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ParentingNCT04445818

More Appreciation and Less Criticism Project

A study testing More appreciation, Less criticism and More Fruit and Vegetable in people with Parenting and Family Research, run by The University of 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

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. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Parenting, Family Research, Family
What is being tested?
More appreciation, Less criticism and More Fruit and Vegetable
Could I receive a placebo?
No, everyone receives an active treatment
How many people
803 participants
Where
No sites listed yet
Study dates
1 Apr 2012to 31 May 2013
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

  • Parents who are Cantonese-speaking, able to complete study questionnaire, and who have children attending p.4 to p.6 will be included.

Who cannot join

  • Parents with active psychiatric problems, suicidal ideations, personality disorders, emotional problems, and mental retardartion will be excluded from the study.

About this study

Official title: A Pilot Intervention Study to Increase Appreciation and Reduce Criticism Among Families in Hong Kong

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.

Read the detailed description

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.

Being tested
More appreciation, Less criticism, More Fruit and Vegetable
Keywords
Parenting, Appreciation, Criticism, Fruit and Vegetable Consumption, Family

What participants receive

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

  • More appreciationBehavioural

  • Less criticismBehavioural

  • More Fruit and VegetableBehavioural

Study groups in NCT04445818
Study groupRoleWhat they receive
More AppreciationExperimentalA 6-minute engaging video will be shown, illustrating examples where a mother initially withholds her appreciation for her son's effort in school and later express it. The video will also capture the effect on the child and the family. Attributional discussion questions will follow to elicit positive outcomes of expressing appreciation and the negative outcomes of withholding appreciation (e.g., What may be the long-term effects of showing appreciation on your child, family, or on yourself?). Key points will be summarised and reinforced to enhance behavioural intention (Schwarzer \& Luszczynska, 2008). Then the participants will be asked to plan by indicating when (e.g., Saturday afternoon), what (e.g., child helping a younger sibling prepare for a dictation test), and how (e.g., "I can see that you gave up your leisure time to help your sister with the spelling. Thank you!") they would express appreciation to their children.
Receives: Behavioral: More appreciation
Less CriticismExperimentalParticipants will watch a 6-minute video showing examples of a father criticising his son, which will be replaced by positive communication later, and the different reactions evoked in the child and the family. Then, participants will have an attributional discussion on the negative effects of criticism (e.g., negative effect on self-worth and motivation) and positive outcomes of using constructive feedback (e.g., promptly identifying undesirable behaviours without relating to personal traits or abilities). In small groups, they will work out alternatives (i.e., constructive feedback; termed "positive reminder" in the intervention) to criticism, and each plan and write down when (e.g., after school), what (e.g., low test marks), and how (e.g., "How do you prepare for the tests?)
Receives: Behavioral: Less criticism
Fruit and VegetableExperimentalThis workshop will emphasise the importance of consuming at least 5 portions of fruit and vegetable daily for a healthy diet, and aim to boost participants' self-efficacy in achieving this. Participants will be presented with examples of one portion of fruit or vegetable, and then create their own recipes. They will also consider how to overcome obstacles of consuming more portions. Each participant will set goals and write down plans on when, where, what, and how they would increase their fruit and vegetable intake of their children and family as a whole.
Receives: Behavioral: More Fruit and Vegetable

What is being measured

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

  1. 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.

    Measured: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).

  2. 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.

    Measured: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).

  3. 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.

    Measured: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).

Secondary outcomes (16)
  1. 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).

    Measured: Baseline (before the workshop, T1), and T2 (immediately after the workshop).

  2. 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).

    Measured: Baseline (before the workshop, T1), and T2 (immediately after the workshop).

  3. 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).

    Measured: Baseline (before the workshop, T1), and T2 (immediately after the workshop).

  4. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  5. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  6. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  7. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  8. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  9. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), and 2-week post-workshop (T3).

  10. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  11. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  12. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  13. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  14. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  15. 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).

    Measured: Baseline (before the workshop, T1), T2 (immediately after the workshop), 2-week post-workshop (T3), and 6-week post-workshop (T4).

  16. 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).

    Measured: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).

Timeline

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

  1. First posted24 Jun 2020
  2. Study start1 Apr 2012
  3. Primary completion31 May 2013
  4. Study completion31 May 2013

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
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study is a cluster randomised controlled trial with three arms: more appreciation arm (MA), less criticism arm (LC), and more fruit and vegetable arm (FV).
Masking
None (open label)
Enrolment
803 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04445818
Sponsor's protocol ID
HKUSPH-MALC
Status last verified
Jun 2020
First submitted
16 Jun 2020
Last updated
24 Jun 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Generally, individual participant data will not be shared with a third party. People not involved in the project can check the data availability from the principal investigator.

Publications

  • Fung SSW, Lam TH, Sun Y, Man PKW, Ip JCM, Wan ANT, Stewart S, Ho SY. A cluster randomized controlled trial of more appreciation and less criticism in Hong Kong parents. J Fam Psychol. 2020 Sep;34(6):731-739. doi: 10.1037/fam0000628. Epub 2020 Jan 16.

    PubMed 31944801

Questions about this trial

What is this clinical trial studying?

A study testing More appreciation, Less criticism and More Fruit and Vegetable in people with Parenting and Family Research, run by The University of 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 1 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 24 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.

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?

Changes from baseline self-reported appreciation behaviours at follow-ups (time frame: Baseline (before the workshop, T1), 2-week post-workshop (T3) and 6-week post-workshop (T4).). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04445818, which also lists 1 linked publication.

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 24 Jun 2020.

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