed : a men-only group , a women-only group , and a couple ’s group . The pre-post intervention analyses revealed reductions in financial stress , disengagement coping , and involuntary disengagement responses , as well as improvements in problem solving . These pre – post changes on stress and coping variables were both statistically significant and reliable as assessed by the Reliable Change Index ( Jacobson and Truax 1991 ) . Results were particularly strong for the couples ’ and women ’s groups . In addition , positive pre-post changes on stress and coping variables were associated with pre-post reductions on symptoms of depression for participants assigned to an intervention . The results demonstrate that participants in FRAME acquire some of the key skills taught in the intervention , and skills acquisition appears to translate into symptom reduction . In addition , this study highlights the value of an intervention aim ing to improve the capacity of parents with economic hardship to cope effectively with stress This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship , parental mental health , the parent-child relationship , and child outcomes . A sample of 169 heterosexual , adult couples expecting their first child was r and omized to intervention and control conditions . The intervention families participated in Family Foundations , a series of eight classes delivered before and after birth , which was design ed as a universal prevention program ( i.e. , applicable to all couples , not just those at high risk ) . Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy , coparenting , harsh parenting , and children 's emotional adjustment among all families , and maternal depression among cohabiting couples . Among families of boys , program effects were found for child behavior problems and couple relationship quality . These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being Objective : To evaluate the feasibility 
    Output:
    
Barriers to engaging men as parents work against father inclusion as well as father retention , and undervalue coparenting as contrasted with mothering .