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EczemaACTeczemaNCT04919330

Acceptance and Commitment Therapy-based Eczema Management Programme

A study testing Family Acceptance and Commitment Therapy-based Eczema Management Programme in people with Eczema, run by Chinese 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

This pilot randomised wait-list controlled trial aims to determine the feasibility, acceptability and preliminary effects of a Family Acceptance and Commitment Therapy-based Eczema Management Programme (FACT-EMP) on the health outcomes of both children patients and their main caregivers over a 3-month… Read more about this study

Who is it for?
Ages 6 to 65 years
Conditions the study is for
Eczema
What is being tested?
Family Acceptance and Commitment Therapy-based Eczema Management Programme
Could I receive a placebo?
No, everyone receives an active treatment
How many people
78 participants
Where
1 siteHong Kong
Study dates
3 Jul 2021to 30 Sep 2023
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 6 to 65 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • The parent-child dyads should fulfil the following criteria:
  • For the child, he or she should be 6-12 years old and diagnosed with eczema by a physician as documented in the medical records.
  • For the parent, he or she should be 19-65 years; either father/mother in each family who is the primary caregiver responsible for the daily care of his/her child (e.g. the same parent who accompanied the child for follow-up appointments of the study hospital at every time), living together with the target child, able to communicate in Cantonese and accessible by telephone.

Who cannot join

  • 1. Any parent and/or his/her child who are currently participating in another eczema-related intervention study, or where the child has significant medical morbidities, including congenital problems, oxygen-dependent conditions, or the presence of tracheotomy, will be excluded.

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital

    Tuenmen, New Territories

Other trials in Hong Kong

About this study

Official title: Embodying a Compassionate Self Through Acceptance and Commitment Therapy for Parents and Children With Eczema: A Family Based Eczema Management Programme

This pilot randomised wait-list controlled trial aims to determine the feasibility, acceptability and preliminary effects of a Family Acceptance and Commitment Therapy-based Eczema Management Programme (FACT-EMP) on the health outcomes of both children patients and their main caregivers over a 3-month post-intervention.

Read the detailed description

Background:

Eczema is the most common paediatric skin condition affecting 15-20% children worldwide and 30% of children in Hong Kong. The highly visible nature of eczema symptoms that deviate from the individual's idealized body image could compromise his/her sense of self, leading to feelings of body image disturbance. It has been reported that children may use their illness to avoid schools, experience low self-esteem, shame and guilt and even stigmatization. In addition, their parents experience high level of stress in caring for their children with eczema, can easily generate shame and guilt feelings if they perceive themselves not performing satisfactory parenting roles in safeguarding their child's health. One emerging therapeutic approach to managing body-image concern, psychological difficulties associated with self-criticism and shame is by fostering self-compassion.

This study is a pilot randomized controlled trial aiming at examining the effects of a family-based eczema management programme in Hong Kong utilizing Acceptance and Commitment Therapy (ACT) to foster self-compassion of parents and their children affected by eczema. It is expected that fostering self-compassion could empower the parent-child dyads in cultivating a more loving, kind and forgiving attitude towards eczema, leading to improved motivation for self-care and better health outcomes. If found effective, the programme can improve the lives of many local families with children living with eczema through addressing their unmet psychological needs. In addition, the programme can be incorporated into current service in hospitals and community settings in Hong Kong and other Chinese communities.

Aim and hypothesis to be tested:

The proposed study will use a single-blinded, pilot randomized wait-list controlled trial design to determine the feasibility, acceptability and preliminary effects of a family ACT-based eczema management programme (FACT-EMP) on the health outcomes of both parent caregivers and children with eczema over 3-month post-intervention. It is hypothesized that when compared with a wait-list control group receiving standard care, the participants of the programme can show significant improvements in:

  1. childhood eczema severity (primary outcome for children),
  2. parental eczema management (primary outcome for parents),
  3. parental depression, anxiety and stress,
  4. health-related quality of life, psychological flexibility and self-compassion of both caregivers and their children with eczema immediately at immediately and 3-month post-intervention.

Design: A randomized wait-list controlled trial

Participants: Parents and their children aged 6-12 years diagnosed with eczema

Intervention condition: The parent-child dyads will receive four weekly 2-hour sessions of FACT-EMP. In each session, a group of 7-8 parent-child dyads will receive 90 minutes of ACT, followed by 30 minutes of education related to eczema management. The dyads in the wait-list control group will be offered to receive the same intervention after the completion of all assessments of the intervention arm.

