ResilienceNCT07165925
Musical Training to Enhance Resilience of Underprivileged School-aged Children
A study testing Gamified music training in people with Resilience and Depressive Symptom, run by Chinese University of Hong Kong at 1 site in Hong Kong.
Trial summary
This is a multi-centre randomised controlled trial aims to examine the effects of a group-based gamified instrumental musical training in enhancing resilience (primary outcome), reducing psychological distress (depressive symptoms and anxiety), enhancing self-esteem, and improving HRQoL (secondary outcomes) among… Read more about this study
- Who is it for?
- Ages 8 to 12 years
- Conditions the study is for
- Resilience, Depressive Symptom, Anxiety
- What is being tested?
- Gamified music training
- Type of treatment
- Injection or infusion, Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 174 participants
- Where
- 1 siteHong Kong
- Study dates
- 8 Sep 2025to 30 Sep 2027
- 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 8 to 12 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Hong Kong Chinese children aged 8-12 years.
- Able to read Chinese and communicate in Cantonese/Mandarin.
- From low-income families.
- Have a risk of mental health problems, specifically depression and/or anxiety (determined through screening during the recruitment process using the Center for Epidemiological Studies Depression Scale for Children, with a cut-off score of ≥16 indicating a high risk of depression, and/or the State Anxiety Scale for Children, with scores between 36 and 60 indicating a significant level of anxiety)
Who cannot join
- Have chronic health conditions, cognitive and learning difficulties
- if they or their siblings are currently receiving or have received any music-based interventions before the study.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Hong Kong1 site, 1 recruiting
- Recruiting
The Chinese University of Hong Kong
Hong Kong
Assistant Professor, BN, MPhil, PhD, 852 39430515, ankiecheung@cuhk.edu.hk
About this study
Official title: A Gamified Instrumental Musical Training to Enhance Resilience of Underprivileged School-aged Children at Risk of Mental Health Problems: A Randomised Controlled Trial
This is a multi-centre randomised controlled trial aims to examine the effects of a group-based gamified instrumental musical training in enhancing resilience (primary outcome), reducing psychological distress (depressive symptoms and anxiety), enhancing self-esteem, and improving HRQoL (secondary outcomes) among underprivileged school-aged children at risk of mental health problems (depression and anxiety) during a 12-month follow-up.
Read the detailed description
Background: Child poverty is a prominent global health issue owing to its detrimental impact on a child's physical and psychosocial well-being. Nearly 356 million children lived in extreme poverty globally before the pandemic and this is estimated to worsen significantly. children growing up in poverty are more vulnerable to its effect and have an increased risk of psychosocial and developmental problems than children from affluent families. The impact of poverty is not only immediate during childhood but can persist into adulthood. Previous studies have shown that Chinese children from low-income families reported significantly higher levels of depressive symptoms, lower levels of self-esteem, quality of life, and life satisfaction than children from affluent families.
Therefore, there is an urgent need to design and implement promising and novel approaches for this vulnerable population to prevent children from developing mental health problems.
Growing evidence indicates the importance of fostering children's resilience to enable them to cope with adversity. Research found that resilience exerts a protective effect on the mental well-being of individuals facing adversity (i.e. exposure to poverty).
Emerging evidence reveals the promising effects of musical training of music-based interventions on enhancing resilience and psychosocial outcomes in paediatric populations. Yet, whether music-based interventions can enhance resilience in underprivileged school-aged children remains unclear.
If the proposed instrumental musical training programme is proven to be effective and sustainable, it can be recommended as usual care in the community care service for underprivileged children.
Hypothesis to be tested: Participants who receive the 6-month gamified instrumental musical training would report higher levels of resilience, reduced levels of psychological distress (depressive symptoms and anxiety), higher self-esteem, and better QoL than the placebo control group.
Design and subjects: A mulit-centre assessor-blind, randomised controlled trial will be conducted following the CONSORT guidelines; 174 underprivileged children aged 8 to 12 who are at risk of depression and/or anxiety will be randomised 1:1 to intervention or control groups.
