Improving Mental Health of Chinese University Students in Hong Kong: Adventure-based Cognitive Behavioural Intervention

A Randomized Controlled Trial of Adventure-based Cognitive Behavioural Intervention for University Students in Hong Kong

This study delivered an adventure-based cognitive behavioral intervention program to a group of Hong Kong university students. The program effectiveness was evaluated by a randomized controlled trial in reducing psychological distress and improving mental health of these students. The 3-month maintenance effect was also tested.

Study Overview

• Status: Completed
• Conditions: Adventure-based Cognitive Behavioral Intervention
• Intervention / Treatment: Other: adventure-based cognitive behavioral intervention

Detailed Description

University students are vulnerable to mental health problems due to the various challenges they have to face in university life. However, few studies have been conducted to evaluate the effectiveness of university counseling programs in Hong Kong. This project aims at developing and systematically evaluating a culturally adapted and adventure-based cognitive behavioral intervention (aCBI) program to decrease psychological distress and improve various mental health outcomes for Chinese university students in Hong Kong. The aCBI program was delivered in a form of general education course in a university setting. Randomized controlled trial (RCT) design was adopted. The program was evaluated its effectiveness in reducing psychological distress, perceived stress, depressive and anxiety symptoms, negative thoughts and negative emotions and increasing positive thoughts and positive emotions.

• Study Type: Interventional
• Enrollment (Actual): 458
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Jiayan Pan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• be of Chinese nationality
• be studying in undergraduate programs at Hong Kong Baptist University (HKBU), as the aCBI program will be provided in the form of a general education course at this university
• have GHQ-12 scores of 2-10 (0-0-1-1) (i.e., mild to moderate levels of psychological distress)
• be willing to complete the entire process of the project.

Exclusion Criteria:

• have GHQ-12 scores of 0-1 (i.e., a low level of psychological distress) or 11-12 (i.e., a high level of psychological distress)
• have one or more psychosis
• have experienced severe depression with suicidal attempts/ideation in the past 3 months, as diagnosed by a psychiatrist or a clinical psychologist.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Adventure-based cognitive behavioral intervention; An adventure-based cognitive behavioral intervention program A 13-session adventure-based cognitive behavioral intervention program, including 6 lectures, 5 workshops and adventure training (one adventure day camp (2 sessions) and adventure activities in the beginning of each workshop). One session per week, 3 hours for each session. A variety of cognitive behavioral skills were taught in lectures and these skills were practiced in two groups (with appropriately 20 students in each group) in workshop to help students to apply these skills to cope with their own daily life stress. Skill briefing, case demonstration and debriefing, group sharing and discussion, in-class exercise and homework were used in the intervention program.	Other: adventure-based cognitive behavioral intervention; The adventure-based cognitive behavioral intervention is a combination of cognitive behavioral therapy and adventure training. The intervention program is delivered in a 39-hour general education course entailed "Improving Mental Health for University Success" in a public university in Hong Kong. The program includes 6 lectures, 5 workshops, 5 adventure games and an adventure day camp. Students are divided into two groups in workshop to practise CBT skills to deal with their own issues.
NO_INTERVENTION: Control group; No intervention of the adventure-based cognitive behavioral program

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
General Health Questionnaire-12	12-item rating scale for psychological distress, scale score ranges from 0-12, with a higher score indicating a higher level of psychological distress	baseline: before the intervention program starts
General Health Questionnaire-12	12-item rating scale for psychological distress, scale score ranges from 0-12, with a higher score indicating a higher level of psychological distress	post-test: 1 month upon completion of the intervention program
General Health Questionnaire-12	12-item rating scale for psychological distress, scale score ranges from 0-12, with a higher score indicating a higher level of psychological distress	3-month follow-up test: 3 months after completion of the intervention program

