***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: OBJECTIVES We examined the effect of a peer-delivered educational intervention , the Malawi Male Motivator intervention , on  couples '  contraceptive uptake . We based the intervention design on the information-motivation-behavioral skills ( IMB ) model . METHODS In 2008 we recruited 400 men from Malawi 's Mangochi province who reported not using any method of contraception . We r and omized them into an intervention arm and a control arm , and administered surveys on contraceptive use at baseline and after the intervention . We also conducted in-depth interviews with a subset of intervention participants . RESULTS After the intervention , contraceptive use increased significantly within both arms ( P < .01 ) , and this increase was significantly greater in the intervention arm than it was in the control arm ( P < .01 ) . Quantitative and qualitative data indicated that increased ease and frequency of communication within couples were the only significant predictors of uptake ( P < .01 ) . CONCLUSIONS Our findings indicate that men facilitated contraceptive use for their partners . Although the IMB model does not fully explain our findings , our results show that the intervention 's content and its training in communication skills are essential mechanisms for successfully enabling men to help couples use a contraceptive The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception ’s method among the women who obligatory attended the Premarital Counseling Center in Yasouj city , Iran . An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions . Respondents were divided by two experimental and control groups r and omly . A pre-evaluation was done on the knowledge and attitude on family planning using a structured question naire . After which , the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method . Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention . Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups . Results showed that there was a significant improvement in respondents ’ knowledge and attitude after educational program in experimental group ( p<0.001 ) , while no significant difference was observed in knowledge and attitude of control group . The finding also indicated that age was significantly associated with the level of respondents ’ knowledge . These results deal the effectiveness of the educational method . In conclusion , the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method . Future educational programs need to incorporate the features that have been associated with successful interventions in the past , as well as including their own evaluation procedures This study tested the hypothesis that individual counselling in the third trimester would increase postpartum contraceptive use to a greater extent than only providing an educational leaflet . A total of 180 third trimester pregnant women of mean age 28.3 years who were attending Marmara University Hospital for prenatal care were enrolled . One-third were r and omly allocated to receive prenatal contraceptive counselling and the remaining two-thirds ( control group ) received an educational leaflet . Participants were followed-up at 6–9 months postpartum . The majority of subjects ( 91.5 % ) wanted to use contraception after delivery but 26.7 % did not know which method to use . At follow-up , 79.6 % of all women had begun a postpartum contraceptive regime and 68.7 % were using a modern contraceptive method . Overall , there was no statistically significant difference in postpartum contraception use between the control and intervention groups in this study population . It is , therefore , concluded that prenatal counselling was not superior to educational leaflets for increasing the use of effective and modern postpartum contraception Background A number of single case reports have suggested that the context within which intervention studies take place may challenge the assumptions that underpin r and omised controlled trials ( RCTs ) . However , the diverse ways in which context may challenge the central tenets of the RCT , and the degree to which this information is known to research ers or subsequently reported , has received much less attention . In this paper , we explore these issues by focusing on seven RCTs of interventions varying in type and degree of complexity , and across diverse context s. Methods This in-depth multiple case study using interviews , focus groups and documentary analysis was conducted in two phases . In phase one , a RCT of a nurse-led intervention  provided a single exploratory case and informed the design , sampling and data collection within the main study . Phase two consisted of a multiple explanatory case study covering a spectrum of trials of different types of complex intervention . A total of eighty-four data sources across the seven trials were accessed . Results We present consistent empirical evidence across all trials to indicate that four key elements of context ( personal , organisational , trial and problem context ) are crucial to underst and ing how a complex intervention works and to enable both assessment s of internal validity and likely generalisability to other setting s. The ways in which context challenged trial operation was often complex , idiosyncratic , and subtle ; often falling outside of current trial reporting formats . However , information on such issues appeared to be available via first h and ‘ insider accounts ’ of each trial suggesting that improved reporting on the role of context is possible . Conclusions Sufficient detail about context needs to be understood and reported in RCTs of complex interventions , in order for the transferability of complex interventions to be assessed . Improved reporting formats that require and encourage the clarification of both general and project-specific threats to the likely internal and external validity need to be developed . In addition , a cultural change is required in which the open and honest