Group Laughie Intervention for Well-Being in Earthquake Survivors: A Pilot Study

April 28, 2026 updated by: Nilgun Kuru Alici, Hacettepe University

A Pilot Study Investigating the Feasibility, Reach-Out, Acceptability, Fidelity, and Efficacy of a Group Laughie Prescription on the Well-Being of Earthquake Survivors in Türkiye

Mental health and quality of life may be negatively impacted among earthquake survivors. This pilot study aims to evaluate the feasibility, acceptability, and potential effects of a 1-minute Laughie (Laugh Intentionally Everyday) laughter prescription on well-being among earthquake survivors in Türkiye. The study is designed as a within-subject pretest-posttest study including approximately 20 participants. The Group Laughie intervention will be delivered once daily over a 2-week period, and participants will be instructed to engage in additional laughter practice using the Group Laughie recording twice daily, resulting in a total of 3 minutes of intentional laughter per day. Data will be collected using a range of questionnaires to assess feasibility, reach, acceptability, fidelity, and well-being outcomes. Measures include Laughie Checklists, a Post-Intervention Perceived Impact Measure (PIPIM), and the World Health Organization Well-Being Index (WHO-5). The findings of this study are expected to provide preliminary evidence regarding the feasibility and potential impact of a brief online laughter intervention on psychological well-being in earthquake survivors.

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.

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.
20

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

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria Adults aged 18 to 65 years Ability to use a smartphone or other smart device Ability to access and participate in online sessions Willingness to participate in the study Ability to provide informed consent Exclusion Criteria Individuals who do not meet the inclusion criteria Individuals unable to participate in online group sessions

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: N/A
  • Interventional Model: Single Group 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.
Active Comparator: Pre-test
Participants assigned to this arm will receive a Group Laughie intervention delivered by a trained nurse and certified laughter yoga instructor. The intervention consists of virtual group sessions conducted via an online platform (e.g., Zoom). Participants will attend one session per day for 14 days, during which they will engage in 1 minute of intentional group laughter to create a Group Laughie. Each session will be recorded, and the recording will be shared with participants. Participants will be instructed to engage in additional laughter practice using the Group Laughie recording twice daily, resulting in a total of approximately 3 minutes of intentional laughter per day. Participants will be encouraged to laugh naturally and voluntarily, either individually or with others, and may focus on personal motivations such as enhancing well-being or positive affect.
Behavioral: Laughie
The intervention is a group-based Laughie (Laugh Intentionally Everyday) prescription delivered over 14 consecutive days. Laughie is a structured well-being approach that incorporates intentional smiling and laughter exercises. The intervention will be delivered through daily virtual group sessions conducted via an online platform (e.g., Zoom). During each session, participants will engage in approximately 1 minute of guided intentional laughter in a group setting. Each session will be recorded, and participants will be provided access to the Group Laughie recording. Participants will be instructed to engage in additional laughter practice using the recording twice daily, resulting in approximately 3 minutes of intentional laughter per day. The group-based format is designed to support participant engagement and social interaction during the intervention period.

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
Laughie checklists
Time Frame: At baseline (prior to intervention) and immediately after the 14-day intervention
Following the Group Laughie participants noted whether they enjoyed it, and whether they laughed for the full minute, or at least for 30 s. Participants were prescribed to laugh with their Group Laughie twice a day. Similarly, and in addition, participants noted if they enjoyed laughing with the Group Laughie and whether they laughed for the full minute, or at least 30 s, after each time. This resulted in data from 840 Laughie experiences (3 × 14 × 20). This data is briefly summarized in the Results section
At baseline (prior to intervention) and immediately after the 14-day intervention
Laughie checklists
Time Frame: At baseline (prior to intervention) and immediately after the 14-day intervention
Following the Group Laughie participants noted whether they enjoyed it, and whether they laughed for the full minute, or at least for 30 s. Participants were prescribed to laugh with their Group Laughie twice a day. Similarly, and in addition, participants noted if they enjoyed laughing with the Group Laughie and whether they laughed for the full minute, or at least 30 s, after each time. This resulted in data from 840 Laughie experiences (3 × 14 × 20). This data is briefly summarized in the Results section.
At baseline (prior to intervention) and immediately after the 14-day intervention
Laughie experience questionnaire
Time Frame: Immediately after the 14-day intervention
The Laughie Experience Questionnaire is a post-intervention questionnaire designed to assess participant experience and intervention acceptability. The questionnaire includes items evaluating enjoyment and perceived experience of the 14-day Laughie prescription and daily group sessions. Participants will respond to statements (e.g., enjoyment of the intervention and group sessions) using a 5-point Likert scale ranging from "strongly agree" to "strongly disagree." The measure is adapted for use in this study based on previously developed Laughie-related questionnaires.
Immediately after the 14-day intervention
Post intervention perceived impact measure (PIPIM): the PPOP
Time Frame: Immediately after the 14-day intervention
The PIPIM is a new descriptive generic post-intervention descriptive measure designed to draw out intervention perceived impact (IPI) by aligning all questions to the intervention being used. Here, the PIPIM used was an adapted version of the PPOP (Positive Psychology One-off Post-intervention measure) conceived by one of the authors and first applied in citizen science research. The PPOP consists of 20 questions including "Do you feel more happy and cheerful after using the Laughie for 14 days" and "Do you have more energy after using the Laughie for 14 days". PIPIMs use an 11-point Likert scale (0 to 10): "A great deal less; A lot less; A fair bit less; A little less; A tiny bit less; The same; A tiny bit more; A little more; A fair bit more; A lot more; A great deal more"
Immediately after the 14-day intervention
WHO five well-being index (WHO-5)
Time Frame: Baseline and Day 14 (end of intervention)
The WHO-5 Well-being Index (WHO-5; World Health Organization, Citation1998), a widely used and validated measure, was administered pre- and post-intervention as a self-report well-being measure. Eser et al. validated and established the reliability of the WHO-5 Turkish scale in their 2019 study. Based on guidance from Eser et al. (Citation2019), the WHO-5 Turkish scale could be used without seeking explicit permission, provided it was cited appropriately. The scale consists of five items (e.g. 'In the last 2 weeks, I have felt cheerful and in good spirits') rated on a 6-point Likert scale grading; At no time = 0, some of the time = 1, less than half of time = 2, more than half of time = 3, most of the time = 4, all of the time = 5. The scoring of the scale is done by summing the score obtained from each item, and the highest score that can be obtained from the scale is 25 and the lowest score is 0.
Baseline and Day 14 (end of intervention)

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.
Hacettepe University

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.

Helpful Links

Study record dates

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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.
February 15, 2024

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.
February 29, 2024

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.
August 30, 2024

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).
April 21, 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.
April 28, 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.
May 1, 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.
May 1, 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.
April 28, 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.
April 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.
  • D69703

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Yes. Individual participant data that underlie the results reported in this study will be made available to qualified researchers upon reasonable request, after de-identification and in accordance with ethical and institutional requirements. Because the study involves a potentially vulnerable population and includes sensitive interview-based data, only data that can be sufficiently anonymized will be shared. Data sharing will require a methodologically sound proposal, approval by the principal investigator, and, where applicable, a data use agreement to ensure confidentiality and appropriate use of the data.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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