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Mental Health Help-seekingNCT06707935

Mental Health Help-seeking Promotion in Older Adults

A study testing Descriptive social norm nudges, Pictorial social norm nudges and Service as usual in people with Mental Health Help-seeking, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The present study aims to examine the effectiveness of descriptive social norm nudges and pictorial social norm nudges in improving mental health help-seeking intention compared to educational information. Read more about this study

Who is it for?
Ages 60 years and olderHealthy volunteers can take part
Conditions the study is for
Mental Health Help-seeking
What is being tested?
Descriptive social norm nudges, Pictorial social norm nudges and Service as usual
Could I receive a placebo?
No, everyone receives an active treatment
How many people
540 participants
Where
1 siteHong Kong
Study dates
1 Dec 2024to 31 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 60 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • aged 60 years or above at the time of the baseline assessment
  • have no severe mental disorder or cognitive impairment
  • have no severe visual impairment
  • be able to read Chinese
  • have a smartphone with an instant communication application to receive text and images

Who cannot join

  • have severe difficulty in reading and communication
  • show imminent suicidal risk at any stage of the study

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site

  • The Hong Kong Polytechnic University

    Hong Kong

Other trials in Hong Kong

About this study

Official title: Is a Picture Worth a Thousand Words: A Participatory Approach to Codesign Descriptive and Pictorial Social Norm Nudges and a Randomised Controlled Trial (RCT) to Examine Their Effectiveness in Improving Mental Health Help-seeking Intention

The present study aims to examine the effectiveness of descriptive social norm nudges and pictorial social norm nudges in improving mental health help-seeking intention compared to educational information.

Read the detailed description

This study is a three-arm randomised controlled trial (RCT) in 540 older adults aged 60 years and above recruited through NGOs, testing the utility of revised TPB with baseline data, and the effectiveness of descriptive social norm-nudges (intervention group 1) and pictorial social norm- nudges (intervention group 2) comparing to traditional mental health education (control). Participants will be evenly randomised and receive 1 message/picture per day consecutively for 2 weeks. Researchers blind to group allocation will interview participants at baseline (T0), 2 weeks (post-intervention, T1), and 12 weeks (follow-up, T2). The primary outcomes are changes in subjective norms and help-seeking intention assessed using a revised Chinese version of the theory of planned behaviour questionnaire (C-TPB); secondary outcomes include perceived behavioural control, help-seeking attitude, perceived barriers to help-seeking (C-TPB subscales), and mental health assessed by PHQ-9, GAD-7 and UCLA-3.

Being tested
Descriptive social norm nudges, Pictorial social norm nudges, Service as usual
Keywords
co-design, nudge, behavioural economics, mental health, help-seeking
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.

  • Descriptive social norm nudgesBehavioural

    A set of messages with descriptive social norm nudges sent to participants.

  • Pictorial social norm nudgesBehavioural

    A set of messages with pictorial social norm nudges sent to participants.

  • Service as usualBehavioural

    Traditional mental health education information disseminated to participants.

Study groups in NCT06707935
Study groupRoleWhat they receive
Descriptive social norm nudgesExperimentalParticipants receive messages with social norm nudges presented in the word form.
Receives: Behavioral: Descriptive social norm nudges
Pictorial social norm nudgesExperimentalParticipants receive messages with social norm nudges presented in graphic form.
Receives: Behavioral: Pictorial social norm nudges
Active controlActive comparatorParticipants receive messages with generic mental health knowledge or information.
Receives: Behavioral: Service as usual

What is being measured

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

  1. Subjective norms toward mental health help-seeking

    Subjective norms toward mental health help-seeking will be measured by six items adapted from the validated Chinese version of the TPB questionnaire (C-TPB) . The three items will measure descriptive norms describing what society, in general, does when facing mental health challenges, and the other three items will measure social norms describing what the significant others of the participant would do. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of subjective norms about mental health help-seeking.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  2. Mental health help-seeking intention

    Mental health help-seeking intention will be measured on a 3-item subscale of C-TPB. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of help-seeking intention.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

Secondary outcomes (6)

  1. Perceived behavioural control

    Perceived behavioural control will be measured on a 3-item subscale of the C-TPB. Responses are rated on a 6-point Likert scale, with higher scores indicating higher levels of behavioural control.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  2. Help-seeking attitude

    Help-seeking attitude will be measured on a 5-item subscale of C-TPB, items will be measured on a 6-point semantic differential scale, with higher scores indicating a more positive attitude towards help-seeking.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  3. Perceived barriers to help-seeking

    Perceived barriers to help-seeking will be measured by a 6-item scale adapted from the Chinese American Psychiatric Epidemiological study (CAPES), responses are rated on a 6-point Likert scale, with higher scores indicating more significant perceived barriers to help-seeking.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  4. Depressive symptoms

    Depressive symptoms will be measured with the Patient Health Questionnaire (PHQ-9). It is a 9-item instrument that incorporates depression diagnostic criteria with other leading major depressive symptoms and rates the frequency of the symptoms, factoring into the scoring severity index. PHQ-9 scores of 5-9, 10-14, 15-19, 20 and above represent mild, moderate, moderately severe, and severe depression, respectively.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  5. Anxiety symptoms

    Anxiety will be measured with the Generalised Anxiety Disorder 7-item scale (GAD-7). It is a 7-item scale; responses to each item are rated on a 4-point Likert scale and range from 0 to 3. It taps on the most prominent diagnostic features for GAD, and scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate, and severe anxiety, respectively.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

  6. Loneliness

    Loneliness will be measured with the UCLA Loneliness Scale (UCLA-3). It is a 3-item scale measuring an individual's perceived loneliness. Each item is evaluated with scores ranging from 0 (never) to 3 (often), the total score is the sum of all items, and a higher score indicates a higher level of perceived loneliness.

    Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)

Timeline

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

  1. First posted27 Nov 2024
  2. Study start1 Dec 2024
  3. Primary completion31 Aug 2026
  4. Study completion31 Dec 2026 (estimated)

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
540 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06707935
Sponsor's protocol ID
HSEARS20231109001
Status last verified
Sep 2026
First submitted
25 Nov 2024
Last updated
16 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Liu T, Liu KHK, Leung DKY, Zhang W, Kwok WW, Wong GHY, Lum TYS. Using Co-Designed Norm-Based Nudges to Promote Mental Health Help-Seeking Intentions Among Older Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2026 Jul 21;15:e103455. doi: 10.2196/103455.

    PubMed 42480100

Questions about this trial

What is this clinical trial studying?

A study testing Descriptive social norm nudges, Pictorial social norm nudges and Service as usual in people with Mental Health Help-seeking, run by The Hong Kong Polytechnic University 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 5 inclusion and 2 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: under way, not looking for participants, as of the sponsor's last update on 16 Sep 2026. 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?

This study is still under way. Results are not available in the source record yet.

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?

Subjective norms toward mental health help-seeking (time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)). 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 NCT06707935, 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 16 Sep 2026.

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