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Depression and anxiety are common mental health problems among adolescents worldwide. In Hong Kong, one in every four secondary school students reports clinical-level depression or anxiety symptoms. Extant research has found that a fixed mindset on intelligence and emotions and failure-is-debilitating belief are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. At the same time, recent research also points to the importance of parental mindset. Parents are the primary social support of adolescents; parental belief systems can strongly influence children's affect, behaviour, and mental health. However, the effects of parent-child mindset interventions on a child's internalising problems have not yet been empirically examined. As emerging evidence has shown the promise of single-session interventions in reducing and preventing youth internalising problems, this project develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) - to tackle depression and anxiety in young people and promote parental well-being.
Using a three-arm randomised controlled trial, the proposed study will examine the effectiveness of PC-SMILE on reducing depression and anxiety symptoms among children, enhancing well-being and parent-child relationships.
A total of 549 parent-child dyads will be recruited from six secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The intervention is approximately 45 minutes in length. In the PC-SMILE group, both parent and child will receive intervention, and their mental health and family relationship will be assessed at three time points: baseline before intervention (T1), within two weeks post-intervention (T2), and three months post-intervention (T3). In the C-SMILE group, only the child will undergo intervention, while both the child and parent will be required to complete the repeated assessments. A pilot test (n = 9) has supported the feasibility and acceptability of the PC-SMILE intervention. We hypothesise that compared to the waitlist control group, the PC-SMILE intervention group and C-SMILE group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and PC-SMILE group is more effective than C-SMILE group. The intention-to-treat principle and linear-regression-based maximum likelihood multi-level models will be used for data analysis.
As of May 2024, we enrolled 75 students and their parents in the study.
This study will not only provide evidence on parent-child growth mindset intervention for adolescent internalising problems but can also serve as a scalable and accessible intervention for improving the well-being of young people and their parents.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The Parent-Child Single-Session-intervention of Mindset Intelligence, Failure and Emotion (PC-SMILE) | Experimental | The PC-SMILE integrates the growth mindsets of intelligence, failure, and negative emotions and introduces these growth mindsets to students and parents, which consist of five components: (a) an introduction to brain functions regarding the potential of neuroplasticity and the possibility of changes in intelligence and emotions; (b) stories and testimonials from high-school-aged youths who describe their beliefs-in-change; (c) short videos with stories of improving intelligence and emotions and of failure-is-enhancing; (d) common questions and misconceptions about growth mindset; and (e) self-persuasion writing exercises in which the participants write notes to young students/others about the growth mindsets. The interventions for parents and students are different in terms of narrative and content. A total of 10 weekly booster messages with core intervention content will be sent between the two-week post-test and the three-month follow-up survey. |
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| The Child Single-Session-intervention of Mindset Intelligence, Failure and Emotion (C-SMILE) | Experimental | The C-SMILE only provides intervention to children, which has the same components as PC-SMILE. |
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| Waitlist control group | No Intervention | The waitlist control group will continue with normal education activities and do the pre- and post-intervention surveys at the same timeframe as the intervention groups. Participants in the waitlist group and C-SMILE group will be invited to complete the PC-SMILE after the three-month post-intervention survey. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The Parent-Child Single-Session-intervention of Mindset Intelligence, Failure and Emotion (PC-SMILE) | Behavioral | This study will be a three-arm cluster-randomised controlled trial to examine the efficacy of the PC-SMILE for adolescents by comparing to a C-SMILE intervention group and a no-intervention waitlist control group. |
| Measure | Description | Time Frame |
|---|---|---|
| Children's depression and anxiety symptoms | 25-item Revised Children's Anxiety and Depression Scale (RCADS-25) | baseline |
| Children's depression and anxiety symptoms | 25-item Revised Children's Anxiety and Depression Scale (RCADS-25) | two weeks post-intervention |
| Children's depression and anxiety symptoms | 25-item Revised Children's Anxiety and Depression Scale (RCADS-25) | three months post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Children's hopelessness | the four-item Hopelessness Scale | baseline |
| Children's hopelessness | the four-item Hopelessness Scale | two weeks post-intervention |
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Inclusion Criteria:
The inclusion criteria for adolescent participants are:
The inclusion criteria for parent participants are:
Exclusion Criteria:
Exclusion criteria for adolescent participants are:
Exclusion criteria for parent participants are:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shimin Zhu, phD | Contact | +85251187809 | jasmine.zhu@polyu.edu.hk |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42346054 | Derived | Zhu S, Hu Y, Qi D, Xi A, Chen S, Wang R, Lee P, Wong PWC. Effects of a Digital Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Symptoms: A Three-Arm Waitlist Randomized Controlled Trial. Eur J Investig Health Psychol Educ. 2026 Jun 17;16(6):84. doi: 10.3390/ejihpe16060084. |
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| ID | Term |
|---|---|
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
| D010549 | Personal Satisfaction |
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Due to the nature of intervention, blinding participants to the allocation is impossible. But Before the intervention starts, participants have no knowledge on which group they are belonging to.
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| Children's hopelessness | the four-item Hopelessness Scale | three months post-intervention |
| Children's psychological well-being | the Warwick-Edinburgh Mental Well-Being Scale-7 | baseline |
| Children's psychological well-being | the Warwick-Edinburgh Mental Well-Being Scale-7 | two weeks post-intervention |
| Children's psychological well-being | the Warwick-Edinburgh Mental Well-Being Scale-7 | three months post-intervention |
| Parents' psychological well-being | the Warwick-Edinburgh Mental Well-Being Scale-7 | baseline |
| Parents' psychological well-being | the Warwick-Edinburgh Mental Well-Being Scale-7 | three months post-intervention |
| Parent-child relationships | three items | baseline |
| Parent-child relationships | three items | two weeks post-intervention |
| Parent-child relationships | three items | three months post-intervention |
| Parent-child interactions | three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week | baseline |
| Parent-child interactions | three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week | two weeks post-intervention |
| Parent-child interactions | three questions about how many days the children spend more than 15 minutes per day doing activities with their parents in a week | three months post-intervention |
| Perceived parent learning versus performance orientation | 8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive | baseline |
| Perceived parent learning versus performance orientation | 8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive | two weeks post-intervention |
| Perceived parent learning versus performance orientation | 8 items for children and 12 items for parents to indicate the extent to which reactions parents would have and which reactions children would perceive | three months post-intervention |
| Children's academic self-efficacy | a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey | baseline |
| Children's academic self-efficacy | a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey | two weeks post-intervention |
| Children's academic self-efficacy | a 5-item scale that was adapted from the part of Patterns of Adaptive Learning Survey | three months post-intervention |