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Mental HealthNCT04329052

Promoting Mental Well-being for Secondary School Students Through an Experiential Learning Activity

A study testing Adventure-based training with health educational talk in people with Mental Health, run by The University of Hong Kong at 1 site in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Mental health problems in adolescents are a global problem and are becoming more prevalent in Hong Kong. Indeed, the rising incidence of emotional disturbances, adjustment and eating problems, depression, and suicidal tendencies have become major public health concerns. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Mental Health
What is being tested?
Adventure-based training with health educational talk
Could I receive a placebo?
No, everyone receives an active treatment
How many people
254 participants
Where
1 siteHong Kong
Study dates
20 Dec 2018to 25 Nov 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • secondary school students from Form 1 to 3,
  • able to speak Cantonese and read Chinese.

Who cannot join

  • children with cognitive and learning problems identified from their school records.

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • The University of Hong Kong

    Hong Kong

Other trials in Hong Kong

About this study

Mental health problems in adolescents are a global problem and are becoming more prevalent in Hong Kong. Indeed, the rising incidence of emotional disturbances, adjustment and eating problems, depression, and suicidal tendencies have become major public health concerns.

Over the past few decades, Hong Kong has experienced a significant change in family structure, with an increase in small nuclear. Therefore, children may be overprotected by parents and become more fragile and less resilient to psychological distress, in the meantime, parents' high expectations for children's academic increase the pressure on the teenagers.

Read more

As resilience can promote better mental well-being with reduced anxiety and depressive symptoms, It is crucial for healthcare professionals to collaborate with youth centers in the community to build effective health promotion programs in schools that can enhance the resilience of adolescents and foster the development of their coping mechanisms and positive mental well-being so that adolescents can better combat mental health problems and lead healthier lives.

Adventure-based training rests on a theory of experiential learning, which involves a four-step model of concrete experience, reflective observation, abstract conceptualisation, and active experimentation. In adventure-based training, participants are required to join the activities which are psychologically and physically demanding. They may experience frustration and anxiety in the earlier stages, but this is potentially therapeutic as it can facilitate the process of concrete experience by encouraging them to accept an innovative approach in dealing with challenges. During the adventure process, the emphasis is placed on changing the dysfunctional and negative actions of team members into functional and positive actions, and on the interaction between team members in accomplishing different challenging tasks. Participants experience difficulties and look for possibilities, and with the proper guidance, facilitation and intervention of instructors the objectives of the training are achieved. Successful experience of this kind can facilitate the personal development and enhance the resilience and self-esteem of participants.

Read the detailed description

Mental health problems in adolescents are a global problem and are becoming more prevalent in Hong Kong. Indeed, the rising incidence of emotional disturbances, adjustment and eating problems, depression, and suicidal tendencies have become major public health concerns.

Over the past few decades, Hong Kong has experienced a significant change in family structure, with small nuclear families gradually replacing extended families. Therefore, children receive more attention and may be overprotected by parents as a result of having fewer, if any, siblings. It is possible that this explains why children are more fragile, more vulnerable, and less resilient to psychological distress than were previous generations. Moreover, parents' high expectations for high academic achievement may also contribute to increased mental health problems among adolescents in Hong Kong. Most parents in Hong Kong believe that better careers and brighter futures are the inevitable results of higher academic achievement. Given this context, Hong Kong Chinese adolescents are exposed to considerable pressure within their families and schools while growing up.

Evidence suggests that depressive symptoms predict suicidal tendencies among children and adolescents. Although suicide rates in Hong Kong have dropped significantly from 18.8 per 100,000 in 2003 to 11.7 per 100,000 in 2016, a trend to increases in youth suicides in the past few years remains a concern. On the other hand, there is some evidence that resilience effectively prevents the development of mental health problems and is associated with positive mental health outcomes in adolescents, such as reduced levels of anxiety and depression [6]. It is therefore crucial for healthcare professionals to collaborate with youth centers in the community to build effective health promotion programs in schools that can enhance the resilience of adolescents and foster the development of their coping mechanisms and positive mental well-being so that adolescents can better combat mental health problems and lead healthier lives.

We conducted a 'proof-of-principle' randomised controlled trial on the effectiveness of experiential learning activity (adventure-based training programme) in promoting the psychological well-being of primary schoolchildren. This study provides some evidence that the adventure-based training programme is effective in enhancing self-esteem and reducing depressive symptoms among schoolchildren. Moreover, the study demonstrated the feasibility of implementing an adventure-based training programme in the Hong Kong Chinese context, with their content and nature shown to be acceptable to children and their parents.

Adventure-based training rests on a theory of experiential learning, which involves a four-step model of concrete experience, reflective observation, abstract conceptualisation, and active experimentation. It aims at changing cognitive thinking and behaviour, on different levels, through experience and practice in an outdoor environment. At the adventure-based training camp, participants would have a 'concrete experience' by having some physical activities. Trainers would observe and note down the important moments for further discussion and could recap the experiences that participants had had in the activity (reflective observation). While recapping the experience, trainers could assist the participants to sum up their experience and help them to discuss what they could do to make the experience better (abstract conceptualisation). With consolidation, the trainer would then encourage participants to think of similar situations that they might face in their daily lives and how they could apply the lessons learnt in this experience into others (active experimentation).

