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: The purpose of this study was to assess the effect of traditional prenatal care versus a group model of care , CenteringPregnancy , on maternal knowledge of pregnancy , social support , health locus of control , and satisfaction . The CenteringPregnancy model of care gives patients extended time with the provider in a group setting . The study used a two-group , pretest/posttest design of pregnant women who elected either the traditional approach to prenatal care ( n = 48 ) or the Centering approach ( n = 50 ) . The results of this study showed statistically significant differences between the groups on posttest in knowledge of pregnancy . For social support and health locus of control , the high scores at pretest contributed to a ceiling effect , which limited the potential for change . Additional research is needed to assess health status outcomes among women electing alternative approaches to prenatal care OBJECTIVES We compared an evidence -based model of group prenatal care to traditional individual prenatal care on birth , neonatal , and reproductive health outcomes . METHODS We performed a multisite cluster r and omized controlled trial in 14 health centers in New York City ( 2008 - 2012 ) . We analyzed 1148 pregnant women aged 14 to 21 years , at less than 24 weeks of gestation , and not at high obstetrical risk . We assessed outcomes via medical records and surveys . RESULTS In intention-to-treat analyses , women at intervention sites were significantly less likely to have infants small for gestational age ( < 10th percentile ; 11.0 % vs 15.8 % ; odds ratio = 0.66 ; 95 % confidence interval = 0.44 , 0.99 ) . In as-treated analyses , women with more group visits had better outcomes , including small for gestational age , gestational age , birth weight , days in neonatal intensive care unit , rapid repeat pregnancy , condom use , and unprotected sex ( P = .030 to < .001 ) . There were no associated risks . CONCLUSIONS CenteringPregnancy Plus group prenatal care result ed in more favorable birth , neonatal , and reproductive outcomes . Successful translation of clinical innovations to enhance care , improve outcomes , and reduce cost requires strategies that facilitate patient adherence and support organizational change To compare the psychosocial outcomes of the CenteringPregnancy ( CP ) model of group prenatal care to individual prenatal care , we conducted a prospect i ve cohort study of women who chose CP group ( N = 124 ) or individual prenatal care ( N = 124 ) . Study participants completed the first survey at study recruitment ( mean gestational age 12.5 weeks ) , with 89 % completing the second survey ( mean gestational age 32.7 weeks ) and 84 % completing the third survey ( 6 weeks ’ postpartum ) . Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress , prenatal planning-preparation and avoidance coping , perceived stress , affect and depressive symptoms , pregnancy-related empowerment , and postpartum maternal-infant attachment and maternal functioning . Using intention-to-treat models , group prenatal care participants demonstrated a 3.2 point greater increase ( p < 0.05 ) in their use of prenatal planning-preparation coping strategies . While group participants did not demonstrate significantly greater positive outcomes in other measures , women who were at greater psychosocial risk benefitted from participation in group prenatal care . Among women reporting inadequate social support in early pregnancy , group participants demonstrated a 2.9 point greater decrease ( p = 0.03 ) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum ( p = 0.03 ) . Among women with high pregnancy-specific distress in early pregnancy , group participants had an 8.3 point greater increase ( p < 0.01 ) in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease ( p = 0.02 ) in postpartum depressive symptom scores . This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping re sources . Large r and omized studies are needed to establish conclusively the biological and psychosocial benefits of group prenatal care for all women Objective To compare maternal and infant outcomes in Hispanic women participating in the Centering Pregnancy Model ( CPM ) to those receiving prenatal care via the traditional model  and determine acceptability of the CPM . Methods Forty-nine women ( n = 24 CPM ; n = 25 traditional ) participated in this quasi-experimental prospect i ve comparative design . Participants self selected the model of care delivery . Data were collected via question naires at the initial visit , 34–36 weeks gestation , and postpartum . Outcome measures included : satisfaction with care delivery model , health behaviors , prenatal/postnatal care knowledge , self-esteem and depression . Breastfeeding initiation and continuation , infant birth weight , gestational age at delivery , mode of delivery and infant length of stay were also collected . Results Traditional participants had a history of more pregnancies , more living children , and higher levels of postpartum self-esteem compared to centering participants . Knowledge deficits and health behaviors were similar between groups . No differences were found for infant outcomes . Conclusions This study provides information regarding Hispanic mothers ’ responses to an alternative care delivery model . Preliminary evidence suggests CPM compares with traditional care and yields a high degree of patient satisfaction . Specific pregnancy-related knowledge deficits were identified in both groups that could focus prenatal education . In light of similar outcomes in both groups ; patient and provider satisfaction and economics would therefore be a factor when choosing a model of prenatal care delivery OBJECTIVE To evaluate the effect of  mother-infant immediate skin-to-skin contact on primiparous mother 's  breastfeeding self-efficacy . STUDY DESIGN A r and omised control trial . SETTING S The study was conducted in Omolbanin obstetrics hospital ( large tertiary hospital ) , Mashhad , Iran . PARTICIPANTS 114 18 - 35 year-old primiparous , Iranian , healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies . INTERVENTION Skin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum . MAIN OUTCOME MEASURE Maternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation . RESULTS A total of 92 mother-infant dyads ( 47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group ) were monitored and analysed . In skin-to-skin contact group , breastfeeding self-efficacy was 53.42±8.57 SD as compared to 49.85±5.50 SD in routine care group which is significantly higher in skin-to-skin contact group ( p=0.0003 ) . Successful breastfeeding initiation rate was 56.6 % in skin-to-skin contact group as compared to 35.6 % in routine care group ( p=0.02 ) . Time to initiate first feed was 21.98±9.10 SD min in SSC group vs. 66.55±20.76 min in routine care group ( p<0.001 ) . CONCLUSION Mother-infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy . High breastfeeding self-efficacy increases exclusive breastfeeding duration OBJECTIVE To examine the impact of group versus individual prenatal care on birth weight and gestational age . METHODS This prospect i ve , matched cohort study included pregnant women ( N = 458 ) entering prenatal care at 24 or less weeks ' gestation ; one half received group prenatal care with women of the same gestational age . Women were matched by clinic , age , race , parity , and infant birth date . Women were predominantly black and Hispanic of low socioeconomic status , served by one of three public clinics in Atlanta , Georgia or New Haven , Connecticut . RESULTS Birth weight was greater for infants of women in group versus individual prenatal care ( P < .01 ) . Among those born preterm , infants of group patients were significantly larger than infants of individual-care patients ( mean , 2398 versus 1990 g , P < .05 ) . Although not statistically significant , infants of group patients were less likely than those of individual-care patients to be low birth weight ( less than 2500 g ; 16 versus 23 infants ) ;  very low birth weight ( less than 1500 g ; three versus six infants ) ; early preterm ( less than 33 weeks ; two versus seven infants ) ; or to  experience neonatal loss  ( none versus three infants ) . There were no differences in number of prenatal visits or other risk characteristics ( patient age , race , prior preterm birth ) . CONCLUSIONS Group prenatal care results in higher birth weight , especially for infants delivered preterm . Group prenatal care provides a structural innovation , permitting more time for provider – patient interaction and therefore the opportunity to address clinical as well as psychological , social , and behavioral factors to promote healthy pregnancy . Results have implication s for design of sustainable prenatal services that might contribute to reduction of racial disparities in adverse perinatal outcomes The military has recognized that health and quality of life for service members are closely tied to the re sources for their families , including how they are cared for during pregnancy and childbirth . However , there has been little examination of women 's experience with different models of prenatal care ( PNC ) in military setting s. The purpose of this article is to describe the results