human
***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 This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer 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 Objective The purpose of this study was to evaluate the effect of a physical therapy exercise and health care education program on the  psychological well-being of new mothers . Design This was a r and omized controlled trial . Participants Primiparous and multiparous English-speaking women ready for discharge from The Angliss Hospital postnatal ward were eligible for this study . Women who were receiving psychiatric care were excluded . One hundred sixty-one women were r and omized into the trial . Intervention The experimental group ( n=62 ) received an 8-week “ Mother and Baby ” ( M&B ) program , including specialized exercise provided by a women 's health physical therapist combined with parenting education . The other group ( education only [ EO ] , n=73 ) received only the same educational material as the experimental group . Main Outcome Measures Psychological well-being ( Positive Affect Balance Scale ) , depressive symptoms ( Edinburgh Postnatal Depression Scale ) , and physical activity levels were assessed at baseline , after 8 weeks ( post-program ) , and then 4 weeks later . Results There was significant improvement in well-being scores and depressive symptoms of the M&B group compared with the EO group over the study period . More specifically , there was a significant positive effect on well-being scores and depressive symptoms at 8 weeks , and this effect was maintained 4 weeks after completion of the program . The number of women identified as “ at risk ” for postnatal depression pre-intervention was reduced by 50 % by the end of the intervention . Limitations Although this study provides promising short-term ( 4-week ) outcomes , further work is needed to explore whether the intervention effects are maintained as sustained psychological and behavioral benefits at 6 months . Conclusions A physical therapy exercise and health education program is effective in improving postnatal well-being . Routine use of this program may reduce longer-term problems such as postnatal depression Background Postpartum weight retention may contribute to the development of obesity . We studied whether individual counselling on diet and physical activity from 2 to 10 months postpartum has positive effects on diet and leisure time physical activity and increases the proportion of primiparas returning to their pre-pregnancy weight . Methods A controlled trial including ninety-two postpartum primiparas was conducted in three intervention and three control child health clinics in primary health care in Finl and . The intervention included individual counselling on diet and physical activity during five routine visits to a public health nurse ; the controls received the usual care . Results In total , 50 % of the intervention group and 30 % of the control group returned to their pre-pregnancy weight ( weight retention ≤ 0 kg ) by 10 months postpartum ( p = 0.06 ) . The confounder-adjusted odds ratio for returning to pre-pregnancy weight was 3.89 ( 95 % CI 1.16–13.04 , p = 0.028 ) for the intervention group compared with the controls . The mean proportion of high-fibre bread ( of total weekly amount of bread ) increased by 16.1 % ( 95 % CI 4.3–27.9 ) by 10 months postpartum in the intervention group compared with the controls when adjusted for confounders ( p = 0.008 ) . No significant differences were observed in changes in leisure time physical activity between the groups . Conclusion The intervention increased the proportion of  primiparas returning to pre-pregnancy weight  and the proportion of high-fibre bread in their diet . Larger r and omized controlled trials are needed to show whether counselling can improve dietary and leisure time physical activity habits in postpartum women and also to confirm the results concerning the effect on reducing postpartum weight retention . Trial registration Current Controlled Trials IS RCT Background Pregnancy and childbirth are associated with weight gain in women , and retention of weight gained during pregnancy can lead to obesity in later life . Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth . Exercise guidelines exist for pregnancy , but recommendations for exercise after childbirth are virtually nonexistent . The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth . Methods We conducted a r and omized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were r and omly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer ( intervention group , n = 32 ) or routine postpartum care ( control group , n = 34 ) . During the 12-week study period , each woman in the intervention group wore a  pedometer and recorded her daily step count .  The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week . Assessed outcomes included anthropometric measures , physical activity level , and energy expenditure per week . Data were analyzed using the paired t-test , independent t-test , Mann-Whitney , chi-square , Wilcoxon , covariance analysis , and the general linear model repeated measures procedure as appropriate . Results After 12 weeks , women in the intervention group had significantly increased their physical activity and energy expenditure per week ( 4394 vs. 1651 calorie , p < 0.001 ) . Significant differences between-group in weight ( P = 0.001 ) , Body Mass Index ( P = 0.001 ) , waist circumference ( P = 0.001 ) , hip circumference ( P = 0.032 ) and waist-hip ratio ( P = 0.02 ) were presented after the intervention . The intervention group significantly increased their mean daily step count over the study period ( from 3249 before , to 9960 after the intervention , p < 0.001 ) . Conclusion A physical activity intervention based on pedometer is an effective means to increase physical activity ; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women . Trial registration IS RCT N : I RCT OBJECTIVE To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory ( SCT ) constructs targeted in the intervention ( barrier self efficacy , goal setting skills , outcome expectancy , social support , and perceived environmental opportunity for exercise ) . This paper also examined if the mediating constructs differed between initial ( baseline to 6 weeks ) and overall ( baseline to 13 weeks ) changes in physical activity . METHODS Secondary analysis of data from a r and omized controlled trial involving 88 postnatal women ( < 12 months postpartum ) . Participants were r and omized to receive either the 12-week MobileMums intervention or a minimal-contact control condition .  