Mental Health LiteracyNCT07238842
Non-inferiority of Virtual vs. Traditional Methods in Adolescent Mental Health Literacy
A study testing Teacher-Led Psychological Literacy Instruction and Virtual Agent-Delivered Psychological Literacy Training in people with Mental Health Literacy, run by Shanghai Mental Health Center at 1 site in China.
Trial summary
The goal of this clinical trial is to determine whether a digital psychological literacy program delivered by an AI-powered virtual agent is non-inferior to traditional teacher-led instruction in improving mental health literacy among adolescents. Read more about this study
- Who is it for?
- Ages 11 to 18 yearsHealthy volunteers can take part
- Conditions the study is for
- Mental Health Literacy
- What is being tested?
- Teacher-Led Psychological Literacy Instruction and Virtual Agent-Delivered Psychological Literacy Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 334 participants
- Where
- 1 siteChina
- Study dates
- 16 May 2025to 28 Feb 2026
- 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 11 to 18 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Age between 11 and 18 years inclusive.
- Able to fluently operate a computer or smartphone.
- Possess normal language expression and reading comprehension abilities.
- Voluntarily agree to participate in the study and provide signed informed consent (and parental consent where required by local regulations).
Who cannot join
- Diagnosed with a psychiatric disorder that impairs the ability to complete assessments or participate in the intervention.
- Suffering from a severe physical illness, central nervous system disease, or substance use disorder that could interfere with study participation or outcomes.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Non-inferiority Study of the Virtual Agent-based Versus Teacher-led Psychological Literacy Enhancement Method in Improving Adolescents' Mental Health Literacy
The goal of this clinical trial is to determine whether a digital psychological literacy program delivered by an AI-powered virtual agent is non-inferior to traditional teacher-led instruction in improving mental health literacy among adolescents. The study focuses on middle and high school students aged 11 to 18 years attending a school in Shanghai, China, including those with varying levels of emotional well-being but excluding those with diagnosed psychiatric disorders or severe physical illness.
The main questions it aims to answer are:
Read more
Is the virtual agent-delivered psychological literacy program as effective as teacher-led instruction in improving adolescents' mental health literacy? Does the virtual agent intervention lead to comparable or better outcomes in secondary measures such as depression, anxiety, psychological resilience, sleep quality, and digital well-being?
Researchers will compare students receiving 6 weekly sessions from a virtual digital agent to students receiving the same curriculum delivered by trained psychology teachers to see if the AI-based approach achieves similar improvements in mental health knowledge, attitudes, and help-seeking behaviors.
Participants will:
Complete online assessments at baseline, week 3, week 6 and week 18 covering mental health literacy (UMHL-A), depression (PHQ-9), anxiety (GAD-7), psychological resilience (RSCA), and other well-being indicators Attend one 45-60 minute session per week for 6 weeks, either interacting with the virtual agent or participating in a teacher-led class Optionally take part in a brief satisfaction survey and/or a focus group interview after the intervention to share their experiences
- Conditions
- Mental Health Literacy
- Being tested
- Teacher-Led Psychological Literacy Instruction, Virtual Agent-Delivered Psychological Literacy Training
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Teacher-Led Psychological Literacy InstructionBehavioural
This intervention delivers the identical 6-week psychological literacy curriculum as the virtual agent arm, but through standard face-to-face instruction by certified school psychology teachers. Teachers follow a detailed manualized lesson plan covering the same four thematic modules and learning objectives. Sessions include traditional pedagogical techniques such as didactic teaching, group discussion, role-playing exercises, reflective writing, and in-class activities. Each session lasts 45-60 minutes and occurs weekly in the regular classroom setting. Teachers are trained to adhere to the protocol to ensure content equivalence with the virtual agent condition, though minor natural variations in delivery style, pacing, or classroom interaction may occur. This intervention represents the current standard of practice for school-based mental health education in China and serves as the active control condition.
Virtual Agent-Delivered Psychological Literacy TrainingBehavioural
This intervention consists of a 6-week, school-based psychological literacy program delivered by an AI-powered virtual digital agent. The agent uses real-time animation, speech synthesis, and scripted but context-sensitive dialogue to guide students through evidence-based mental health content aligned with China's national mental health education guidelines. The curriculum includes four modules: (1) psychological foundations and self-awareness, (2) stress and coping skills, (3) interpersonal and family communication, and (4) healthy digital habits, sleep, and future planning. Each weekly session (45-60 minutes) is fully digital, interactive, and delivered via classroom computers. The virtual agent maintains consistent content fidelity across all participants. This intervention leverages AI technologies-including natural language understanding and emotion-aware feedback-but does not provide clinical therapy or real-time personalized adaptation beyond pre-programmed branching logic.