Instruments: Validated questionnaires (RSES, CES-DC, SAS-C, RS10,and PedsQL 4.0).
Interventions: Weekly one-hour group-based gamified instrumental musical training session delivered by certified musicians for 6 months. The control group will receive weekly one-hour group-based indoor community leisure activities for 6 months.
Main outcome measures: Data collection will be conducted at baseline (T0), 6-month (T1;immediately post-intervention), 9-(T2), and 12-month(T3). The primary outcome is resilience level. Secondary outcomes include psychological distress (i.e., depressive symptoms and anxiety levels), self-esteem, and quality of life.
- Conditions
- Resilience, Depressive Symptom, Anxiety
- Being tested
- Gamified music training, Active placebo intervention
- Keywords
- Musical training, Resilience, underprivileged children, mental health
- Medical subject headings
- Depression, Anxiety Disorders, Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Gamified music trainingBehavioural
Instrumental musical training will progress from basic (playing simple notes) to advanced levels (playing an entire song). Key training elements will include fundamental music knowledge and skills, music improvisation, rhythm, and pitch identification exercises. In particular, the core concepts of resilience will be incorporated into the training process through various gamified music activities.
Active placebo interventionBehavioural
Participants in the active placebo control group will participate in weekly 1-hour group-based indoor community leisure activities for 6 months. These activities will include (i) drawing, (ii) drama workshops, (iii) cartoon film screenings, (iv) handcraft workshops, (v) board games, and (vi) exercise classes. Each activity will span for four sessions, that is, totally 24 sessions and will be delivered by trained staff at the study centres of the collaborating non-governmental organisations.
| Study group | Role | What they receive |
|---|---|---|
| Gamified musical training | Experimental | Participants in the gamified musical training group will receive weekly 1-hour lessons on a musical instrument for 6 months, delivered by professionally certified musicians. The intervention will be conducted in small groups (7-8 children/group). Two types of musical instruments (keyboard and ukulele) will be assigned to the participants based on their preferences. Receives: Behavioral: Gamified music training |
| Active placebo control group | Placebo comparator | Participants in the active placebo control group will participate in weekly 1-hour group-based (7-8 children/group) indoor community leisure activities for 6 months. Receives: Behavioral: Active placebo intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Resilience
Children's resilience will be measured by the Resilience Scale for Children- 10 (RS10) which was developed based on the Resilience Scale originally developed by Wagnild and Young. Total scores ranging from 10 to 40, with higher scores indicate higher levels of resilience.
Measured: Change from baseline to 12-month post-intervention
Secondary outcomes (5)
Social competence aspect of resilience
The Chinese version of Child Behaviour Checklist - Parent Report Form (CBCL) will be used as an objective measure in assessing children's social competency aspect of resilience. The CBCL is a 118-item scale for assessing a range of emotional and behavioural problems among school-aged children aged 6 to 18 years old. The 20-item social competence scale of CBCL will be used to assess social competency aspect of resilience of children. These 20 items will focus on children's (i) involvement in activities, (ii) social interaction patterns and (iii) school performance.
Measured: Change from baseline to 12-month post-intervention
Depressive symptoms
The Chinese version of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) will be used to assess the participants' depressive symptoms. It consists of 20 items which are rated on a 4- point Likert scale from 0 to 3 (0= "not at all", 3= "a lot") regarding the children' feelings and experiences of last week. Possible score ranges from 0 to 60, higher scores indicate higher level of depression. The cut-off score of this scale is 16, indicating the children are currently experiencing a significant level of depressive symptoms.
Measured: Change from baseline to 12-month post-intervention
Anxiety
The State Anxiety Scale for Children (SAS-C), which is a 20-item subscale of the State-Trait Anxiety Scales Inventory for Children will be used to measure children's levels of anxiety. It is rated on a three-point Likert scale from 1 to 3 to indicate the degree to which an individual is experiencing a particular feeling at present.