Physical activity and proposed mediators were assessed by self-report at baseline , 6 weeks , and 13 weeks .  Walking for Exercise frequency was assessed using the Australian Women 's Activity Survey and frequency of moderate-to-vigorous physical activity ( MVPA ) was assessed using a single-item question . RESULTS Initial improvements in goal - setting skills mediated the relationship between experimental condition and initial changes in MVPA , αβ ( 95 % CI ) = 0.23(0.01 , 0.59 ) , and Walking for Exercise , αβ ( 95 % CI ) = 0.34(0.06 , 0.73 ) . Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA , αβ ( 95 % CI ) = 0.36(0.12 , 0.65 ) , but not Walking for Exercise . None of the SCT outcomes significantly mediated the relationship between experimental condition and overall ( baseline to 13 weeks ) change in frequency of MVPA or Walking for Exercise . CONCLUSION Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity BACKGROUND Women with children are less likely to engage in  adequate physical activity ( PA )  than women without children . This study aim ed to evaluate the efficacy of two strategies for promoting increased  PA  among mothers of preschool-aged children , and to explore the mediators of any result ing change in PA behavior . DESIGN Controlled intervention trial incorporating repeated data collection from 554 women , r and omized to one of three experimental conditions . Intervention Group 1 served as a control , while women in Groups 2 and 3 were given print information about overcoming PA barriers . Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children . The primary strategies included increasing partner support , social advocacy , and capacity building , and were implemented through collaboration among participants , research ers , and community organizations . MAIN OUTCOME MEASURES Adequate physical activity ( PA ) , self-efficacy ( SE ) and partner support ( PS ) . RESULTS Following the intervention , women in Group 3 were significantly more likely to meet guidelines for PA than controls ( odds ratio [OR]=1.71 , confidence interval [CI]=1.05 - 2.77 ) ] after controlling for age and PA at baseline . After controlling for baseline PA , residualized change in SE ( OR=1.86 , CI=1.17 - 2.94 ) and PS ( OR=2.29 , CI=1.46 - 3.58 ) significantly predicted meeting guidelines . After controlling for residual change in PS and SE , the significant intervention effect was attenuated ( Group 3 OR=1.40 , CI=0.76 - 2.36 ) , indicating that partner support and self-efficacy may be mediators of physical activity behavior change . CONCLUSIONS The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA  among mothers 
    Output:
    
agent
***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 This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer 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 Objective The purpose of this study was to evaluate the effect of a physical therapy exercise and health care education program on the  psychological well-being of new mothers . Design This was a r and omized controlled trial . Participants Primiparous and multiparous English-speaking women ready for discharge from The Angliss Hospital postnatal ward were eligible for this study . Women who were receiving psychiatric care were excluded . One hundred sixty-one women were r and omized into the trial . Intervention The experimental group ( n=62 ) received an 8-week “ Mother and Baby ” ( M&B ) program , including specialized exercise provided by a women 's health physical therapist combined with parenting education . The other group ( education only [ EO ] , n=73 ) received only the same educational material as the experimental group . Main Outcome Measures Psychological well-being ( Positive Affect Balance Scale ) , depressive symptoms ( Edinburgh Postnatal Depression Scale ) , and physical activity levels were assessed at baseline , after 8 weeks ( post-program ) , and then 4 weeks later . Results There was significant improvement in well-being scores and depressive symptoms of the M&B group compared with the EO group over the study period . More specifically , there was a significant positive effect on well-being scores and depressive symptoms at 8 weeks , and this effect was maintained 4 weeks after completion of the program . The number of women identified as “ at risk ” for postnatal depression pre-intervention was reduced by 50 % by the end of the intervention . Limitations Although this study provides promising short-term ( 4-week ) outcomes , further work is needed to explore whether the intervention effects are maintained as sustained psychological and behavioral benefits at 6 months . Conclusions A physical therapy exercise and health education program is effective in improving postnatal well-being . Routine use of this program may reduce longer-term problems such as postnatal depression Background Postpartum weight retention may contribute to the development of obesity . We studied whether individual counselling on diet and physical activity from 2 to 10 months postpartum has positive effects on diet and leisure time physical activity and increases the proportion of primiparas returning to their pre-pregnancy weight . Methods A controlled trial including ninety-two postpartum primiparas was conducted in three intervention and three control child health clinics in primary health care in Finl and . The intervention included individual counselling on diet and physical activity during five routine visits to a public health nurse ; the controls received the usual care . Results In total , 50 % of the intervention group and 30 % of the control group returned to their pre-pregnancy weight ( weight retention ≤ 0 kg ) by 10 months postpartum ( p = 0.06 ) . The confounder-adjusted odds ratio for returning