Gratitude Interventions for Academic Stress Among Pakistani Adolescents

December 6, 2022 updated by: Najam us Sahar, University of Malaya

Effectiveness of Gratitude Interventions for Academic Stress and Emotional Experiences Among Pakistani Adolescents

The experimental nature of this study will provide the empirical data in analyzing the effectiveness of gratitude exercises which later can be adapted in stress reduction programs at school level. This research will focus on the school related positive life experiences for example thinking about a teacher/mentor kindness and contribution in their lives, then write a letter that describes their gratitude & letter will be delivered to that person indirectly. This may help in focusing on the positive aspects of school life. This modification will serve as testing this new model for assessing the combined effect of gratitude interventions.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Academic stress is an inevitable part of students' lives with long-term negative consequences on physical health, mental well-being, and social relations. In Asian cultures, expectations of parents and teachers are additional components of academic stress which have not been addressed in different stress management programs. Therefore, the present research addresses these contributory stress factors by using gratitude interventions in Pakistani high schools.

The study employs Broaden and Build Theory and Cognitive Appraisal Theory in formulating the intervention model and variables being tested through pretest-posttest experimental research design with a control group. A total of 102 high school students from two genders segregated schools of Rawalpindi city, Pakistan, served as the participants. They were randomly assigned into experimental and control groups, with 51 participants in each group. There were 41 boys and 61 girls with a mean age of 15.71+ 0.92 years. The measures included Academic Expectations Stress Inventory (AESI), Inventory of High-School Students' Recent Life Experiences (IHSSRLE), Modified Differential Emotions Scale (mDES), Gratitude Questionnaire-6 (GQ-6) and Gratitude Adjective Checklist (GAC). Three gratitude interventions, including Count your Blessings, Gratitude Letters and Loving-Kindness Meditation, were modified to focus on school-related experiences. The model consisted of nine sessions applied in schools for four weeks with 30-40 minutes each day. The research protocol and intervention model were adapted into Urdu for better understanding among participants. The data were analyzed through descriptive and inferential statistics (frequency, percentage, mean, SD, paired sample t-test, independent sample t-test, multivariate analysis of variance and effect size).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
102

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Rawalpindi, Punjab, Pakistan, 46000
        • Govt Islamia High School & Govt Girls High School

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

14 years to 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • High School Students
  • Studying in same school for at least last six months
  • within 14-17 years of age
  • not having severe physical health issue or going under treatment for chronic illness

Exclusion Criteria:

  • not able to understand Urdu language
  • above 17 years of age or below 14 years
  • recently enrolled in the particular school

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental
This group received 03 gratitude interventions for 4 weeks
Behavioral: School based Gratitude Interventions
Three gratitude interventions including Count your blessings, Gratitude Letter and Loving Kindness Meditation were applied with modification focusing on school related experiences. For example, writing a gratitude letter to a teacher, mentor or coach who played a significant role in one's life then imagining on the same person during LKM exercise of imagery. There were 9 sessions with 3-4 exercises in each session.
No Intervention: Control Group
This group did not receive any intervention during active phase. Only the scores on dependent variables were measured. After completion of study, the same interventions were repeated with this group.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Academic Stress
Time Frame: 4 weeks
Academic Expectations, Daily Hassles. Academic Expectation Stress Inventory is a nine (09) item inventory developed by Ang and Huan (Ang, Huan 2006) is a reliable and valid instrument widely used especially in assessing parental expectations (Ang et al., 2009; Qadir et al., 2012; Sun, 2012; Zhang et al., 2016). The two subscales are Self-Expectations and Other expectations covering the domains of stress, self-blame, disappointment, anxiety, and feeling of inadequacy. It has Likert - type scoring ranging from 1 (never true) to 5 (almost always true) with high scores showing more stress.
4 weeks
Emotional Experiences
Time Frame: 4 weeks
Positive Emotions, Positivity Ratio. it will be measured through Modified Differential Emotions Scale is a reliable & valid instrument to assess positive and negative emotions separately.It is a twenty (20) items instrument with Five (05) points likert scoring from "Not at all" to "Extremely". Overall positive and negative emotions ratio can also be created by computing the mean of 10 positive emotions divided by mean of 10 negative emotions. The scale is suitable to be used with adolescents
4 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Daily Hassles
Time Frame: 4 weeks
Daily Hassles: It is assessed through Inventory of High-School Students' Recent Life Experiences (IHSSRLE) is a self-reported reliable and valid measure that assesses daily hassles among adolescents.The scale has been developed by Kohn and Milrose in 1993. The inventory has 41 items with four points scoring ranging from 01(Not at all) to 04 (Completely true) and has eight (08) subscales. A high score reflects a high-stress level.
4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Malaya

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2018

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 2, 2019

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 1, 2019

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 26, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 6, 2022

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 7, 2022

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 7, 2022

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 6, 2022

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UM.TNC2/UMREC-621

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

IPD Plan Description

In SPSS sheet, Alpha Numerical ID will be assigned to each participant and only the combined statistical results would be published.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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