***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: Latino children experience higher rates of obesity than do non-Latino white children .  Family-centered nutrition interventions can slow the rate of weight gain in this population . Niños Sanos , Familia Sana ( Healthy Children , Healthy Family ) is a 5-year , community-based , participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California ’s Central Valley . Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages , pilot testing and implementation of key messages and activities at family nights , and continual modification to incorporate culturally innovative elements . Of the 238 families enrolled , 53 % ( 125 ) attended the recommended minimum of 5 ( of 10 possible ) classes during the first year . A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs Background Overweight and obesity have a dramatic negative impact on children 's health not only during the childhood but also throughout the adult life . Preventing the development of obesity in children is therefore a world-wide health priority . There is an obvious urge for sustainable and evidence d-based interventions that are suitable for families with young children , especially for families with overweight or obese parents . We have developed a prevention program , Early STOPP , combating multiple obesity-promoting behaviors such unbalanced diet , physical inactivity and disturbed sleeping patterns . We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents . This protocol outlines methods for the recruitment phase of the study . Design and methods This r and omized controlled trial ( RCT ) targets overweight and /or obese parents with infants , recruited from the Child Health Care Centers ( CHCC ) within the Stockholm area . The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach ( dietitian , physiotherapist or a nurse ) . The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC , which include advices on healthy food choices and eating patterns , increasing physical activity/reducing sedentary behavior  and regulating  sleeping patterns . Discussion The Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population , defining a feasible , theory-based intervention and assessing multiple measurements to vali date and interpret the program effectiveness . The early years hold promise as a time in which obesity prevention may be most effective . To our knowledge , this longitudinal RCT is the first attempt to demonstrate whether an early , long-term , targeted health promotion program focusing on  healthy eating , physical activity/reduced sedentary behaviors and normalizing sleeping patterns could be effective . If proven so , Early STOPP may protect children from the development of overweight and obesity . Trial registration The protocol for this study is registered with the clinical trials registry clinical trials.gov , ID : ES-2010 OBJECTIVE The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity ! , a r and omized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler ( 2 - 5 years old ) dyads in North Carolina ( 2007 - 2011 ) . The outcomes include change from baseline in the child 's diet , physical activity and weight , and in the mother 's parenting behaviors , diet , physical activity , and weight . METHOD The intervention targeted parenting through maternal emotion regulation , home environment , feeding practice s , and modeling of healthy behaviors .  400 mother-child dyads were r and omized . RESULTS Mothers in the intervention arm , compared to the control arm , reduced  instrumental feeding  ( -0.24 vs. 0.01 , p<0.001 ) and TV snacks ( -.069 vs. -0.24 , p=0.001 ) . There were also improvements in emotional feeding ( p=0.03 ) , mother 's sugary beverage ( p=0.03 ) and fruit/vegetable ( p=0.04 ) intake , and dinners eaten in front of TV ( p=0.01 ) ; these differences were not significant after adjustment for multiple comparisons . CONCLUSION KAN-DO , design ed to maximize the capacity of mothers as agents of change , improved several channels of maternal influence . There were no group differences in the primary outcomes , but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers ' diets . Long-term follow-up will address whether these short-term trends ultimately improve weight status Background Childhood obesity is an increasing health problem globally . Overweight and obesity may be established as early as 2–5 years of age , highlighting the need for evidence -based effective prevention and treatment programs early in life . In adults , mobile phone based interventions for weight management ( mHealth ) have demonstrated positive effects on body mass , however , their use in child population s has yet to be examined . The aim of this paper is to report the study design and methodology of the MINSTOP ( Mobile-based Intervention Intended to Stop Obesity in Preschoolers ) trial . Methods / Design A two-arm , parallel design r and omized controlled trial in 300 healthy Swedish 4-year-olds is conducted . After baseline measures , parents are allocated to either an intervention- or control group . The 6- month mHealth intervention consists of a web-based application ( the MINSTOP app ) to help  parents promote healthy eating and physical activity in children .  MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive , personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children . Parents also register physical activity and intakes of c and y , soft drinks , vegetables as well as fruits of their child and receive feedback through the application . Primary outcomes include body fatness and energy intake , while secondary outcomes are time spent in sedentary , moderate , and vigorous physical activity , physical fitness and intakes of fruits and vegetables , snacks , soft drinks and c and y. Food and energy intake ( Tool for Energy balance in Children , TECH ) , body fatness ( pediatric option for BodPod ) , physical activity ( Actigraph wGT3x-BT ) and physical fitness ( the PREFIT battery of five fitness tests ) are measured at baseline , after the intervention ( six months after baseline ) and at follow-up ( 12 months after baseline ) . Discussion This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children . If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity . Trial registration Clinical Trials.gov NCT02021786 ; 20 Dec 2013 Introduction Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course . Early feeding choices , including breast