| Study group | Role | What they receive |
|---|---|---|
| Teacher-Led Psychological Literacy Instruction | Active comparator | Participants in this arm receive the identical 6-week psychological literacy curriculum, but delivered by trained school psychology teachers through traditional face-to-face classroom instruction. Each weekly session lasts 45-60 minutes and follows the same structure and content as the virtual agent arm, including the same four thematic modules. Teachers use standard pedagogical methods such as lectures, group discussions, role-playing, and worksheet activities. This arm serves as the active control condition, representing the current standard of school-based mental health education in China. Receives: Behavioral: Teacher-Led Psychological Literacy Instruction |
| Virtual Agent-Delivered Psychological Literacy Program | Experimental | Participants in this arm receive a 6-week psychological literacy curriculum delivered entirely by an AI-powered virtual digital agent. The program consists of weekly 45-60 minute interactive sessions aligned with China's national guidelines for mental health education (e.g., Guidelines for Mental Health Education in Primary and Secondary Schools, 2012). The content covers four core modules: (1) psychological foundations and self-awareness, (2) stress and challenge coping skills, (3) interpersonal and communication skills, and (4) healthy lifestyle and future planning. The virtual agent uses scripted but adaptive dialogue, emotion-aware responses, and multimedia engagement to deliver the same evidence-based curriculum used in the control arm. Sessions are conducted in a classroom setting using school-provided computers. Receives: Behavioral: Virtual Agent-Delivered Psychological Literacy Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Adolescent Mental Health Literacy
Mental health literacy is assessed using the Universal Mental Health Literacy Scale for Adolescents (UMHL-A), a validated 17-item Chinese-language instrument. Part A contains eight items assessing attitudes toward help-seeking and mental health-related stigma, scored on a 5-point Likert scale (range: 8-40). Part B contains nine items assessing general mental health knowledge and knowledge of specific mental illnesses, with each item scored 0 or 1 (range: 0-9). The total score ranges from 8 to 49. Higher scores indicate greater mental health literacy, including more positive attitudes and better knowledge, whereas lower scores indicate poorer mental health literacy. The Chinese version has demonstrated good reliability and validity among adolescents.
Measured: Baseline, week 3, week 6, week 18
Secondary outcomes (7)
Change in Depressive Symptom Severity
Depressive symptoms were assessed using the Visual Analogue Scale-Depression (VAS-Depression).Depressive symptoms during the preceding week are assessed using a 10-cm visual analogue scale ranging from 0 ("not depressed at all") to 10 ("extremely depressed"). Higher scores indicate greater symptom severity. Scores are categorized as mild (0-3), moderate (4-6), or severe (7-10). The scale demonstrates good concurrent validity with established depression measures, including the Beck Depression Inventory (r = 0.70-0.78), and test-retest reliability exceeding 0.80.
Measured: baseline, week 3, week 6, week 18
Change in Anxiety Symptom Severity
Anxiety symptoms were assessed using the Visual Analogue Scale-Anxiety. Anxiety symptoms during the preceding week are assessed using a 10-cm visual analogue scale ranging from 0 ("not anxious at all") to 10 ("extremely anxious"). Higher scores indicate greater symptom severity. Scores are categorized as mild (0-3), moderate (4-6), or severe (7-10). Correlations with established measures, including the State-Trait Anxiety Inventory, range from 0.65 to 0.76.
Measured: Baseline, week 3, week 6, week 18
Change in Sleep Quality
Sleep quality over the past month is assessed using the PSQI (Pittsburgh Sleep Quality Index), a 19-item self-report instrument that evaluates seven dimensions: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Total scores range from 0 to 21, with higher scores indicating poorer sleep quality.
Measured: Baseline， week 3， week 6， week 18
Change in Risk of Gaming Disorder
Risk of gaming disorder is measured using the GDSS (Gaming Disorder Screening Scale), an 18-item Likert-type scale based on DSM-5 and ICD-11 criteria. It assesses symptoms such as loss of control over gaming, prioritizing gaming over other activities, and continued use despite negative consequences. Total scores range from 18 to 72, with higher scores indicating greater risk.
Measured: Baseline, week 3, week 6, week18
Change in Self-esteem
Self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). The Chinese version of the Rosenberg Self-Esteem Scale is a 10-item unidimensional measure rated on a 4-point Likert scale, with five reverse-scored items. Total scores range from 10 to 40, with higher scores indicating greater self-esteem. Scores are classified as low (10-20), moderate (21-30), or high (31-40). The Chinese version has shown good internal consistency (Cronbach's α = 0.84-0.88) and test-retest reliability of approximately 0.82.
