JMIR Publications

ABSTRACT

Background:

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 intelligence, emotion and failure-is-debilitating beliefs (fixed mindsets) are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. Recent research also points to the importance of parental mindset, which 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.

Objective:

Using a three-arm randomised controlled trial, the proposed study will examine the effectiveness of PC-SMILE in reducing depression and anxiety symptoms among children.

Methods:

A total of 549 parent-child dyads will be recruited from eight 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 interventions include parent-version and child-version, which are approximately 45 minutes long. Both parents and students in the PC-SMILE group receive the intervention. Student participants in three groups will be assessed at three time points: baseline before intervention (T1), within two weeks post-intervention (T2), and three months post-intervention (T3) and parents will be assessed in baseline and three-month follow-up. 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.

Results:

Recruitment is expected to begin in May 2024, with a target sample size of 549 pairs of parent and student participants (183 per condition). Participants will begin the study according to the school schedule and reminders of follow-up surveys will be sent to parent and student participants. The final wave of data is expected by the end of the first quarter of 2025. The trial results are expected to demonstrate improved anxiety and depression among students assigned to the intervention condition, alongside improvements in academic efficacy, hopelessness, and well-being when compared with students assigned to the control condition.

Conclusions:

The efficacy and effectiveness of the intervention will be discussed. Clinical Trial: ClinicalTrials.gov NCT05493865; https://clinicaltrials.gov/study/NCT05493865