In adventure-based training, participants are required to join in different activities which are psychologically and physically demanding. They may experience frustration and anxiety in the earlier stages, but this is potentially therapeutic as it can facilitate the process of concrete experience by encouraging them to accept an innovative approach in dealing with challenges. During the adventure process, the emphasis is placed on changing the dysfunctional and negative actions of team members into functional and positive actions, and on the interaction between team members in accomplishing different challenging tasks. Participants experience difficulties and look for possibilities, and with the proper guidance, facilitation and intervention of instructors the objectives of the training are achieved. Successful experience of this kind can facilitate the personal development and enhance the resilience and self-esteem of participants.

Conditions
Mental Health
Being tested
Adventure-based training with health educational talk
Medical subject headings
Psychological Well-Being

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Adventure-based training with health educational talkBehavioural

    Participants need to attend an adventure-based training with various experiential learning activities with a health educational talk on mental health.

Study groups in NCT04329052
Study groupRoleWhat they receive
Experimental groupExperimentalParticipants need to attend an adventure-based training with various experiential learning activities with a health educational talk on mental health.
Receives: Behavioral: Adventure-based training with health educational talk
Control groupNo interventionParticipants would have their usual activity without any intervention.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in resilience levels from baseline to 6-month follow-up between intervention and control group

    The Resilience Scale-14 (RS-14) is a 14-item scale measuring personal competence, and acceptance of self and life. The item is answered using a 7-point Likert scale ranging from "strongly disagree" to "strongly agree," with total possible scores ranging from 14 to 98. Higher scores indicate higher levels of resilience.

    Measured: 6-month follow-up

Secondary outcomes (8)
  1. Resilience level at baseline

    The Resilience Scale-14 (RS-14) is a 14-item scale measuring personal competence, and acceptance of self and life. The item is answered using a 7-point Likert scale ranging from "strongly disagree" to "strongly agree," with total possible scores ranging from 14 to 98. Higher scores indicate higher levels of resilience.

    Measured: baseline

  2. Change in resilience levels from baseline to 1-month follow-up between intervention and control group

    The Resilience Scale-14 (RS-14) is a 14-item scale measuring personal competence, and acceptance of self and life. The item is answered using a 7-point Likert scale ranging from "strongly disagree" to "strongly agree," with total possible scores ranging from 14 to 98. Higher scores indicate higher levels of resilience.

    Measured: 1-month follow-up

  3. Depressive symptoms at baseline

    The Center for Epidemiologic Studies Depression Scale for Children (CES-DC) comprises 20 standardized items to evaluate depressive symptoms. All items are evaluated on a 4-point Likert scale in relation to their incidence during the previous week, and are scored from 0 to 3 (0 = not at all, 1 = a little, 2 = some, 3 = a lot); total possible scores thus range from 0 to 60, with higher scores indicating greater number of symptoms.

    Measured: baseline

  4. Change in depressive symptoms from baseline to 1-month follow-up between intervention and control group

    The Center for Epidemiologic Studies Depression Scale for Children (CES-DC) comprises 20 standardized items to evaluate depressive symptoms. All items are evaluated on a 4-point Likert scale in relation to their incidence during the previous week, and are scored from 0 to 3 (0 = not at all, 1 = a little, 2 = some, 3 = a lot); total possible scores thus range from 0 to 60, with higher scores indicating greater number of symptoms.

    Measured: 1-month follow-up

  5. Self-esteem levels at baseline

    The Rosenberg Self-esteem Scale (RSES) was designed to measure self-esteem as a global disposition and has been widely used with children [9]. The RSES consists of 10 items rated on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with total possible scores ranging from 10 to 40. Higher scores indicate higher levels of self-esteem.

    Measured: baseline

  6. Change in self-esteem levels from baseline to 1-month follow-up between intervention and control group

    The Rosenberg Self-esteem Scale (RSES) was designed to measure self-esteem as a global disposition and has been widely used with children [9]. The RSES consists of 10 items rated on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with total possible scores ranging from 10 to 40. Higher scores indicate higher levels of self-esteem.

    Measured: 1-month follow-up

  7. Change in depressive symptoms from baseline to 6-month follow-up between intervention and control group

    The Center for Epidemiologic Studies Depression Scale for Children (CES-DC) comprises 20 standardized items to evaluate depressive symptoms. All items are evaluated on a 4-point Likert scale in relation to their incidence during the previous week, and are scored from 0 to 3 (0 = not at all, 1 = a little, 2 = some, 3 = a lot); total possible scores thus range from 0 to 60, with higher scores indicating greater number of symptoms.

    Measured: 6-month follow-up

  8. Change in self-esteem levels from baseline to 6-month follow-up between intervention and control group

    The Rosenberg Self-esteem Scale (RSES) was designed to measure self-esteem as a global disposition and has been widely used with children [9]. The RSES consists of 10 items rated on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with total possible scores ranging from 10 to 40. Higher scores indicate higher levels of self-esteem.

    Measured: 6-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Apr 2020
  2. Study start20 Dec 2018
  3. Primary completion25 Nov 2019
  4. Study completion25 Nov 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
254 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04329052
Sponsor's protocol ID
UW18456
Status last verified
Mar 2020
First submitted
30 Mar 2020
Last updated
1 Apr 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Adventure-based training with health educational talk in people with Mental Health, run by The University of Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Apr 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in resilience levels from baseline to 6-month follow-up between intervention and control group (time frame: 6-month follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Apr 2020.

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