Measured: Baseline，week 3， week 6 ，week 18
Change in Perceived social support
Perceived social support was assessed using the Adolescent Social Support Scale (ASSS). The Chinese Adolescent Social Support Scale comprises 17 items assessing support from parents, teachers, classmates, close friends, and the school. Items are rated on a 5-point Likert scale (1 = never to 5 = always), yielding a total score of 17-85; higher scores indicate greater perceived social support. Scores are classified as low (17-39), moderate (40-62), or high (63-85). The scale has excellent internal consistency overall (Cronbach's α = 0.96), with subscale α coefficients of 0.85-0.93 and test-retest reliability of 0.84.
Measured: Baseline, week 3, week 6, week18
Change in Psychological Resilience
Psychological resilience was assessed using the Resilience Scale for Chinese Adolescents (RSCA). The Resilience Scale for Chinese Adolescents contains 27 items covering two broad domains-personal strength and supportive resources-and five underlying factors. Items are rated on a 5-point Likert scale, with 12 reverse-scored items. Total scores range from 27 to 135, with higher scores indicating greater resilience. Scores are classified as low (27-81), moderate (82-105), or high (106-135). The scale has demonstrated good internal consistency (Cronbach's α = 0.83) and split-half reliability (0.80).
Measured: Baseline, week 3, week 6, week 18
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Nov 2025
- Study start16 May 2025
- Primary completion29 Nov 2025
- Study completion28 Feb 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mental Health LiteracyStudies of the same condition, open and under way.
- More trials run by Shanghai Mental Health CenterThe 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
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 334 participants (actual)
Sponsor and investigators
- Lead sponsor
- Shanghai Mental Health Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07238842
- Sponsor's protocol ID
- MZhao-024
- Status last verified
- May 2025
- First submitted
- 16 Nov 2025
- Last updated
- 4 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 4 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Non-inferiority Study of the Virtual Agent-based Versus Teacher-led Psychological Literacy Enhancement Method in Improving Adolescents' Mental Health Literacy
- ClinicalTrials.gov ID
- NCT07238842
- Acronym / sponsor ID
- MZhao-024
- Conditions
- Mental Health Literacy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 334 participants (actual)
- Lead sponsor
- Shanghai Mental Health CenterUniversity, hospital or other
- Study start
- 16 May 2025 (actual)
- Primary completion
- 29 Nov 2025 (actual)
- Study completion
- 28 Feb 2026 (actual)
- First posted
- 20 Nov 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.
The goal of this clinical trial is to determine whether a digital psychological literacy program delivered by an AI-powered virtual agent is non-inferior to traditional teacher-led instruction in improving mental health literacy among adolescents. The study focuses on middle and high school students aged 11 to 18 years attending a school in Shanghai, China, including those with varying levels of emotional well-being but excluding those with diagnosed psychiatric disorders or severe physical illness.
The main questions it aims to answer are:
Is the virtual agent-delivered psychological literacy program as effective as teacher-led instruction in improving adolescents' mental health literacy? Does the virtual agent intervention lead to comparable or better outcomes in secondary measures such as depression, anxiety, psychological resilience, sleep quality, and digital well-being?
Researchers will compare students receiving 6 weekly sessions from a virtual digital agent to students receiving the same curriculum delivered by trained psychology teachers to see if the AI-based approach achieves similar improvements in mental health knowledge, attitudes, and help-seeking behaviors.
Participants will:
Complete online assessments at baseline, week 3, week 6 and week 18 covering mental health literacy (UMHL-A), depression (PHQ-9), anxiety (GAD-7), psychological resilience (RSCA), and other well-being indicators Attend one 45-60 minute session per week for 6 weeks, either interacting with the virtual agent or participating in a teacher-led class Optionally take part in a brief satisfaction survey and/or a focus group interview after the intervention to share their experiences
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Teacher-Led Psychological Literacy Instruction | Active comparator | Behavioral: Teacher-Led Psychological Literacy InstructionParticipants in this arm receive the identical 6-week psychological literacy curriculum, but delivered by trained school psychology teachers through traditional face-to-face classroom instruction. Each weekly session lasts 45-60 minutes and follows the same structure and content as the virtual agent arm, including the same four thematic modules. Teachers use standard pedagogical methods such as lectures, group discussions, role-playing, and worksheet activities. This arm serves as the active control condition, representing the current standard of school-based mental health education in China. |
| Virtual Agent-Delivered Psychological Literacy Program | Experimental | Behavioral: Virtual Agent-Delivered Psychological Literacy TrainingParticipants in this arm receive a 6-week psychological literacy curriculum delivered entirely by an AI-powered virtual digital agent. The program consists of weekly 45-60 minute interactive sessions aligned with China's national guidelines for mental health education (e.g., Guidelines for Mental Health Education in Primary and Secondary Schools, 2012). The content covers four core modules: (1) psychological foundations and self-awareness, (2) stress and challenge coping skills, (3) interpersonal and communication skills, and (4) healthy lifestyle and future planning. The virtual agent uses scripted but adaptive dialogue, emotion-aware responses, and multimedia engagement to deliver the same evidence-based curriculum used in the control arm. Sessions are conducted in a classroom setting using school-provided computers. |
Who may qualify
- Ages
- 11 to 18 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (4 listed)
- Age between 11 and 18 years inclusive.