and /or formula , timing of introduction of solids , physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity . Parents play a primary role in shaping these behaviours through parental modelling , feeding styles , and the food and physical activity environments provided . Children from low socio-economic background s have higher rates of obesity , making early intervention particularly important . However , such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours . Parents across all socio-demographic groups frequently access primary health care ( PHC ) services , including nurses in community health services and general medical practice s , providing unparalleled opportunity for engagement to influence family behaviours . One emerging and promising area that might maximise engagement at a low cost is the provision of support for  healthy parenting  through electronic media such as the Internet or smart phones . The Growing healthy study explores the feasibility of delivering such support via primary health care services . Methods This paper describes the Growing healthy study , a non-r and omised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app ( or website ) for parents living in socioeconomically disadvantaged areas , for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain .  Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old . Data will be collected via web-based question naires and the data collected inherently by the app itself . Ethics and dissemination This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer- review ed publications and conference presentations To assess the feasibility of a pediatric primary care based intervention to promote healthful behaviors among 0–6 month old infants and their mothers . We enrolled  two intervention practice s ( 60 mother-infant pairs ) and one usual care control practice ( 24 pairs ) in a non-r and omized controlled trial . We completed visits and interviews with 80 ( 95 % ) pairs at birth and 6 months . The intervention included ( 1 ) brief focused negotiation by pediatricians , ( 2 ) motivational counseling by a health educator , and ( 3 ) group parenting workshops . We evaluated the intervention effects on infant feeding , sleep duration , TV viewing , and mothers ’ responsiveness to satiety cues . Maternal behavioral targets included postpartum diet , physical activity , TV and sleep . At 6 months , fewer intervention than control infants had been introduced to solid foods ( 57 % vs. 82 % ; P = 0.04 ) , and intervention infants viewed less TV ( mean 1.2 vs. 1.5 h/d ; P = 0.07 ) . Compared to control infants , intervention infants had larger increases in their nocturnal sleep duration from baseline to follow up ( mean increase 1.9 vs. 1.3 h/d ; P = 0.05 ) ; larger reductions in settling time ( mean reduction −0.70 vs. −0.10 h/d ; P = 0.02 ) ; and larger reductions in hours/day of nighttime wakefulness ( mean reduction −2.9 vs. −1.5 h/d ; P = 0.08 ) . There were no differences in breastfeeding , response to satiety cues , or maternal health behaviors . A program of brief focused negotiation by pediatricians , individual coaching by health educators using motivational interviewing , and group parenting workshops tended to improve infant feeding , sleep and media exposure , but had less impact on mothers ’ own health-related behaviors IMPORTANCE Rapid infant weight gain  is associated with later obesity , but interventions to prevent rapid infant growth and reduce risk for overweight status in infancy are lacking . OBJECTIVE To examine the effect of a responsive parenting ( RP ) intervention on  infant weight gain between birth and 28 weeks and overweight status at age 1 year . DESIGN , SETTING , AND PARTICIPANTS The Intervention Nurses Start Infants Growing on Healthy Trajectories ( INSIGHT ) study is an ongoing r and omized clinical trial comparing an RP intervention design ed to prevent childhood obesity with a safety control . The study includes primiparous mother-newborn dyads ( n = 291 ) and was conducted at the Penn State Milton S. Hershey Medical Center , Hershey , Pennsylvania , in addition to home visits . Enrollment was initiated in January 2012 , and evaluable population analyses for this study were conducted between April 2015 and November 2015 . INTERVENTIONS At 2 weeks post partum , initial intervention material s appropriate to the assigned treatment group were mailed to the participant 's home . Research nurses conducted home visits at 3 weeks , 16 weeks , 28 weeks , and 40 weeks , and a research center visit occurred at 1 year . The Intervention Nurses Start Infants Growing on Healthy Trajectories curriculum included messages about infant feeding , sleep hygiene , active social play , emotion regulation , and growth record education . The control group received a developmentally appropriate home safety intervention also delivered by nurse home visitors . MAIN OUTCOMES AND MEASURES Conditional weight gain from birth to 28 weeks was calculated . General linear models examined intervention effect on conditional weight gain . The intervention 's effect on infant weight-for-length percentiles was tested using analysis of variance . Logistic regression compared the odds of overweight status ( weight for length ≥95th percentile ) at 1 year as a function of conditional weight gain . RESULTS Of the mothers included in the study , 246 were white ( 88 % ) , 260 were non-Hispanic ( 93 % ) , 210 were married ( 75 % ) , and 201 were working full time ( 72 % ) at time of enrollment . The mean conditional weight gain score was lower among infants in the RP group compared with the control group ( -0.18 ; 95 % CI , -0.36 to -0.001 ) , reflecting that the RP infants gained weight more slowly than control group infants ( 0.18 ; 95 % CI , 0.02 - 0.34 ) ; this effect did not differ by feeding mode ( predominantly fed breast milk or not ) . Infants in the RP group also had lower mean weight-for-length percentiles at 1 year than infants in the control group ( 57.5 % ; 95 % CI , 52.56%-62.37 % vs 64.4 % ; 95 % CI , 59.94%-69.26 % ; P = .04 ) and were less likely to be overweight at age 1 year ( 5.5 % vs 12.7 % ; P = .05 ) . CONCLUSIONS AND RELEVANCE An RP intervention is associated with reduced rapid weight gain during the first 6 months after birth and overweight status at age 1 year . TRIAL REG 
    Output:
    
Results demonstrate that sleep promotion is underrepresented and variable in family-based childhood obesity interventions .