***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 This project aim ed to evaluate the impact of a home visiting programme that targeted families where the child , for environmental reasons , was at great risk of poor health and developmental outcomes . METHODOLOGY Women in the immediate postpartum period were recruited to a r and omized double-blind controlled trial on the basis of self-reported vulnerability factors and were r and omly assigned to receive either a structured programme of nurse home visiting , supported by a social worker and paediatrician ( n = 90 ) , or assigned to a comparison group receiving st and ard community child health services ( n = 91 ) . Parenting stress and maternal depression were measured at enrollment and at 6 weeks . Preventive health behaviour , service satisfaction and home environment outcomes were tested at 6 weeks , as were child health outcomes . RESULTS At six weeks , women receiving the home-based programme had significant reductions in postnatal depression screening scores as well as improvements in their experience of the parental role and improvement in the ability to maintain their own identity . Maternal-infant interactions were more likely to be positive , with significantly higher ( better ) scores in aspects of the home environment related to optimal development in children , particularly maternal-infant secure attachment . Intervention group mothers were significantly more satisfied with the community child health service . CONCLUSIONS This form of intervention for families is effective in promoting secure maternal-infant attachment , preventing maternal mood disorder and is welcomed by the families receiving it . These findings may predict long-term benefits for the healthy development of children otherwise at risk of a range of poor health and development outcomes Background There is evidence that exposure to passive smoking in general , and in babies in particular , is an important cause of morbimortality . Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome , acute respiratory diseases , worsening of asthma , acute-chronic middle ear disease and slowing of lung growth . The objective of this article is to describe the BIBE study protocol . The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care , directed to mothers and fathers that smoke , in order to reduce the exposure of babies to passive smoking ( ETS ) . Methods / Design Cluster r and omized field trial ( control and intervention group ) , multicentric and open . Subject : Fathers and /or mothers who are smokers and their babies ( under 18 months ) that attend pediatric services in Primary Care in Catalonia . The measurements will be taken at three points in time , in each of the fathers and /or mothers who respond to a question naire regarding their baby 's clinical background and characteristics of the baby 's exposure , together with variables related to the parents ' tobacco consumption . A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit ( biological determination of nicotine ) . The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care . Discussion Exposure to ETS is an avoidable factor related to infant morbimortality . Interventions to reduce exposure to ETS in babies are potentially beneficial for their health . The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits . Interventions in the form of advice , conducted by pediatric professionals , are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS.Trial Registration Clinical Trials.gov Identifier : NCT00788996 Background Tobacco smoke exposure ( TSE ) is a serious threat to child health . Roughly 40 % of children worldwide are exposed to tobacco smoke , and the very young are often " captive smokers " in homes in which others smoke . The goal of this research project is to develop and evaluate an intervention to reduce  young child tobacco smoke exposure .  The objective of this paper is to document our approach to building the intervention , to describe the planned intervention , and to explore the conceptual issues regarding the intervention and its evaluation . Methods / Design This project is being developed using an iterative approach . We are currently in the middle of Stage 1 . In this first stage , Intervention Development , we have already conducted a comprehensive search of the professional literature and internet re sources , consulted with experts in the field , and conducted several Design Workshops . The planned intervention consists of parental group support therapy , a website to allow use of an " online/offline " approach , involvement of pediatricians , use of a video simulation game ( " Dr . Cruz " ) to teach parents about child TSE , and personalized biochemical feedback on exposure levels . As part of this stage we will draw on a social marketing approach . We plan to use in-depth interviews and focus groups in order to identify barriers for behavior change , and to test the acceptability of program components . In Stage II , we plan to pilot the planned intervention with 5 - 10 groups of 10 parents each . In Stage III , we plan to implement and evaluate the intervention using a cluster r and omized controlled trial with an estimated 540 participants . Discussion The major challenges in this research are twofold : building an effective intervention and measuring the effects of the intervention . Creation of an effective intervention to protect children from TSE is a challenging but sorely needed public health endeavor . We hope that our approach will contribute to building a stronger evidence base for control of child exposure to tobacco smoke . Trial registration Clinical Trials.gov Identifier : BACKGROUND Children with asthma who live in the inner city are exposed to multiple indoor allergens and environmental tobacco smoke in their homes . Reductions in these triggers of asthma have been difficult to achieve and have seldom been associated with decreased morbidity from asthma . The objective of this study was to determine whether an environmental intervention tailored to each child 's allergic sensitization and environmental risk factors could improve asthma-related outcomes . METHODS We enrolled 937 children with atopic asthma ( age , 5 to 11 years ) in seven major U.S. cities in a r and omized , controlled trial of an environmental intervention that lasted one year ( intervention year ) and included education and remediation for exposure to both allergens and environmental tobacco smoke . Home environmental exposures were assessed every six months , and asthma-related complications were assessed every two months during the intervention and for one year after the intervention . RESULTS For every 2-week period , the intervention group had fewer days with symptoms than did the control group both during the intervention year ( 3.39 