Outcomes: The primary outcome for children is childhood eczema severity, while the primary outcome for parents is parental eczema management. The secondary outcomes for children are quality of life, self-compassion and psychological flexibility, while the secondary outcomes for parents are symptoms of depression, anxiety and stress, quality of life, psychological flexibility and self-compassion. The assessments of the aforementioned outcomes will be conducted at baseline, at post-intervention and at 3-month post-intervention by trained nurses/ research staff blinded to treatment allocation.

Conditions
Eczema
Being tested
Family Acceptance and Commitment Therapy-based Eczema Management Programme, Wait-list Control Group
Keywords
Acceptance and Commitment Therapy, Eczema, Randomised Controlled Trial
Medical subject headings
Eczema

What participants receive

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

  • Family Acceptance and Commitment Therapy-based Eczema Management ProgrammeBehavioural

    The parent-child dyads will receive four weekly 2-hour sessions of family ACT-based eczema management programme (FACT-EMP). In each session, a group of 6-8 parent-child dyads will receive 90 minutes of ACT, followed by 30 minutes of education related to eczema management. Throughout the sessions, ACT strategies will help the dyads achieve the following therapeutic processes: To weaken the rumination cycle and "fused thoughts" related to eczema with body-image concern, shame and self-criticism for extending kindness and understanding to oneself; to build self-perspective-taking when seeing one's experience as part of the larger human experience; to strengthen their stands for their values related to self-kindness with acceptance of one's experience; and to take steps to act on values while practising kindness and compassion. Same as the waitlist control, the dyads will receive routine eczema care provided by the study hospital, including medical follow-ups and nurses' consultation.

  • Wait-list Control GroupBehavioural

    The parent-child dyads will receive routine eczema care provided by the study hospital, including medical follow-ups and nurses' consultation. To ensure equity of access to potentially effective treatment (i.e., family ACT-based eczema management programme), the dyads in the wait-list control group will receive the same programme after the completion of all assessments of the intervention arm.

Study groups in NCT04919330
Study groupRoleWhat they receive
ACT GroupExperimentalOne four weekly 2-hour sessions of family ACT-based eczema management programme (FACT-EMP) and routine eczema care provided by the study hospital, including medical follow-ups and nurses' consultation.
Receives: Behavioral: Family Acceptance and Commitment Therapy-based Eczema Management Programme
Wait-list Control GroupOtherRoutine eczema care provided by the study hospital, including medical follow-ups and nurses' consultation
Receives: Behavioral: Wait-list Control Group

What is being measured

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

  1. Child's eczema severity

    The Severity scoring of atopic dermatitis (SCORAD) will be used to assess the severity of childhood eczema, including the extent and intensity of the disease, and the degree of itching and sleep disturbance (Rehal et al., 2011).

    Measured: Change from baseline to 3 months post-intervention

  2. Parent's self-efficacy of eczema management

    The 29-item Chinese Version of Parental Self-Efficacy with Eczema Care Index (PASECI; Cheng et al., 2020) will be adopted to assess the parents' self-efficacy for performing eczema management tasks, managing the child's symptoms and behavior. The PASECI is arranged in 4 subscales: Managing Medication, Managing Eczema and Symptoms, Communicating with Health Professionals, and Managing Personal Challenges. Each item is scored on an 11-point Linkert scale, ranging from 0 (Cannot do at all) to 10 (Highly certain can do it). The scores of PASECI are gained by adding items up. The higher the PASECI score, the greater the parental self-efficacy in respective scales. The PASECI possessed high internal consistency (α=.97), test-retest reliability (ICC =.93-.99), and acceptable convergent validity in the Hong Kong population.

    Measured: Change from baseline to 3 months post-intervention

Secondary outcomes (7)
  1. Child's quality of life

    The 10-item Children's Dermatology Life Quality Index (CDLQI; Chuh, 2003) will be used to assess the quality of life of children living with eczema. A total of six dimensions will be assessed comprising Symptoms and Feelings, Leisure, School or Holidays, Personal Relationships, Sleep, and Treatment. A 4-point scale is used, ranging from 0 (Not at all) to 3 (Very much/Prevented school). The 10-item CDLQI score is calculated by summing the scores of the 10 questions, giving a maximum of 30 and a minimum of 0. The higher the score, the greater the degree of handicap (the more quality of life is impaired). The CDLQI has high internal consistency and a strong correlation with physical-rated disease severity.

    Measured: Change from baseline to 3 months post-intervention

  2. Child's self-compassion

    The 12-item Self-Compassion Scale for Children (SCS-C; Sutton et al., 2018) will be adopted to measure the self-compassion of children. A 5-point scale is used, ranging from 1 (Never) to 5 (Always). Items on the Self-Compassion Scale for Children (SCS-C) addressed each of the six components of Neff's definition of self-compassion. The items assessing self-judgment, isolation, and over-identification were reverse-scored. The SCS-C comprises negatively-worded items and positively-worded items, each with acceptable internal consistency (α = .81-.83).

