***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 estimate the efficacy of a psycho-behavioral intervention in reducing intimate partner violence recurrence during pregnancy and postpartum and in improving birth outcomes in African-American women . METHODS : We conducted a r and omized controlled trial for which 1,044 women were recruited . Women were r and omly assigned to receive either intervention ( n=521 ) or usual care ( n=523 ) . Individually tailored counseling sessions were adapted from evidence -based interventions for intimate partner violence and other risks . Logistic regression was used to model intimate partner violence victimization recurrence and to predict minor , severe , physical , and sexual intimate partner violence . RESULTS : Women r and omly assigned to the intervention group were less likely to have recurrent episodes of intimate partner violence victimization ( odds ratio [ OR ] 0.48 , 95 % confidence interval [ CI ] 0.29–0.80 ) . Women with minor intimate partner violence were significantly less likely to experience further episodes during pregnancy ( OR 0.48 , 95 % CI 0.26–0.86 , OR 0.53 , 95 % CI 0.28–0.99 ) and postpartum ( OR 0.56 , 95 % CI 0.34–0.93 ) . Numbers needed to treat were 17 , 12 , and 22 , respectively , as compared with the usual care group . Women with severe intimate partner violence showed significantly reduced episodes postpartum ( OR 0.39 , 95 % CI 0.18–0.82 ) ; the number needed to treat was 27 . Women who experienced physical intimate partner violence showed significant reduction at the first follow-up ( OR 0.49 , 95 % CI 0.27–0.91 ) and postpartum ( OR 0.47 , 95 % CI 0.27–0.82 ) ; the numbers needed to treat were 18 and 20 , respectively . Women in the intervention group had significantly fewer very preterm neonates ( 1.5 % intervention group , 6.6 % usual care group ; P=.03 ) and an increased mean gestational age ( 38.2±3.3 intervention group , 36.9±5.9 usual care group ; P=.016 ) . CONCLUSION : A relatively brief intervention during pregnancy had discernible effects on intimate partner violence and pregnancy outcomes . Screening for intimate partner violence as well as other psychosocial and behavioral risks and incorporating similar interventions in prenatal care is strongly recommended . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00381823 . LEVEL OF EVIDENCE : BACKGROUND Women experiencing domestic violence ( DV ) frequent health care setting s , but DV is rarely identified . METHODS We conducted a r and omized controlled trial to determine the effect of computer screening on health care provider-patient DV communication  at 2 socioeconomically diverse emergency departments ( EDs ) . Consenting nonemergent female patients , aged 18 to 65 years , were r and omized to self-administered computer-based health risk assessment , with a prompt for the health care provider , or to " usual care " ; all visits were audiotaped . Outcome measures were rates of DV discussion , disclosure , and services . RESULTS Of 2169 eligible patients , 1281 ( 59 % ) consented ; 871 ( 68 % ) were successfully audiotaped , and 903 ( 71 % ) completed an exit question naire . Rates of current DV risk on exit question naire were 26 % in the urban ED and 21 % in the suburban ED . In the urban ED , the computer prompt increased rates of DV discussion ( 147/262 [ 56 % ] vs 123/275 [ 45 % ] ; P = .004 ) , disclosure ( 37/262 [ 14 % ] vs 23/275 [ 8 % ] ; P = .07 ) , and services provided ( 21 [ 8 % ] vs 10 [ 4 % ] ; P = .04 ) . Women at the suburban site and those with private insurance or higher education were much less likely to be asked about experiences with abuse . Only 48 % of encounters with a health care provider prompt regarding potential DV risk led to discussion s. Both inquiries about and disclosures of abuse were associated with higher patient satisfaction with care . CONCLUSIONS Computer screening for DV increased but did not guarantee that DV would be addressed during ED encounters . Nonetheless , it is likely that low-cost interventions that allow patients the opportunity to self-disclose can be used to improve detection of DV This study examines whether an integrated behavioral intervention with proven efficacy in reducing psycho-behavioral risks ( smoking , environmental tobacco smoke exposure ( ETSE ) , depression , and intimate partner violence ( IPV ) ) in African-Americans is associated with improved pregnancy outcomes . A r and omized controlled trial targeting risks during pregnancy was conducted in the District of Columbia . African-American women were recruited if reporting at least one of the risks mentioned above . R and omization to intervention or usual care was site and risk specific . Sociodemographic , health risk and pregnancy outcome data were collected . Data on 819 women , and their singleton live born infants were analyzed using an intent-to-treat approach . Bivariate analyses preceded a reduced logistical model approach to eluci date the effect of the intervention on the reduction of prematurity and low birth weight . The incidence of low birthweight ( LBW ) was 12 % and very low birthweight ( VLBW ) was 1.6 % . Multivariate logistic regression results showed that depression was associated with LBW ( OR = 1.71 , 95 % CI = 1.12–2.62 ) . IPV was associated with preterm birth ( PTB ) and very preterm birth ( VPTB ) ( OR 1.64 , 95 % CI = 1.07–2.51 , OR = 2.94 , 95 % CI = 1.40–6.16 , respectively ) . The occurrence of VPTB was significantly reduced in the intervention compared to the usual care group ( OR = 0.42 , 95 % CI = 0.19 - 0.93 ) . Our study confirms the significant associations between multiple psycho-behavioral risks and poor pregnancy outcomes , including LBW and PTB . Our behavioral intervention with demonstrated efficacy in addressing multiple risk factors simultaneously reduced VPTB within an urban minority population OBJECTIVES To estimate whether home visitation beginning after childbirth was associated with changes in average rates of mothers ' intimate partner violence ( IPV ) victimization and perpetration as well as rates of specific IPV types ( physical assault , verbal abuse , sexual assault , and injury ) during the 3 years of program implementation and during 3 years of long-term follow-up . DESIGN R and omized controlled trial . SETTING Oahu , Hawaii . PARTICIPANTS Six hundred forty-three families with an infant at high risk for child maltreatment born between November 1994 and December 1995 . Intervention Home visitors provided direct services and linked families to community re sources . Home visits were to initially occur weekly and to continue for at least 3 years . MAIN OUTCOME MEASURES Women 's self-reports of past-year IPV victimization and perpetration using the Conflict Tactics Scale . Blinded research staff conducted maternal interviews following the child 's birth and annually when children were aged 1 to 3 years and then 7 to 9 years . RESULTS During program implementation ,  intervention mothers as compared with control mothers reported lower rates of IPV victimization ( incidence rate ratio [ IRR ] , 0.86 ; 95 % confidence interval [ CI ] , 0.73 - 1.01 ) and significantly lower rates of perpetration ( IRR , 0.83 ; 95 % CI , 0.72 - 0.96 ) . Considering specific IPV types , intervention women reported significantly lower rates of physical assault victimization ( IRR , 0.85 ; 95 % CI , 0.71 - 1.00 ) and perpetration ( IRR , 0.82 ; 95 % CI , 0.70 - 0.96 ) . During long-term follow-up , rates of overall IPV victimization and perpetration decreased , with nonsignificant between-group differences . Verbal abuse victimization rates ( IRR , 1.14 , 95 % CI , 0.97 - 1.34 ) may have increased among intervention mothers . CONCLUSION Early-childhood home visitation may be a promising strategy for reducing IPV To assess the accuracy of 5  domestic violence screening questions design ed with less graphic language that they may be appropriate when children are present , mothers ( n = 400 ) were recruited from primary care waiting rooms .  Sensitivities , specificities , and predictive values were calculated using the revised Conflict Tactic Scale . “ How do you and your partner work out arguments ? ” was the best individual question ( area under the receiver operating characteristics curve 0.82 , sensitivity 25 % , specificity 97.7 % ) . The 3- question combination with the domains of argument , safety , and manner of treating you and the children had the best results ( area under the receiver operating characteristics curve 0.86 , sensitivity 45.5 % , and specificity 94.6 % ) . The high specificity suggests a less graphic and potentially more acceptable group of questions for introductory discussion s about domestic violence Abstract Background Effective interventions to increase safety and wellbeing of mothers experiencing intimate partner violence ( IPV ) are scarce . As much attention is focussed on professional intervention , this study aim ed to determine the effectiveness of non-professional mentor support in reducing IPV and depression among pregnant and recent mothers experiencing , or at risk of IPV . Methods MOSAIC was a cluster r and omised trial in 106 primary care ( maternal and child health nurse and general practitioner ) clinics in Melbourne , Australia . 63/106 clinics referred 215 eligible culturally and linguistically diverse women between January 2006 and December 2007 . 167 in the intervention ( I ) arm , and 91 in the comparison ( C ) arm . 174 ( 80.9 % ) were recruited . 133 ( 76.4 % ) women ( 90 I and 43 C ) completed follow-up at 12 months . Intervention : 12 months of weekly home visiting from trained and supervised local mothers , ( English & Vietnamese speaking ) offering non-professional befriending , advocacy , parenting support and referrals . Main outcome measures : Primary outcomes ; IPV ( Composite Abuse Scale CAS ) and depression ( Edinburgh Postnatal Depression Scale EPDS ) ; secondary measures included wellbeing ( SF-36 ) , parenting stress ( PSI-SF ) and social support ( MOS-SF ) at baseline and follow-up . Analysis : Intention-to-treat using multivariable logistic regression and propensity scoring . Results There was evidence of a true difference in mean abuse scores at follow-up in the intervention compared with the comparison arm ( 15.9 vs 21.8 , AdjDiff -8.67 , CI -16.2 to -1.15 ) . There was weak evidence for other outcomes , but a trend was evident favouring the intervention : proportions of women with CAS scores ≥7 , 51/88 ( 58.4 % ) vs 27/42 ( 64.3 % ) AdjOR 0.47 , CI 0.21 to 1.05 ) ; depression ( EPDS score ≥13 ) ( 19/85 , 22 % ( I ) vs 14/43 , 33 % ( C ) ; AdjOR 0.42 , CI 0.17 to 1.06 ) ; physical wellbeing mean scores ( PCS-SF36 : AdjDiff 2.79 ; CI -0.40 to 5.99 ) ; mental wellbeing mean scores ( MCS-SF36 : AdjDiff 2.26 ; CI -1.48 to 6.00 ) . There was no observed effect on parenting stress . 82 % of women mentored would recommend mentors to friends in similar situations . Conclusion Non-professional mentor mother support appears promising for improving safety and enhancing physical and mental wellbeing among mothers experiencing intimate partner violence referred from primary care . Trial registration Background Intimate partner violence ( IPV ) is prevalent globally , experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children . There are very few studies with rigorous design s which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women . Evidence for the separate benefit to victims of social support , advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence , the associated mental health damage and may increase a woman 's health , safety and connection with her children . This paper describes the development , design and implementation of a trial of mentor mother support set in primary care , including baseline characteristics of participating women . Methods / Design MOSAIC ( MOtherS ' Advocates In the Community ) was a cluster r and omised trial embedded in general practice and maternal and child health ( MCH ) nursing services in disadvantaged suburbs of Melbourne , Australia . Women who were pregnant or with infants , identified as abused or symptomatic of abuse , were referred by IPV-trained GPs and MCH nurses from 24 general practice s and eight nurse teams from January 2006 to December 2007 . Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers .  Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub- study 
    Output:
    
Screening instruments accurately identify women experiencing IPV .
Screening women for IPV can provide benefits that vary by population , while potential adverse effects have minimal effect on most women .