***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 pilot , among women with gestational diabetes mellitus ( GDM ) , the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program . The intervention was delivered by telephone , and support for breastfeeding was addressed . RESEARCH DESIGN AND METHODS The goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5 % reduction from prepregnancy weight if overweight . Eligible participants were identified shortly after a GDM diagnosis ; 83.8 % consented to be r and omly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) . The retention was 85.2 % at 12 months postpartum . RESULTS The proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4 % , absolute difference 16.1 % , P = 0.07 ) . The intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5 % , P = 0.04 ) . The intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : −3.6 % , P = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0 % , P = 0.09 ) . No differences in postpartum physical activity were observed between conditions . CONCLUSIONS This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight . Strategies to help postpartum women overcome barriers to increasing physical activity are needed Objective To assess the feasibility of implementing a dedicated feeding support team on a postnatal ward and pilot the potential effectiveness and cost-effectiveness of team ( proactive ) and woman-initiated ( reactive ) telephone support after discharge . Design R and omised controlled trial embedded within a before- and -after study . Participatory approach and mixed- method process evaluation . Setting A postnatal ward in Scotl and . Sample Women living in disadvantaged areas initiating breast feeding . Methods Eligible women were recruited to a before- and -after intervention study , a proportion of whom were independently r and omised after hospital discharge to intervention : daily proactive and reactive telephone calls  for ≤14 days or control : reactive telephone calls ≤ day 14 . Intention-to-treat analysis compared the r and omised groups on cases with complete outcomes at follow-up . Main outcome measures Primary outcome : any breast feeding at 6–8 weeks assessed by a telephone call from a research er blind to group allocation . Secondary outcomes : exclusive breast feeding , satisfaction with care , NHS costs and cost per additional woman breast feeding . Results There was no difference in feeding outcomes for women initiating breast feeding before the intervention ( n=413 ) and after ( n=388 ) . 69 women were r and omised to telephone support : 35 intervention ( 32 complete cases ) and 34 control ( 26 complete cases ) . 22 intervention women compared with 12 control women were giving their baby some breast milk ( RR 1.49 , 95 % CI 0.92 to 2.40 ) and 17 intervention women compared with eight control women were exclusively breast feeding ( RR 1.73 , 95 % CI 0.88 to 3.37 ) at 6–8 weeks after birth . The incremental cost of providing proactive calls was £ 87 per additional woman breast feeding and £ 91 per additional woman exclusively breast feeding at 6–8 weeks ; costs were sensitive to service organisation . Conclusions Proactive telephone care delivered by a dedicated feeding team shows promise as a cost-effective intervention for improving breastfeeding outcomes . Integrating the FEeding Support Team ( FEST ) intervention into routine postnatal care was feasible . Trial registration number IS RCT N27207603 . The study protocol and final report are available on request Background Postnatal women ( < 12 months postpartum ) are at increased risk of physical inactivity . Purpose To evaluate the efficacy and feasibility of a theory-based physical activity ( PA ) intervention delivered to postnatal women primarily via mobile telephone short message service ( SMS ) . Methods Eighty-eight women were r and omized to the intervention ( n = 45 ) or minimal contact control ( n = 43 ) condition . The 12-week intervention consisted of a face-to-face PA goal - setting consultation , a goal - setting magnet , three to five personally tailored SMS/week and a nominated support person who received two SMS per week . SMS content targeted constructs of social cognitive theory . Frequency ( days/week ) and duration ( min/week ) of PA participation and walking for exercise  were assessed via self-report at baseline , 6 and 13 weeks . Results Intervention participants increased PA frequency by 1.82 days/week ( SE ± 0.18 ) by 13 weeks ( F(2,85 ) = 4.46 , p = 0.038 ) and walking for exercise frequency by 1.08 days/week ( SE ± 0.24 ) by 13 weeks ( F(2,85 ) = 5.38 , p = 0.02 ) . Positive trends were observed for duration ( min/week ) of PA and walking for exercise . Conclusions Intervention exposure result ed in increased frequency of PA and walking for exercise in postnatal women The purpose of this prospect i ve , r and omized controlled study was to determine the efficacy of an intensified , late pregnancy , smoking cessation intervention for resistant pregnant smokers ( n = 269 ) . Participants received 3 - 5 min of counseling plus a self-help booklet at their first prenatal visit and seven booklets mailed weekly thereafter ; at 28 weeks , all had been smoking in the past 28 days . The experimental group received a stage of change-based , personalized feedback letter and two telephone counseling calls using Motivational Interviewing ( MI ) strategies . The control group received care as usual . The 34th week cotinine data demonstrated no overall difference between groups . However , an implementation analysis suggested that 43 % of women who received the full intervention ( E2 ) were classified as not smoking compared to 34 % of the control group . At 6 weeks postpartum , 27.1 % of the E2 group reported being abstinent or light smokers vs. 14.6 % of the controls . No differences were detected at 3 and 6 months postpartum . Results lend preliminary but very modest support for this intervention with resistant pregnant smokers . Improvements in the intervention and implementation issues are discussed Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea , so that they could start exclusive breast-feeding during their hospital stay . Infants ( n = 250 ) up to 12 weeks of age were r and omized to intervention and control groups . Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education . During follow-up at home by the counsellors a week later , only the mothers in the intervention group were counselled . All the mothers were evaluated for infant feeding practice s at home two weeks after discharge . Among the 125 mother-infant pairs in each group , 60 % of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6 % in the control group ( P < 0.001 ) ; two weeks later , these rates rose to 75 % and 8 % in the intervention and control groups , respectively ( P < 0.001 ) . However , 49 % of mothers in the control group reverted back to bottle-feeding compared with 12 % in the intervention group ( P < 0.001 ) . Thus , individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home . Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practice This study reports on the evaluation of the feasibility , cost , and cost-effectiveness of a proactively provided telephone-based motivational smoking cessation intervention to an underserved population of pregnant smokers who may or may not receive ongoing prenatal care . As part of the New Engl and SCRIPT r and omized clinical trial comparing the efficacy of three types of smoking cessation interventions for pregnant smokers , one-third of the women ( n = 358 ) received a motivational telephone counseling intervention ( MI ) delivered by trained counselors using a semistructured protocol . Although this population was very mobile , the MI counselors were able to reach 86 % of the women with at least one call and 46 % received all three calls . The group receiving three MI calls had a cotinine-confirmed quit rate of 23 % . Cost-effectiveness analyses for those women receiving telephone counseling supported the net benefit in favor of the three phone calls compared with the women who did not receive any telephone calls , with an effectiveness to cost ratio of 1:US dollars 84 . Our results suggest that telephone-based motivational smoking cessation counseling may be a feasible and cost-effective method for low-income pregnant smokers enrolled in prenatal care This study examined the effect of a mother-baby intervention on the quality of mother-child interaction , infant-mother attachment security , and infant socioemotional functioning in a group of depressed mothers with infants aged 1 - 12 months . A r and omized controlled trial compared an experimental group ( n = 35 ) receiving the intervention ( 8 - 10 home visits )  with a  control group ( n = 36 ) receiving parenting support by telephone .  There were assessment s pre , post , and follow-up after 6 months . The intervention had positive effects on the quality of mother-infant interaction . Infants in the experimental group had higher scores for attachment security and for one aspect of socioemotional functioning , namely , competence . The intervention proved successful in preventing deterioration of the quality of mother-child interaction A r and omized controlled trial including 2235 women at high risk of low birthweight was conducted in four Latin American institutions . The objective of this trial was to evaluate a  psychosocial support intervention during pregnancy aim ed at improving perinatal health and mothers ' psychosocial conditions . The core of the intervention was four to six home visits where emotional support , counseling and strengthening of the woman 's social network was provided . Outcomes were measured at 36 weeks of pregnancy , post-partum and 40 days after delivery . The intervention was not successful in either altering women 's perception of social support and satisfaction with the reproductive experience , as well as maternal and newborn 's health care . It is concluded that although high levels of psychosocial distress during pregnancy may play an independent role in determining adverse pregnancy outcomes , this adverse effect does not appear to be ameliorated by psychosocial interventions conducted only during pregnancy , particularly those of a magnitude that can be realistically implemented ( in content and frequency ) at public care services in most developing countries OBJECTIVE Maternal obesity is associated with poor breastfeeding outcomes , yet no intervention has been developed to improve them . To ascertain whether increased breastfeeding support or provision of a breast pump is a feasible , effective intervention to improve breastfeeding , we enrolled obese women who intended to breastfeed in two r and omized trials . METHODS In Bassett Improving Breastfeeding Study ( BIBS ) 1 , 40 women received targeted breastfeeding support in the hospital  and via telephone or usual care .  Information regarding breastfeeding was collected via telephone for 7 days after delivery and at 30 and 90 days postpartum . In BIBS 2 , 34 obese mothers received a manual or electric breast pump to use for 10 - 14 days or no pump ; data collection was similar . RESULTS In both experiments , r and omization failed to distribute women of differing postpartum body mass index adequately among the treatment groups . When analyses were adjusted for this , there was no difference in BIBS 1 between targeted and usual care groups and in BIBS 2 among the treatment groups in the proportion of women still breastfeeding at the times studied . CONCLUSIONS In future studies of obese women , stratified r and omization may be necessary . Further development of interventions to help obese women achieve optimal breastfeeding outcomes is required Background Telephone hotlines design ed to address common concerns in the early postpartum could be a useful re source for parents . Our aim was to test the feasibility of using a telephone as an intervention in a r and omized controlled trial . We also aim ed to test to use of algorithms to address parental concerns through a telephone hotline . Methods Healthy first-time mothers were recruited from postpartum wards of hospitals throughout Lebanon . Participants were given the number of a 24-hour telephone hotline that they could access for the first four months after delivery . Calls were answered by a midwife using algorithms developed by the study team whenever possible . Callers with medical complaints were referred to their physicians . Call patterns and content were recorded and analyzed . Results Eighty-four of the 353 women enrolled ( 24 % ) used the hotline . Sixty percent of the women who used the service called more than once , and all callers reported they were satisfied with the service . The midwife received an average of three calls per day and most calls occurred during the first four weeks postpartum . Our algorithms were used to answer questions in 62.8 % of calls and 18.6 % of calls required referral to a physician . Of the questions related to mothers , 66 % were about breastfeeding . Sixty percent of questions related to the infant were about routine care and 23 % were about excessive crying . Conclusions Utilization of a telephone hotline service for postpartum support is highest in the first four weeks 
    Output:
    
Overall , results were inconsistent and inconclusive although there was some evidence that telephone support may be a promising intervention .
Results from trials offering breastfeeding telephone support were also inconsistent , although the evidence suggests that telephone support may increase the duration of breastfeeding .
There was no strong evidence that women receiving telephone support were less likely to be smoking at the end of pregnancy or during the postnatal period .