Depression and anxiety are common mental health problems among adolescents worldwide. In Hong Kong, one in every four secondary school students reports clinical-level depression or anxiety symptoms. Extant research has found that a fixed mindset on intelligence and emotions and failure-is-debilitating belief are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. At the same time, recent research also points to the importance of parental mindset. Parents are the primary social support of adolescents; parental belief systems can strongly influence children's affect, behaviour, and mental health. However, the effects of parent-child mindset interventions on a child's internalising problems have not yet been empirically examined. As emerging evidence has shown the promise of single-session interventions in reducing and preventing youth internalising problems, this project develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) - to tackle depression and anxiety in young people and promote parental well-being. Using a three-arm randomised controlled trial, the proposed study will examine the effectiveness of PC-SMILE on reducing depression and anxiety symptoms among children, enhancing well-being and parent-child relationships. A total of 549 parent-child dyads will be recruited from six secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The intervention is approximately 45 minutes in length. In the PC-SMILE group, both parent and child will receive intervention, and their mental health and family relationship will be assessed at three time points: baseline before intervention (T1), within two weeks post-intervention (T2), and three months post-intervention (T3). In the C-SMILE group, only the child will undergo intervention, while both the child and parent will be required to complete the repeated assessments. A pilot test (n = 9) has supported the feasibility and acceptability of the PC-SMILE intervention. We hypothesise that compared to the waitlist control group, the PC-SMILE intervention group and C-SMILE group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and PC-SMILE group is more effective than C-SMILE group. The intention-to-treat principle and linear-regression-based maximum likelihood multi-level models will be used for data analysis. As of May 2024, we enrolled 75 students and their parents in the study. This study will not only provide evidence on parent-child growth mindset intervention for adolescent internalising problems but can also serve as a scalable and accessible intervention for improving the well-being of young people and their parents.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
549
This study will be a three-arm cluster-randomised controlled trial to examine the efficacy of the PC-SMILE for adolescents by comparing to a C-SMILE intervention group and a no-intervention waitlist control group.
Children's depression and anxiety symptoms
25-item Revised Children's Anxiety and Depression Scale (RCADS-25)
Time frame: baseline
Children's depression and anxiety symptoms
25-item Revised Children's Anxiety and Depression Scale (RCADS-25)
Time frame: two weeks post-intervention
Children's depression and anxiety symptoms
25-item Revised Children's Anxiety and Depression Scale (RCADS-25)
Time frame: three months post-intervention
Children's hopelessness
the four-item Hopelessness Scale
Time frame: baseline
Children's hopelessness
the four-item Hopelessness Scale
Time frame: two weeks post-intervention
Children's hopelessness
the four-item Hopelessness Scale
Time frame: three months post-intervention
Children's psychological well-being
the Warwick-Edinburgh Mental Well-Being Scale-7
Time frame: baseline
Children's psychological well-being
the Warwick-Edinburgh Mental Well-Being Scale-7
Time frame: two weeks post-intervention
Children's psychological well-being
the Warwick-Edinburgh Mental Well-Being Scale-7
Time frame: three months post-intervention
Parents' psychological well-being
the Warwick-Edinburgh Mental Well-Being Scale-7
Time frame: baseline
Parents' psychological well-being
the Warwick-Edinburgh Mental Well-Being Scale-7
Time frame: three months post-intervention
Parent-child relationships
three items
Time frame: baseline
Parent-child relationships
three items
Time frame: two weeks post-intervention
Parent-child relationships
three items
Time frame: three months post-intervention
Parent-child interactions
three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week
Time frame: baseline
Parent-child interactions
three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week
Time frame: two weeks post-intervention
Parent-child interactions
three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week
Time frame: three months post-intervention
Perceived parent learning versus performance orientation
8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive
Time frame: baseline
Perceived parent learning versus performance orientation
8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive
Time frame: two weeks post-intervention
Perceived parent learning versus performance orientation
8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive
Time frame: three months post-intervention
Children's academic self-efficacy
a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey
Time frame: baseline
Children's academic self-efficacy
a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey
Time frame: two weeks post-intervention
Children's academic self-efficacy
a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey
Time frame: three months post-intervention
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