Improving Family Communication in Older Adults: A Pilot Randomized Controlled Trial (ReFrame-P)
Pilot Evaluation of ReFrame-R: A Communication Training to Reframe Older Adults' Family Roles and Promote Active Aging
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Yee Man Branda Yu
- Phone Number: +852-39173914
- Email: branda.yu@hku.hk
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Cantonese-speaking older adults
- have regular contact with adult children
- can comprehend traditional Chinese
Exclusion Criteria:
- known mental health diagnosis
- mild or higher depressive symptoms (scored ≥5 on the Patient Health Questionnaire [PHQ-9; Kroenke et al., 2001; Manea et al., 2015])
- communication difficulties
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: ReFrame-R training
The ReFrame-R comprises four weekly 90-minute group sessions (total 6 hours), supplemented by brief weekly individual consultations to troubleshoot barriers and reinforce home practice.
Adapted from an existing MI protocol for lay people (Kline et al., 2022), the program is grounded in Family Systems Theory to address over-/underfunctioning dynamics in older parent-adult child relationships, while also emphasizing empathic listening and autonomy-supportive communication.
An MI skills booklet will be distributed to support and record home practice.
|
The ReFrame-R program is adapted from an established Motivational Interviewing (MI) protocol for laypersons (Kline et al., 2022).
Grounded in Family Systems Theory, the curriculum specifically addresses over-functioning and under-functioning dynamics often found in older parent-adult child dyads and the cultural specific context of Hong Kong.
Unlike general communication workshops, this program emphasizes role boundaries within parent-adult child relationship.
|
|
No Intervention: Control group
Participants in the control group will not receive active training during the study period.
They will be provided with the same MI skills booklet for reference and self-directed practice.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Perceived communication competence
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
Participants' self-perceived communication competence is assessed using an 11-item scale adapted from the Family Communication Scale (FCS).
The scale consists of 10 items adapted from the original FCS to measure perceived ability to engage in positive communication with adult children, plus an additional item regarding overall communicagtion competence.
Each item is rated on a 5-point scale (1-5), with a total score ranging from 11 to 55. Higher scores indicate a higher level of perceived communication competence.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
|
Meaning in life
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
The 10-item Meaning in Life Questionnaire (MLQ; Steger et al., 2006) is used.
It consists of two subscales: presence of meaning (5 items) and search of meaning (5 items).
Each subscale is rated on a 7-point scale, with summed scores are calculated (ranged 5-35 for each).
Higher scores indicate stronger sense of purpose and motivation to find meaning, respectively.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Self-efficacy
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
Participants' self-efficacy will be assessed using the 6-item General Self-Efficacy Scale (GSE-6; Romppel et al., 2013).
It is typically rated on a 4-point scale from 1 to 4. Total scores range from 6 to 24, with higher scores reflecting greater perceived self-efficacy.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
|
Well-being
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
The 5-item WHO Well-Being Index will be adopted for measuring participants' subjective well-being (Bech, 1998; Kong et al., 2016), rated on a 7-point scale.
The WHO-5 score ranges from 0 to 25, zero representing worst possible mental well-being and 25 representing best possible mental well-being.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
|
Role boundaries
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
We used a 5-item scale adapted from the Control subscale of the Parent-Adult Child Relationship Questionnaire's Relationship with Father component (PACQF; Peisah et al., 1999).
While the original scale assess children's perceptions of parental conrtol, this adapted version is a self-report measure for parent to assess their attempt to maintain power, influence, or dominance over their adult children.
Each item is rated on a 5-point scale, with a total score ranging 5-25.
Higher scores indicater higher levels of parent control, reflecting weaker awareness of role boundaries in parent-adult children relationship.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
|
Family functioning
Time Frame: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
The 5-item Family Adaption, Partnership, Growth, Affection, Resolve questionnaire (Family APGAR; Chan et al., 1988; Smilkstein, 1978) is used.
This scale assesses participants' satisfaction with five aspects of family function.
Each item is rated on a 3-point scale (0-2), with a total score ranged from 0 to 10. Higher scores indicate better family functioning.
|
Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up)
|
|
Training appropriateness
Time Frame: Week 4 (end of training)
|
We used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training appropriateness.
All items are rated on a 5-point scale (1-5), with an average score being calculated.
Higher scores indicate greater perceived appropriateness of training.
|
Week 4 (end of training)
|
|
Training acceptability
Time Frame: Week 4 (end of training)
|
The 4-item Acceptability of Intervention Measure (AIM) from Weiner et al (2017) is adopted to access training appropriateness.
All items are rated on a 5-point scale (1-5), with an average score being calculated.
Higher scores indicate greater perceived acceptability of training.
|
Week 4 (end of training)
|
|
Training feasibility
Time Frame: Week 6 (2 week follow-up)
|
This study used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training feasibility.
All items are rated on a 5-point scale (1-5), with an average score being calculated.
Higher scores indicate greater perceived feasibility of training.
|
Week 6 (2 week follow-up)
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
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- Marquez, M. P. N. (2019). Family Support and Intergenerational Exchanges. In G. T. Cruz, C. J. P. Cruz, & Y. Saito (Eds.), Ageing and Health in The Philippines. Economic Research Institute for ASEAN and East Asia.
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- Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9), 606-613.
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Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- EA260121
- 2501262488 (Other Grant/Funding Number: The University of Hong Kong)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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