    Measured: Change from baseline to 3 months post-intervention

  3. Child's psychological flexibility

    The 10-item Child and Adolescent Mindfulness Measure (CAMM; Greco et al., 2011) will be adopted to measure the psychological flexibility in terms of acceptance and mindfulness of the children with a 5-point Linkert scale, ranging from 0 (Never true) to 4 (Always true). Total scores on the CAMM were computed by summing the responses to the 10 items, yielding a possible range of 0 - 40. The CAMM has good reliability (α = .78-.83) and positive correlations with quality of life, social skills, and academic performance as well as negative correlations with somatic complaints, internalizing and externalizing symptoms.

    Measured: Change from baseline to 3 months post-intervention

  4. Parent's symptoms of depression, anxiety and stress

    The 21-item Depression Anxiety Stress Scales-21 (DASS-21; Lovibond et al., 1995) will be applied to evaluate the parents' states of depression, anxiety, and stress. A 4-point Linkert scale is used, ranging from 0 (Did not apply to me at all) to 3 (Applied to me very much/most of the time) with 3 subscales consisting of Depression, Anxiety, and Stress. Higher scores indicate more frequent symptomatology. The reliabilities for the depression, anxiety, and stress subscales in the DASS-21 were .82, .88, and .90, respectively.

    Measured: Change from baseline to 3 months post-intervention

  5. Parent's quality of life.

    The 28-item Parents' Index of Quality of Life in Atopic Dermatitis (PIQoL-AD; McKenna et al., 2005) will be used to assess the quality of life of parents in caring for children with eczema with a dichotomous yes/no response format, 0 = No and 1 = Yes. The total score of PIQoL-AD ranging from 0 to 28, and a high score indicates poor quality of life. The PiQoL-AD is a standardized measure possessing good internal consistency (α=.88-.93) and test-retest reliability(r=.85) in various populations.

    Measured: Change from baseline to 3 months post-intervention

  6. Parent's psychological flexibility

    The 7-item Chinese version of the Acceptance and Action Questionnaire-II (AAQ-II; Chong et al., 2019) will be used to assess the psychological flexibility of the parents with a 7-point Likert scale, ranging from 1 (Never true) to 7 (Always true). The item scores are added together to create a total score (range 7 to 49). The higher the total score, the poor psychological flexibility (more psychologically inflexible), and the lower the total score, the better the psychological flexibility. The AAQ-II possessed good internal consistencies (α=.88) and test-retest reliabilities (r=.79-.81) in Hong Kong parents of children with asthma.

    Measured: Change from baseline to 3 months post-intervention

  7. Parent's self-compassion

    The 26-item Self Compassion Scale (SCS; Chen et al., 2011; Neff et al., 2016) will be adopted to measure self-compassion of the parents covering six domains: Self-Kindness, Self-Judgment, Common Humanity, Isolation, Mindfulness, and Over-Identification. An overall self-compassion score was calculated for each participant by reverse coding responses to the negatively worded items comprising self-judgment, isolation, and over-identification subscales, then calculating the means for each of the six subscales, and finally summing the means to create a total self-compassion score. The SCS has good internal reliability in Chinese and Western populations (α ≥ 0.86 in all samples).

    Measured: Change from baseline to 3 months post-intervention

Timeline

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

  1. First posted9 Jun 2021
  2. Study start3 Jul 2021
  3. Primary completion30 Jun 2023
  4. Study completion30 Sep 2023

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel Assignment; repeated-measures 2-arm randomized controlled trial
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
78 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04919330
Sponsor's protocol ID
RG2019/2020_A_7
Acronym
ACTeczema
Status last verified
Jul 2024
First submitted
4 Jun 2021
Last updated
12 Jul 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Chong YY, Chien WT, Mou HY, Leung SP, Wong OY, Lam SY. Acceptance and Commitment Therapy Eczema Management Program for Children With Eczema: A Pilot Randomised Controlled Trial. Clin Exp Allergy. 2025 Aug;55(8):701-715. doi: 10.1111/cea.70003. Epub 2025 Feb 3.

    PubMed 39900107

Questions about this trial

What is this clinical trial studying?

A study testing Family Acceptance and Commitment Therapy-based Eczema Management Programme in people with Eczema, run by Chinese 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 3 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 12 Jul 2024. 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?

Child's eczema severity (time frame: Change from baseline to 3 months post-intervention). The study lists 2 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 NCT04919330, 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 12 Jul 2024.

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