reporting of such issues is seen as an indicator of study strength and research er integrity , rather than a symbol of a poor quality study or investigator ability OBJECTIVES This study was undertaken to determine the relative efficacy of home visitation with and without husb and participation on the use of modern contraception in Ethiopia . METHODS A r and omized field trial of a family planning education intervention using home visitation with and without husb and participation was conducted in Addis Ababa , Ethiopia , from August 1990 to December 1991 and included a 12-month postintervention follow-up . A total of 266 experimental and 261 control subjects were entered , of whom 91.7 % and 88.9 % , respectively , were followed through 12 months . RESULTS A greater proportion of couples in the experimental group were practicing modern contraception at 2 months ( 25 % vs 15 % ) and 12 months ( 33 % vs 17 % ) following the home visit intervention . By 12 months following the home visits , experimental subjects were less likely to have defaulted and more likely to have started using modern contraception following an initial delay . CONCLUSIONS The inclusion of husb and s in family planning programs will result in relevant increases in the use of modern contraception . However , there exists an important " sleeper " effect to the education intervention , reflected by a delay of greater than 2 months in the initiation of modern contraception for most couples A r and omized community trial of a family planning outreach program  was conducted in Rakai District , Ug and a. Five communities received st and ard services ; six intervention communities  received additional family planning information , counseling , and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies . Condom use was promoted in all of the communities . The community-based family planning outreach program was implemented in two phases--1999 - 2000 ( early ) and 2001(late)-- and its impact was evaluated by means of population surveys in 2002 - 03 . At follow-up , hormonal contraceptive prevalence was 23 percent in the intervention communities , compared with 20 percent in the control communities . The differential was greater in the early-intervention communities than the late-intervention communities . Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities . No differentials in condom use were found between study arms . Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates , but the impact of this outreach program was modest BACKGROUND The study was conducted to determine the impact of counseling and educational leaflets on contraceptive practice s of couples . STUDY DESIGN R and omization of 600 women was done in two groups matched for age , parity and socioeconomic status at the Department of Obstetrics and Gynaecology , Shifa Foundation Community Health Centre , Shifa International Hospital , Islamabad , Pakistan . In Group A , the intervention group was exposed to contraceptive counseling and educational leaflets in the postnatal ward after delivery , whereas in Group B , the nonintervention group was not given any formal contraceptive advice . Later on , both groups were assessed regarding their contraceptive practice s. RESULTS At their follow-up visit ( 8 - 12 weeks ) postpartum , 19 ( 6.3 % ) women in the nonintervention group had started contraceptive use , whereas 153 ( 50.8 % ) had decided to start contraception in the next 6 months , and 129 ( 42.8 % ) women were still undecided . The main contraceptive user was the male partner ( n=117 , 38.8 % ) , and the most common method used was coitus interruptus ( n=62 , 36.3 % ) . In the intervention group , 170 women ( 56.9 % ) had started using contraceptives , whereas 129 ( 43.1 % ) had decided to start contraceptive use in the next 6 months . The predominant contraceptive user was the females ( n=212 - 70.9 % ) , and the most popular method chosen was oral contraceptive pills ( n=111 , 37.1 % ) . CONCLUSION There is a definite increase in contraceptive uptake in women provided with educational leaflets and counseling session with a shift toward use of more reliable contraceptive methods The impact of antenatal counselling on  couples '  knowledge and practice of contraception was investigated . An interview question naire was used before and after conducting counselling sessions with 200 pregnant women and 100 spouses . The participants were followed up immediately after delivery and 3 months later . Both the control and study groups displayed a lack of knowledge of contraception . Counselling sessions improved the couples ' knowledge and practice in the study group . Involving husb and s in family planning counselling sessions led to joint decisions being made and encouraged women 's use of contraception . The majority of couples retained most of the information given . Integrating family planning counselling into antenatal care in all facilities and involving the husb and are recommended BACKGROUND Group , rather than individual , family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human re sources . STUDY DESIGN A r and omized , noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana . Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008 . Patients were r and omized to receive either group or individual family planning counseling .  The primary outcome in this study was change in modern contraceptive method knowledge . Changes in family planning use intention before and after the intervention and intended method type were also explored . RESULTS Comparisons between the two study arms suggest that r and omization was successful . The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms ( group-individual ) , adjusted for study site , was -0.21 , ( 95 % confidence interval : -0.53 to 0.12 ) suggesting no difference between the two arms . CONCLUSIONS Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana 
    Output:
    
Dem and generation interventions contribute to increases in modern contraceptive methods use .