vs. 4.20 days , P<0.001 ) and the year afterward ( 2.62 vs. 3.21 days , P<0.001 ) , as well as greater declines in the levels of allergens at home , such as Dermatophagoides farinae ( Der f1 ) allergen in the bed ( P<0.001 ) and on the bedroom floor ( P=0.004 ) , D. pteronyssinus in the bed ( P=0.007 ) , and cockroach allergen on the bedroom floor ( P<0.001 ) . Reductions in the levels of cockroach allergen and dust-mite allergen ( Der f1 ) on the bedroom floor were significantly correlated with reduced complications of asthma ( P<0.001 ) . CONCLUSIONS Among inner-city children with atopic asthma , an individualized , home-based , comprehensive environmental intervention decreases exposure to indoor allergens , including cockroach and dust-mite allergens , result ing in reduced asthma-associated morbidity The aim of this r and omized-controlled trial was to evaluate the effectiveness of an intensive intervention to reduce  children 's environmental tobacco smoke ( ETS ) exposure at their home compared with a minimal intervention . The target population of the study was the mothers of children aged 1 - 5 who lived in the Cengizhan district of Izmir in Turkey , who smoked and /or whose spouses smoked . It was found that at least one parent of a total of 182 children smoked and 80 of these mothers were taken into stratified sampling based on the number of the smoking parents . Mothers were visited at their homes . During the initial visit , they were educated and urine sample s were taken from their children . Following this initial visit , mothers were r and omized to the intensive intervention ( n = 38 ) or the minimal intervention group ( n = 40 ) . The levels of cotinine in the intensive intervention ( P = 0.000 ) and minimal intervention ( P = 0.000 ) groups in the final follow-up were significantly lower than the initial levels . The proportion of mothers reporting a complete smoking ban at home in the final follow-up was higher in the intensive intervention group than the minimal intervention group ( P = 0.000 ) . The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children 's exposure to ETS at their home Purpose . Assess the effectiveness of a two-step health education program by nurses delivered through nonsmoking mothers to help fathers of sick children quit smoking . Design . R and omized , controlled trial . Setting . General pediatric wards of four major hospitals in Hong Kong . Subjects . Nonsmoking mothers who had a live-in smoking spouse were recruited when they brought sick children to the hospital . A total of 752 mothers were r and omized into the intervention arm and 731 into the control arm . Intervention . The intervention group received st and ardized health advice , behavior modification booklets , and a 1–week telephone reminder . The control group received usual care . Measurements . The main outcome measure was the quit rate ( 7–day point prevalence ) of smoking fathers as determined by telephone follow-up with mothers at 3 and 12 months . Quit attempts and smoking reduction were secondary outcome measures . Results . At 3 months , more fathers in the intervention group had quit smoking ( 7.4 % vs. 4.8 % ; p = .03 ) , reduced daily cigarette consumption by 50 % or more ( 30.6 % vs. 22.6 % ; p < .001 ) , and reported quit attempts ( 6.5 % vs. 3.6 % ; p = .01 ) . The differences were not statistically significant by 12 months . Conclusion . A simple health education intervention provided by nurses to mothers of sick children has a short-term effect in helping smoking fathers  quit , reduce consumption , and trigger quit attempts . Future studies should confirm the longer-term sustainability of the effect Study objective : To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on  maternal and child health outcomes . Design : R and omised controlled trial with economic and process evaluations and follow up at 12 and 18 months . The two intervention groups received either the offer of a year of monthly supportive listening home visits by a support health visitor ( SHV ) , or a year of support from community groups providing drop in sessions , home visiting and /or telephone support ( CGS ) . Each was compared with a control group that received st and ard health visitor services . Setting : Two disadvantaged boroughs of London , United Kingdom . Participants : 731 women from culturally diverse background s with infants . Main results : At 12 and 18 months , there was little impact for either intervention on the main outcomes : child injury ( SHV : relative risk 0.99 ; 95 % confidence intervals 0.68 to 1.45 , CGS : 0.91 ; 0.61 to1.36 ) , maternal smoking ( SHV : 0.86 ; 0.62 to 1.19 , CGS : 0.97 ; 0.72 to 1.33 ) or maternal depression ( SHV : 0.86 ; 0.62 to1.19 , CGS : 0.93 ; 0.69 to 1.27 ) . SHV women had different patterns of health service use ( with fewer taking their children to the GP ) and had less anxious experiences of motherhood than control women . User satisfaction with the SHV intervention was high . Uptake of the CGS intervention was low : 19 % , compared with 94 % for the SHV intervention . Conclusions : There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population . The SHV intervention was associated with improvement in some of the secondary outcomes OBJECTIVE To test an air cleaner and health coach intervention to reduce secondh and smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter ( PM ) , air nicotine , and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker . DESIGN R and omized controlled trial , with r and omization embedded in study data base . SETTING S The Johns Hopkins Hospital Children 's Center and homes of children . PARTICIPANTS Children with asthma , residing with a smoker , r and omly assigned to interventions consisting of air cleaners only ( n = 41 ) , air cleaners plus a health coach ( n = 41 ) , or delayed air cleaner ( control ) ( n = 44 ) . MAIN OUTCOME MEASURES Changes in PM , air nicotine , and urine cotinine concentrations and symptom-free days during the 6-month study . RESULTS The overall follow-up rate was high ( 91.3 % ) . Changes in mean fine and coarse PM ( PM(2.5 ) and PM(2.5 - 10 ) ) concentrations ( baseline to 6 months ) were significantly lower in both air cleaner groups compared with the control group ( mean differences for PM(2.5 ) concentrations : control , 3.5 μg/m(3 ) ; air cleaner only , -19.9 μg/m(3 ) ; and air cleaner plus health coach , -16.1 μg/m(3 ) ; P = .003 ; and PM(2.5 - 10 ) concentrations : control , 2.4 μg/m(3 ) ; air cleaner only , -8.7 μg/m(3 ) ; and air cleaner plus health coach , -10.6 μg/m(3 ) ; P = .0 
    Output:
    
We found little evidence of difference in effectiveness of interventions between the well infant , child respiratory illness , and other child illness setting s as context s for parental smoking cessation interventions .