- Able to fluently operate a computer or smartphone.
- Possess normal language expression and reading comprehension abilities.
- Voluntarily agree to participate in the study and provide signed informed consent (and parental consent where required by local regulations).
Key exclusion criteria (2 listed)
- Diagnosed with a psychiatric disorder that impairs the ability to complete assessments or participate in the intervention.
- Suffering from a severe physical illness, central nervous system disease, or substance use disorder that could interfere with study participation or outcomes.
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 |
|---|---|---|
| Teacher-Led Psychological Literacy InstructionThis intervention delivers the identical 6-week psychological literacy curriculum as the virtual agent arm, but through standard face-to-face instruction by certified school psychology teachers. Teachers follow a detailed manualized lesson plan covering the same four thematic modules and learning objectives. Sessions include traditional pedagogical techniques such as didactic teaching, group discussion, role-playing exercises, reflective writing, and in-class activities. Each session lasts 45-60 minutes and occurs weekly in the regular classroom setting. Teachers are trained to adhere to the protocol to ensure content equivalence with the virtual agent condition, though minor natural variations in delivery style, pacing, or classroom interaction may occur. This intervention represents the current standard of practice for school-based mental health education in China and serves as the active control condition. | Behavioural | Teacher-Led Psychological Literacy Instruction |
| Virtual Agent-Delivered Psychological Literacy TrainingThis intervention consists of a 6-week, school-based psychological literacy program delivered by an AI-powered virtual digital agent. The agent uses real-time animation, speech synthesis, and scripted but context-sensitive dialogue to guide students through evidence-based mental health content aligned with China's national mental health education guidelines. The curriculum includes four modules: (1) psychological foundations and self-awareness, (2) stress and coping skills, (3) interpersonal and family communication, and (4) healthy digital habits, sleep, and future planning. Each weekly session (45-60 minutes) is fully digital, interactive, and delivered via classroom computers. The virtual agent maintains consistent content fidelity across all participants. This intervention leverages AI technologies-including natural language understanding and emotion-aware feedback-but does not provide clinical therapy or real-time personalized adaptation beyond pre-programmed branching logic. | Behavioural | Virtual Agent-Delivered Psychological Literacy Program |
Primary outcome
Change in Adolescent Mental Health Literacy
Time frame: Baseline, week 3, week 6, week 18
Mental health literacy is assessed using the Universal Mental Health Literacy Scale for Adolescents (UMHL-A), a validated 17-item Chinese-language instrument. Part A contains eight items assessing attitudes toward help-seeking and mental health-related stigma, scored on a 5-point Likert scale (range: 8-40). Part B contains nine items assessing general mental health knowledge and knowledge of specific mental illnesses, with each item scored 0 or 1 (range: 0-9). The total score ranges from 8 to 49. Higher scores indicate greater mental health literacy, including more positive attitudes and better knowledge, whereas lower scores indicate poorer mental health literacy. The Chinese version has demonstrated good reliability and validity among adolescents.
7 secondary outcomes
Change in Depressive Symptom Severity
Time frame: baseline, week 3, week 6, week 18
Change in Anxiety Symptom Severity
Time frame: Baseline, week 3, week 6, week 18
Change in Sleep Quality
Time frame: Baseline， week 3， week 6， week 18
Change in Risk of Gaming Disorder
Time frame: Baseline, week 3, week 6, week18
Change in Self-esteem
Time frame: Baseline，week 3， week 6 ，week 18
Change in Perceived social support
Time frame: Baseline, week 3, week 6, week18
Change in Psychological Resilience
Time frame: Baseline, week 3, week 6, week 18
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Aug 2026.
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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. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Teacher-Led Psychological Literacy Instruction and Virtual Agent-Delivered Psychological Literacy Training in people with Mental Health Literacy, run by Shanghai Mental Health Center at 1 site in China.
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: finished, as of the sponsor's last update on 4 Aug 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 China. 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 Adolescent Mental Health Literacy (time frame: Baseline, week 3, week 6, week 18). 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 4 Aug 2026.