The project "More Appreciation and Less Criticism Project" (MALC) is a collaboration between the Tung Wah Group of Hospitals (TWGHs) and the School of Public Health of The University of Hong Kong (HKUSPH), funded by The Hong Kong Jockey Club Charities Trust. The objectives are to develop and test theory-driven group programmes to increase parents' intention and actual behaviours to express more appreciation or less criticism when interacting with their children, thereby enhancing family harmony and happiness.
This study is a cluster randomized controlled trial (RCT) with three arms: More Appreciation (MA), Less Criticism and Fruit and Vegetable (FV) group. Clusters, mostly schools, are the unit of random allocation to one of the three arms. Participants from all three arms will be assessed a total of four times, i.e. baseline (before the intervention workshop; (T1), immediate post-workshop (T2), 2-week post-workshop (T3) and 6-week post-workshop (T4). "Fruit and vegetable consumption" is a subsidiary study to the More Appreciation and Less Criticism (MALC) Project. The study will take advantage of the cluster RCT design adopted by the MALC study, and aims at testing the active HAPA-based intervention (increasing fruit and vegetable intervention) delivered to the MALC control group. The fruit and vegetable group will serve as the intervention arm, and the groups that received interventions regarding increasing appreciation or decreasing criticism, served as the control arms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
803
Changes from baseline self-reported appreciation behaviours at follow-ups
Being assessed by averaging two items, measuring the frequency with which parents expressed appreciation (express appreciation towards children's efforts; express appreciation towards children's strengths) in the past 7 days. Responses range from 0 to 6 (0: '0 time,' 1: 'one to two times per week,' 2: 'three to four times per week,' 3: 'five to six times per week,' 4: 'once a day,' 5: 'two to three times a day,' and 6: 'four times or more per day'). The Cronbach's alpha is 0.90.
Time frame: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).
Changes from baseline self-reported criticism behaviours at follow-ups
Being assessed by averaging two items, measuring the frequency with which parents expressed criticism (criticise children; express dissatisfaction towards children's behavior) in the past 7 days. Responses range from 0 to 6 (0: '0 time,' 1: 'one to two times per week,' 2: 'three to four times per week,' 3: 'five to six times per week,' 4: 'once a day,' 5: 'two to three times a day,' and 6: 'four times or more per day'). The Cronbach's alpha is 0.93.
Time frame: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).
Changes from baseline self-reported fruit and vegetable intake behaviours at follow-ups
Being assessed by summing two items, one each for the number of servings of fruits and vegetables consumed in the past week.
Time frame: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).
Changes from baseline outcome expectancies of more appreciation at post-workshop
Measured by averaging three items, "If I express my appreciation through words or action more often, my children will be more positive to themselves", "If I express my appreciation through words or action more often, my children will appreciate the other family members more", "If I express my appreciation through words or action more often, my family will be happier and more harmonious". Participants rated their agreement using a 10-point scale (1 = totally disagree, 10 = totally agree).
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Baseline (before the workshop, T1), and T2 (immediately after the workshop).
Changes from baseline outcome expectancies of less criticism at post-workshop
Measured by averaging three items. "If I criticize my children, they will be more negative to themselves", "If I criticize my children, they will learn to criticize the other family members", "If I criticize my children, my family will be less happy and less harmonious". Participants rated their agreement using a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), and T2 (immediately after the workshop).
Changes from baseline outcome expectancies of fruit and vegetable intake at post-workshop
Measured by averaging two items. "if I eat more servings of fruit and vegetables every day, that would be good for my health", "If I eat more fruit and vegetable, I will set a good example for my children". Participants rated their agreement using a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), and T2 (immediately after the workshop).
Changes from baseline intention to express more appreciation at post-workshop and 2-week
Measured by a single item "In the coming 2 weeks, I intend to express appreciation to my child through words or action more often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline intention to criticize less at post-workshop and 2-week
Measured by a single item "In the coming 2 weeks, I intend to criticize my child less often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline intention of more fruit and vegetable intake at post-workshop and 2-week
Measured by a single item "in the coming 2 weeks, I intend to eat more servings of fruit and vegetables every day". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline self-efficacy of more appreciation at post-workshop and 2-week
Measured by a single item "In the coming 2 weeks, I am confident that I can express appreciation to my child through words or action more often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline self-efficacy of less criticism at post-workshop and 2-week
Measured by a single item "In the coming 2 weeks, I am confident that I can criticize my child less often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline self-efficacy of more fruit and vegetable intake at post-workshop and 2-week
Measured by a single item "In the coming 2 weeks, I am confident that I could eat more servings of fruit and vegetables every day". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).
Changes from baseline action planning of more appreciation at post-workshop, 2-week and 6-week
Measured by a single item "In the coming 2 weeks, I have a clear plan on how to express appreciation to my child through words or action more often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline action planning of less criticism at post-workshop, 2-week and 6-week
Measured by a single item "In the coming 2 weeks, I have a clear plan on how to criticize my child less often. Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline action planning of more fruit and vegetable intake at post-workshop, 2-week and 6-week
Measured by a single item "In the coming 2 weeks, I have a clear plan on how to eat more servings of fruit and vegetables every day". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline coping planning of more appreciation at post-workshop, 2-week and 6-week
Measured by a single item "In the coming 2 weeks, I have a clear plan on how to overcome challenges in expressing appreciation to my child through words or action more often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline coping planning of less criticism at post-workshop, 2-week and 6-week
Measured by a single item "in the coming 2 weeks, I have a clear plan on how to overcome challenges to criticize my child less often". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline coping planning of more fruit and vegetable intake at post-workshop, 2-week and 6-week
Measured by a single item "In the coming 2 weeks, I have a clear plan on how to overcome challenges to eat more servings of fruit and vegetables every day". Participants rated their agreement on a 10-point scale (1 = totally disagree, 10 = totally agree).
Time frame: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).
Changes from baseline family well-being
Being assessed by a composite score of 3 items, namely the 3Hs: family harmony, family happiness, and family health. Participants rated each item on a scale from 0 (not at all harmonious/ happy/ healthy) to 10 (very harmonious/ happy/ healthy). This composite score has been used in another study in Hong Kong (M. P. Wang et al., 2014) which showed a satisfactory Cronbach's alpha (0.84).
Time frame: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).