Measured: Change from baseline to 12-month post-intervention
Self-esteem
The Chinese version of the Rosenberg self-esteem scale (RSES) will be used to assess children's level of self-esteem. The scale contains 10 items, which are rated on a 4-point Likert scale with score 1 to 4 (1= strongly disagree, 2= disagree, 3= agree, 4 = strongly agree), with total possible scores ranging from 10 to 40. Higher scores indicate higher levels of self-esteem.
Measured: Change from baseline to 12-month post-intervention
Quality of life
The Chinese version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scale (PedsQL 4.0) will be used to assess children's health-related quality of life. The scale consists of 23 items which are categorised into four dimensions, namely physical functioning (8 items), emotional functioning (5 items), social functioning (5 items) and school functioning (5 items). All items are rated on a 5-point Likert scale from 0 (never) to 4 (almost always). Higher scores indicating better quality of life.
Measured: Change from the baseline to 12-month post-intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Sep 2025
- Study start8 Sep 2025
- Primary completion30 Sep 2027 (estimated)
- Study completion30 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ResilienceStudies of the same condition, open and under way.
- More trials run by Chinese University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 174 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Chinese University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Cheung Tan, Chinese University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07165925
- Sponsor's protocol ID
- CRE-2024.498
- Status last verified
- Dec 2025
- First submitted
- 3 Sep 2025
- Last updated
- 18 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 18 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Gamified Instrumental Musical Training to Enhance Resilience of Underprivileged School-aged Children at Risk of Mental Health Problems: A Randomised Controlled Trial
- ClinicalTrials.gov ID
- NCT07165925
- Acronym / sponsor ID
- CRE-2024.498
- Conditions
- Resilience, Depressive Symptom, Anxiety
- Keywords
- Musical training, Resilience, underprivileged children, mental health
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 174 participants (estimated)
- Lead sponsor
- Chinese University of Hong KongUniversity, hospital or other
- Study start
- 8 Sep 2025 (actual)
- Primary completion
- 30 Sep 2027 (estimated)
- Study completion
- 30 Sep 2027 (estimated)
- First posted
- 10 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a multi-centre randomised controlled trial aims to examine the effects of a group-based gamified instrumental musical training in enhancing resilience (primary outcome), reducing psychological distress (depressive symptoms and anxiety), enhancing self-esteem, and improving HRQoL (secondary outcomes) among underprivileged school-aged children at risk of mental health problems (depression and anxiety) during a 12-month follow-up.
Detailed description
Background: Child poverty is a prominent global health issue owing to its detrimental impact on a child's physical and psychosocial well-being. Nearly 356 million children lived in extreme poverty globally before the pandemic and this is estimated to worsen significantly. children growing up in poverty are more vulnerable to its effect and have an increased risk of psychosocial and developmental problems than children from affluent families. The impact of poverty is not only immediate during childhood but can persist into adulthood. Previous studies have shown that Chinese children from low-income families reported significantly higher levels of depressive symptoms, lower levels of self-esteem, quality of life, and life satisfaction than children from affluent families.
Therefore, there is an urgent need to design and implement promising and novel approaches for this vulnerable population to prevent children from developing mental health problems.
Growing evidence indicates the importance of fostering children's resilience to enable them to cope with adversity. Research found that resilience exerts a protective effect on the mental well-being of individuals facing adversity (i.e. exposure to poverty).
Emerging evidence reveals the promising effects of musical training of music-based interventions on enhancing resilience and psychosocial outcomes in paediatric populations. Yet, whether music-based interventions can enhance resilience in underprivileged school-aged children remains unclear.
If the proposed instrumental musical training programme is proven to be effective and sustainable, it can be recommended as usual care in the community care service for underprivileged children.
Hypothesis to be tested: Participants who receive the 6-month gamified instrumental musical training would report higher levels of resilience, reduced levels of psychological distress (depressive symptoms and anxiety), higher self-esteem, and better QoL than the placebo control group.