to pre-pregnancy weight was 3.89 ( 95 % CI 1.16–13.04 , p = 0.028 ) for the intervention group compared with the controls . The mean proportion of high-fibre bread ( of total weekly amount of bread ) increased by 16.1 % ( 95 % CI 4.3–27.9 ) by 10 months postpartum in the intervention group compared with the controls when adjusted for confounders ( p = 0.008 ) . No significant differences were observed in changes in leisure time physical activity between the groups . Conclusion The intervention increased the proportion of  primiparas returning to pre-pregnancy weight  and the proportion of high-fibre bread in their diet . Larger r and omized controlled trials are needed to show whether counselling can improve dietary and leisure time physical activity habits in postpartum women and also to confirm the results concerning the effect on reducing postpartum weight retention . Trial registration Current Controlled Trials IS RCT Background Pregnancy and childbirth are associated with weight gain in women , and retention of weight gained during pregnancy can lead to obesity in later life . Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth . Exercise guidelines exist for pregnancy , but recommendations for exercise after childbirth are virtually nonexistent . The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth . Methods We conducted a r and omized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were r and omly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer ( intervention group , n = 32 ) or routine postpartum care ( control group , n = 34 ) . During the 12-week study period , each woman in the intervention group wore a  pedometer and recorded her daily step count .  The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week . Assessed outcomes included anthropometric measures , physical activity level , and energy expenditure per week . Data were analyzed using the paired t-test , independent t-test , Mann-Whitney , chi-square , Wilcoxon , covariance analysis , and the general linear model repeated measures procedure as appropriate . Results After 12 weeks , women in the intervention group had significantly increased their physical activity and energy expenditure per week ( 4394 vs. 1651 calorie , p < 0.001 ) . Significant differences between-group in weight ( P = 0.001 ) , Body Mass Index ( P = 0.001 ) , waist circumference ( P = 0.001 ) , hip circumference ( P = 0.032 ) and waist-hip ratio ( P = 0.02 ) were presented after the intervention . The intervention group significantly increased their mean daily step count over the study period ( from 3249 before , to 9960 after the intervention , p < 0.001 ) . Conclusion A physical activity intervention based on pedometer is an effective means to increase physical activity ; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women . Trial registration IS RCT N : I RCT OBJECTIVE To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory ( SCT ) constructs targeted in the intervention ( barrier self efficacy , goal setting skills , outcome expectancy , social support , and perceived environmental opportunity for exercise ) . This paper also examined if the mediating constructs differed between initial ( baseline to 6 weeks ) and overall ( baseline to 13 weeks ) changes in physical activity . METHODS Secondary analysis of data from a r and omized controlled trial involving 88 postnatal women ( < 12 months postpartum ) . Participants were r and omized to receive either the 12-week MobileMums intervention or a minimal-contact control condition .  Physical activity and proposed mediators were assessed by self-report at baseline , 6 weeks , and 13 weeks .  Walking for Exercise frequency was assessed using the Australian Women 's Activity Survey and frequency of moderate-to-vigorous physical activity ( MVPA ) was assessed using a single-item question . RESULTS Initial improvements in goal - setting skills mediated the relationship between experimental condition and initial changes in MVPA , αβ ( 95 % CI ) = 0.23(0.01 , 0.59 ) , and Walking for Exercise , αβ ( 95 % CI ) = 0.34(0.06 , 0.73 ) . Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA , αβ ( 95 % CI ) = 0.36(0.12 , 0.65 ) , but not Walking for Exercise . None of the SCT outcomes significantly mediated the relationship between experimental condition and overall ( baseline to 13 weeks ) change in frequency of MVPA or Walking for Exercise . CONCLUSION Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity BACKGROUND Women with children are less likely to engage in  adequate physical activity ( PA )  than women without children . This study aim ed to evaluate the efficacy of two strategies for promoting increased  PA  among mothers of preschool-aged children , and to explore the mediators of any result ing change in PA behavior . DESIGN Controlled intervention trial incorporating repeated data collection from 554 women , r and omized to one of three experimental conditions . Intervention Group 1 served as a control , while women in Groups 2 and 3 were given print information about overcoming PA barriers . Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children . The primary strategies included increasing partner support , social advocacy , and capacity building , and were implemented through collaboration among participants , research ers , and community organizations . MAIN OUTCOME MEASURES Adequate physical activity ( PA ) , self-efficacy ( SE ) and partner support ( PS ) . RESULTS Following the intervention , women in Group 3 were significantly more likely to meet guidelines for PA than controls ( odds ratio [OR]=1.71 , confidence interval [CI]=1.05 - 2.77 ) ] after controlling for age and PA at baseline . After controlling for baseline PA , residualized change in SE ( OR=1.86 , CI=1.17 - 2.94 ) and PS ( OR=2.29 , CI=1.46 - 3.58 ) significantly predicted meeting guidelines . After controlling for residual change in PS and SE , the significant intervention effect was attenuated ( Group 3 OR=1.40 , CI=0.76 - 2.36 ) , indicating that partner support and self-efficacy may be mediators of physical activity behavior change . CONCLUSIONS The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA  among mothers 
    Output:
    