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Stress Scale	10-item rating scale for perceived stress, scale score ranges from 0-4, with a higher score indicating a higher level of perceived stress	baseline: before the intervention program starts
Perceived Stress Scale	10-item rating scale for perceived stress, scale score ranges from 0-4, with a higher score indicating a higher level of perceived stress	post-test: 1 month upon completion of the intervention program
Perceived Stress Scale	10-item rating scale for perceived stress, scale score ranges from 0-4, with a higher score indicating a higher level of perceived stress	3-month follow-up test: 3 months after completion of the intervention program
Beck Anxiety Inventory	21-item rating scale for anxiety symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of anxiety symptoms	baseline: before the intervention program starts
Beck Anxiety Inventory	21-item rating scale for anxiety symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of anxiety symptoms	post-test: 1 month upon completion of the intervention program
Beck Anxiety Inventory	21-item rating scale for anxiety symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of anxiety symptoms	3-month follow-up test: 3 months after completion of the intervention program
Chinese Affect Scale	20-item rating scale for positive and negative emotions, score ranges from 1-6 for positive emotion subscale and negative emotion subscale, with a higher score indicating a higher level of positive/negative emotion	baseline: before the intervention program starts
Chinese Affect Scale	20-item rating scale for positive and negative emotions, score ranges from 1-6 for positive emotion subscale and negative emotion subscale, with a higher score indicating a higher level of positive/negative emotion	post-test: 1 month upon completion of the intervention program
Chinese Affect Scale	20-item rating scale for positive and negative emotions, score ranges from 1-6 for positive emotion subscale and negative emotion subscale, with a higher score indicating a higher level of positive/negative emotion	3-month follow-up test: 3 months after completion of the intervention program
Beck Depression Inventory	21-item rating scale for depressive symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of depressive symptoms	baseline: before the intervention program starts
Beck Depression Inventory	21-item rating scale for depressive symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of depressive symptoms	post-test: 1 month upon completion of the intervention program
Beck Depression Inventory	21-item rating scale for depressive symptoms, scale score ranges from 0-63, with a higher score indicating a higher level of depressive symptoms	3-month follow-up test: 3 months after completion of the intervention program
Automatic Thoughts Questionnaire	14-item rating scale for positive and negative automatic thoughts, score ranges from 1-5 for the positive thought subscale and negative thought subscale, with a higher score indicating a higher level of positive/negative thought.	baseline: before the intervention program starts
Automatic Thoughts Questionnaire	14-item rating scale for positive and negative automatic thoughts, score ranges from 1-5 for the positive thought subscale and negative thought subscale, with a higher score indicating a higher level of positive/negative thought.	post-test: 1 month upon completion of the intervention program
Automatic Thoughts Questionnaire	14-item rating scale for positive and negative automatic thoughts, score ranges from 1-5 for the positive thought subscale and negative thought subscale, with a higher score indicating a higher level of positive/negative thought.	3-month follow-up test: 3 months after completion of the intervention program
Chinese Making Sense of Adversity Scale	12-item rating scale for measuring sense-making coping, score ranges from "1" = "totally disagree" to "6" = "totally agree", with a higher score indicating a higher level of sense-making coping.	baseline: before the intervention program starts
Chinese Making Sense of Adversity Scale	12-item rating scale for measuring sense-making coping, score ranges from "1" = "totally disagree" to "6" = "totally agree", with a higher score indicating a higher level of sense-making coping.	post-test: 1 month upon completion of the intervention program
Chinese Making Sense of Adversity Scale	12-item rating scale for measuring sense-making coping, score ranges from "1" = "totally disagree" to "6" = "totally agree", with a higher score indicating a higher level of sense-making coping.	3-month follow-up test: 3 months after completion of the intervention program
Connor-Davidson Resilience Scale	25-item rating scale for measuring resilience, score ranges from "1" = "not true at all" to "5" = "true all the time". All the Item scores are summed up as a total score, with a higher score indicating greater resilience.	baseline: before the intervention program starts
Connor-Davidson Resilience Scale	25-item rating scale for measuring resilience, score ranges from "1" = "not true at all" to "5" = "true all the time". All the Item scores are summed up as a total score, with a higher score indicating greater resilience.	post-test: 1 month upon completion of the intervention program
Connor-Davidson Resilience Scale	25-item rating scale for measuring resilience, score ranges from "1" = "not true at all" to "5" = "true all the time". All the Item scores are summed up as a total score, with a higher score indicating greater resilience.	3-month follow-up test: 3 months after completion of the intervention program

Collaborators and Investigators

• Sponsor: Hong Kong Baptist University
• Collaborators: Research Grants Council, Hong Kong

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2018
• Primary Completion (ACTUAL): December 31, 2020
• Study Completion (ACTUAL): December 31, 2020

Study Registration Dates

• First Submitted: August 6, 2021
• First Submitted That Met QC Criteria: August 6, 2021
• First Posted (ACTUAL): August 10, 2021

Study Record Updates

• Last Update Posted (ACTUAL): August 10, 2021
• Last Update Submitted That Met QC Criteria: August 6, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Other Study ID Numbers: HKBU 22603717

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No