Design and subjects: A mulit-centre assessor-blind, randomised controlled trial will be conducted following the CONSORT guidelines; 174 underprivileged children aged 8 to 12 who are at risk of depression and/or anxiety will be randomised 1:1 to intervention or control groups.
Instruments: Validated questionnaires (RSES, CES-DC, SAS-C, RS10,and PedsQL 4.0).
Interventions: Weekly one-hour group-based gamified instrumental musical training session delivered by certified musicians for 6 months. The control group will receive weekly one-hour group-based indoor community leisure activities for 6 months.
Main outcome measures: Data collection will be conducted at baseline (T0), 6-month (T1;immediately post-intervention), 9-(T2), and 12-month(T3). The primary outcome is resilience level. Secondary outcomes include psychological distress (i.e., depressive symptoms and anxiety levels), self-esteem, and quality of life.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Gamified musical training | Experimental | Behavioral: Gamified music trainingParticipants in the gamified musical training group will receive weekly 1-hour lessons on a musical instrument for 6 months, delivered by professionally certified musicians. The intervention will be conducted in small groups (7-8 children/group). Two types of musical instruments (keyboard and ukulele) will be assigned to the participants based on their preferences. |
| Active placebo control group | Placebo comparator | Behavioral: Active placebo interventionParticipants in the active placebo control group will participate in weekly 1-hour group-based (7-8 children/group) indoor community leisure activities for 6 months. |
Who may qualify
- Ages
- 8 to 12 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Hong Kong Chinese children aged 8-12 years.
- Able to read Chinese and communicate in Cantonese/Mandarin.
- From low-income families.
- Have a risk of mental health problems, specifically depression and/or anxiety (determined through screening during the recruitment process using the Center for Epidemiological Studies Depression Scale for Children, with a cut-off score of ≥16 indicating a high risk of depression, and/or the State Anxiety Scale for Children, with scores between 36 and 60 indicating a significant level of anxiety)
Key exclusion criteria (2 listed)
- Have chronic health conditions, cognitive and learning difficulties
- if they or their siblings are currently receiving or have received any music-based interventions before the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Gamified music trainingInstrumental musical training will progress from basic (playing simple notes) to advanced levels (playing an entire song). Key training elements will include fundamental music knowledge and skills, music improvisation, rhythm, and pitch identification exercises. In particular, the core concepts of resilience will be incorporated into the training process through various gamified music activities. | Behavioural | Gamified musical training |
| Active placebo interventionParticipants in the active placebo control group will participate in weekly 1-hour group-based indoor community leisure activities for 6 months. These activities will include (i) drawing, (ii) drama workshops, (iii) cartoon film screenings, (iv) handcraft workshops, (v) board games, and (vi) exercise classes. Each activity will span for four sessions, that is, totally 24 sessions and will be delivered by trained staff at the study centres of the collaborating non-governmental organisations. | Behavioural | Active placebo control group |
Primary outcome
Resilience
Time frame: Change from baseline to 12-month post-intervention
Children's resilience will be measured by the Resilience Scale for Children- 10 (RS10) which was developed based on the Resilience Scale originally developed by Wagnild and Young. Total scores ranging from 10 to 40, with higher scores indicate higher levels of resilience.
5 secondary outcomes
Social competence aspect of resilience
Time frame: Change from baseline to 12-month post-intervention
Depressive symptoms
Time frame: Change from baseline to 12-month post-intervention
Anxiety
Time frame: Change from baseline to 12-month post-intervention
Self-esteem
Time frame: Change from baseline to 12-month post-intervention
Quality of life
Time frame: Change from the baseline to 12-month post-intervention
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Dec 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Gamified music training in people with Resilience and Depressive Symptom, 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 4 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: looking for participants now, as of the sponsor's last update on 18 Dec 2025. 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. Some participants in this study may receive a placebo. 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?
Contact Tan Cheung, PhD, MPhil (+85239430515, ankiecheung@cuhk.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Resilience (time frame: Change from baseline to 12-month post-intervention). 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 18 Dec 2025; AzTrials last refreshed its copy on 8 Nov 2026.