of a qualitative study of women 's experiences with the CenteringPregnancy model of group PNC compared to individual PNC in two military health care setting s. This clinical trial enrolled 322 women who were r and omized into group or individual PNC at two military treatment facilities . Qualitative interviews were completed with 234 women during the postpartum period . Interpretative narrative and thematic analysis was used to identify three themes : 1 ) " I was n't alone"-the experience with group PNC ; 2 ) " I liked it but ... "- recommendations to improve group PNC ; and 3 ) " They really need to listen"-general concerns across the sample about PNC . Greatest concerns of women in individual PNC included lack of continuity and time with the provider . Our military families must be assured that their health care system meets their needs through personal and family-centered care . Group PNC offers the potential for continuity of provider while also offering community with other women . In the process , women gain knowledge and power as a health care consumer OBJECTIVE The purpose of this study was to evaluate the impact of group prenatal care on rates of preterm birth . STUDY DESIGN We conducted a retrospective cohort study of 316 women in group prenatal care that was compared with 3767 women in traditional prenatal care .  Women self-selected participation in group care . RESULTS Risk factors for preterm birth were similar for group prenatal care vs traditional prenatal care :  smoking ( 16.9 % vs 20 % ; P = .17 ) , sexually transmitted diseases ( 15.8 % vs 13.7 % ; P = .29 ) , and previous preterm birth ( 3.2 % vs 5.4 % ; P = .08 ) . Preterm delivery ( < 37 weeks ' gestation ) was lower in group care than traditional care ( 7.9 % vs 12.7 % ; P = .01 ) , as was delivery at < 32 weeks ' gestation ( 1.3 % vs 3.1 % ; P = .03 ) . Adjusted odds ratio for preterm birth for participants in group care was 0.53 ( 95 % confidence interval , 0.34 - 0.81 ) . The racial disparity in preterm birth for black women , relative to white and Hispanic women , was diminished for the women in group care . CONCLUSION Among low-risk women , participation in group care improves the rate of preterm birth compared with traditional care , especially among black women . R and omized studies are needed to eliminate selection bias 
    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: The purpose of this study was to assess the effect of traditional prenatal care versus a group model of care , CenteringPregnancy , on maternal knowledge of pregnancy , social support , health locus of control , and satisfaction . The CenteringPregnancy model of care gives patients extended time with the provider in a group setting . The study used a two-group , pretest/posttest design of pregnant women who elected either the traditional approach to prenatal care ( n = 48 ) or the Centering approach ( n = 50 ) . The results of this study showed statistically significant differences between the groups on posttest in knowledge of pregnancy . For social support and health locus of control , the high scores at pretest contributed to a ceiling effect , which limited the potential for change . Additional research is needed to assess health status outcomes among women electing alternative approaches to prenatal care OBJECTIVES We compared an evidence -based model of group prenatal care to traditional individual prenatal care on birth , neonatal , and reproductive health outcomes . METHODS We performed a multisite cluster r and omized controlled trial in 14 health centers in New York City ( 2008 - 2012 ) . We analyzed 1148 pregnant women aged 14 to 21 years , at less than 24 weeks of gestation , and not at high obstetrical risk . We assessed outcomes via medical records and surveys . RESULTS In intention-to-treat analyses , women at intervention sites were significantly less likely to have infants small for gestational age ( < 10th percentile ; 11.0 % vs 15.8 % ; odds ratio = 0.66 ; 95 % confidence interval = 0.44 , 0.99 ) . In as-treated analyses , women with more group visits had better outcomes , including small for gestational age , gestational age , birth weight , days in neonatal intensive care unit , rapid repeat pregnancy , condom use , and unprotected sex ( P = .030 to < .001 ) . There were no associated risks . CONCLUSIONS CenteringPregnancy Plus group prenatal care result ed in more favorable birth , neonatal , and reproductive outcomes . Successful translation of clinical innovations to enhance care , improve outcomes , and reduce cost requires strategies that facilitate patient adherence and support organizational change To compare the psychosocial outcomes of the CenteringPregnancy ( CP ) model of group prenatal care to individual prenatal care , we conducted a prospect i ve cohort study of women who chose CP group ( N = 124 ) or individual prenatal care ( N = 124 ) . Study participants completed the first survey at study recruitment ( mean gestational age 12.5 weeks ) , with 89 % completing the second survey ( mean gestational age 32.7 weeks ) and 84 % completing the third survey ( 6 weeks ’ postpartum ) . Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress , prenatal planning-preparation and avoidance coping , perceived stress , affect and depressive symptoms , pregnancy-related empowerment , and postpartum maternal-infant attachment and maternal functioning . Using intention-to-treat models , group prenatal care participants demonstrated a 3.2 point greater increase ( p < 0.05 ) in their use of prenatal planning-preparation coping strategies . While group participants did not demonstrate significantly greater positive outcomes in other measures , women who were at greater psychosocial risk benefitted from participation in group prenatal care . Among women reporting inadequate social support in early pregnancy , group participants demonstrated a 2.9 point greater decrease ( p = 0.03 ) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum ( p = 0.03 ) . Among women with high pregnancy-specific distress in early pregnancy , group participants had an 8.3 point greater increase ( p < 0.01 ) in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease ( p = 0.02 ) in postpartum depressive symptom scores . This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping re sources . Large r and omized studies are needed to establish conclusively the biological and psychosocial benefits of group prenatal care for all women Objective To compare maternal and infant outcomes in Hispanic women participating in the Centering Pregnancy Model ( CPM ) to those receiving prenatal care via the traditional model  and determine acceptability of the CPM . Methods Forty-nine women ( n = 24 CPM ; n = 25 traditional ) participated in this quasi-experimental prospect i ve comparative design . Participants self selected the model of care delivery . Data were collected via question naires at the initial visit , 34–36 weeks gestation , and postpartum . Outcome measures included : satisfaction with care delivery model , health behaviors , prenatal/postnatal care knowledge , self-esteem and depression . Breastfeeding initiation and continuation , infant birth weight , gestational age at delivery , mode of delivery and infant length of stay were also collected . Results Traditional participants had a history of more pregnancies , more living children , and higher levels of postpartum self-esteem compared to centering participants . Knowledge deficits and health behaviors were similar between groups . No differences were found for infant outcomes . Conclusions This study provides information regarding Hispanic mothers ’ responses to an alternative care delivery model . Preliminary evidence suggests CPM compares with traditional care and yields a high degree of patient satisfaction . Specific pregnancy-related knowledge deficits were identified in both groups that could focus prenatal education . In light of similar outcomes in both groups ; patient and provider satisfaction and economics would therefore be a factor when choosing a model of prenatal care delivery OBJECTIVE To evaluate the effect of  mother-infant immediate skin-to-skin contact on primiparous mother 's  breastfeeding self-efficacy . STUDY DESIGN A r and omised control trial . SETTING S The study was conducted in Omolbanin obstetrics hospital ( large tertiary hospital ) , Mashhad , Iran . PARTICIPANTS 114 18 - 35 year-old primiparous , Iranian , healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies . INTERVENTION Skin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum . MAIN OUTCOME MEASURE Maternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation . RESULTS A total of 92 mother-infant dyads ( 47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group ) were monitored and analysed . In skin-to-skin contact group , breastfeeding self-efficacy was 53.42±8.57 SD as compared to 49.85±5.50 SD in routine care group which is significantly higher in skin-to-skin contact group ( p=0.0003 ) . Successful breastfeeding initiation rate was 56.6 % in skin-to-skin contact group as compared to 35.6 % in routine care group ( p=0.02 ) . Time to initiate first feed was 21.98±9.10 SD min in SSC group vs. 66.55±20.76 min in routine care group ( p<0.001 ) . CONCLUSION Mother-infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy . High breastfeeding self-efficacy increases exclusive breastfeeding duration OBJECTIVE To examine the impact of group versus individual prenatal care on birth weight and gestational age . METHODS This prospect i ve , matched cohort study included pregnant women ( N = 458 ) entering prenatal care at 24 or less weeks ' gestation ; one half received group prenatal care with women of the same gestational age . Women were matched by clinic , age , race , parity , and infant birth date . Women were predominantly black and Hispanic of low socioeconomic status , served by one of three public clinics in Atlanta , Georgia or New Haven , Connecticut . RESULTS Birth weight was greater for infants of women in group versus individual prenatal care ( P < .01 ) . Among those born preterm , infants of group patients were significantly larger than infants of individual-care patients ( mean , 2398 versus 1990 g , P < .05 ) . Although not statistically significant , infants of group patients were less likely than those of individual-care patients to be low birth weight ( less than 2500 g ; 16 versus 23 infants ) ;  very low birth weight ( less than 1500 g ; three versus six infants ) ; early preterm ( less than 33 weeks ; two versus seven infants ) ; or to  experience neonatal loss  ( none versus three infants ) . There were no differences in number of prenatal visits or other risk characteristics ( patient age , race , prior preterm birth ) . CONCLUSIONS Group prenatal care results in higher birth weight , especially for infants delivered preterm . Group prenatal care provides a structural innovation , permitting more time for provider – patient interaction and therefore the opportunity to address clinical as well as psychological , social , and behavioral factors to promote healthy pregnancy . Results have implication s for design of sustainable prenatal services that might contribute to reduction of racial disparities in adverse perinatal outcomes The military has recognized that health and quality of life for service members are closely tied to the re sources for their families , including how they are cared for during pregnancy and childbirth . However , there has been little examination of women 's experience with different models of prenatal care ( PNC ) in military setting s. The purpose of this article is to describe the results of a qualitative study of women 's experiences with the CenteringPregnancy model of group PNC compared to individual PNC in two military health care setting s. This clinical trial enrolled 322 women who were r and omized into group or individual PNC at two military treatment facilities . Qualitative interviews were completed with 234 women during the postpartum period . Interpretative narrative and thematic analysis was used to identify three themes : 1 ) " I was n't alone"-the experience with group PNC ; 2 ) " I liked it but ... "- recommendations to improve group PNC ; and 3 ) " They really need to listen"-general concerns across the sample about PNC . Greatest concerns of women in individual PNC included lack of continuity and time with the provider . Our military families must be assured that their health care system meets their needs through personal and family-centered care . Group PNC offers the potential for continuity of provider while also offering community with other women . In the process , women gain knowledge and power as a health care consumer OBJECTIVE The purpose of this study was to evaluate the impact of group prenatal care on rates of preterm birth . STUDY DESIGN We conducted a retrospective cohort study of 316 women in group prenatal care that was compared with 3767 women in traditional prenatal care .  Women self-selected participation in group care . RESULTS Risk factors for preterm birth were similar for group prenatal care vs traditional prenatal care :  smoking ( 16.9 % vs 20 % ; P = .17 ) , sexually transmitted diseases ( 15.8 % vs 13.7 % ; P = .29 ) , and previous preterm birth ( 3.2 % vs 5.4 % ; P = .08 ) . Preterm delivery ( < 37 weeks ' gestation ) was lower in group care than traditional care ( 7.9 % vs 12.7 % ; P = .01 ) , as was delivery at < 32 weeks ' gestation ( 1.3 % vs 3.1 % ; P = .03 ) . Adjusted odds ratio for preterm birth for participants in group care was 0.53 ( 95 % confidence interval , 0.34 - 0.81 ) . The racial disparity in preterm birth for black women , relative to white and Hispanic women , was diminished for the women in group care . CONCLUSION Among low-risk women , participation in group care improves the rate of preterm birth compared with traditional care , especially among black women . R and omized studies are needed to eliminate selection bias 
    Output:
    