Improving Family Communication in Older Adults: A Pilot Randomized Controlled Trial (ReFrame-P)

September 2, 2026 updated by: YU Yee Man Branda, The University of Hong Kong

Pilot Evaluation of ReFrame-R: A Communication Training to Reframe Older Adults' Family Roles and Promote Active Aging

This study evaluates the effectiveness of "ReFrame-R," a communication training program designed to help older adults in Hong Kong navigate intergenerational challenges. By focusing on enhancing communication competence and clarifying role boundaries within parent-child relationships, the research seeks to determine if this specialized intervention can improve the mental well-being of both older and younger generations. The study asks whether participating in the "ReFrame-R" curriculum leads to measurable improvements in how families interact, hypothesizing that older adults in the training group will demonstrate significantly better communication quality and a stronger sense of meaning compared to those in a control group. This study also aims to evaluate the program's overall feasibility and acceptability.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

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.

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.
42

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 Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong, 000000
        • The University of Hong Kong

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

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

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: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

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: 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.
Behavioral: ReFrame-R
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

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
Perceived communication competence
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
Meaning in life
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training

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
Self-efficacy
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
Well-being
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
Role boundaries
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
Family functioning
Time Frame: Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
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.
Both groups: Baseline, Week 4 (end of training), Week 6 (2 weeks follow-up); Intervention group only: 4 months post-training
Training appropriateness
Time Frame: Week 6 (2 week follow-up)
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 6 (2 week follow-up)
Training acceptability
Time Frame: Week 6 (2 week follow-up)
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 6 (2 week follow-up)
Training feasibility
Time Frame: Week 4 (end of training)
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 4 (end of training)

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.
The University of Hong Kong

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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.
March 23, 2026

Primary Completion (Estimated)

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.
December 1, 2026

Study Completion (Estimated)

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.
June 1, 2027

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).
March 16, 2026

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.
March 19, 2026

First Posted (Actual)

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.
March 27, 2026

Study Record Updates

Last Update Posted (Actual)

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.
September 9, 2026

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.
September 2, 2026

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.
September 1, 2026

More Information

Terms related to this study

Keywords

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.
  • EA260121
  • 2501262488 (Other Grant/Funding Number: The University of Hong Kong)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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