Partial Digitalization of Mission ReST

September 25, 2026 updated by: HO Wing Ka Grace, The Hong Kong Polytechnic University

Partial Digitalization and Pragmatic Evaluation of Mission ReST Using AI-Based Recommendation System: A Pragmatic, Preference-Based, Open-Label, Non-Randomized Trial

The goal of this non-randomized trial is to partially digitalize and develop a web-based resilience-building intervention and pilot-test its feasibility, acceptability, and appropriateness in an undergraduate sample over a 6-month implementation period. The main questions it aims to answer are:

  • What are the rates of recruitment, adoption, and full program completion?
  • What is the intervention's overall effectiveness in enhancing resilience and mental health outcomes?

Researchers will compare the partially digitalized intervention with a structurally equivalent in-person mode of delivery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

INTRODUCTION

Resilience is a well-established protective factor against stress and the development of mental health problems in young people. Prior work suggests that resilient responses to stressors are shaped, in part, by earlier experiences of navigating challenges and adversity in childhood. To address the limitations of one-size-fits-all resilience interventions, our research team developed Mission ReST, a person-specific, context-dependent program that tailors resilience-building strategies to individuals' response typologies to adversity.

Mission ReST is a three-session, face-to-face, gamified intervention that combines psychoeducation, skill practice, and experiential learning. Session 1 is a 60-minute individual self-discovery meeting with a trained facilitator, during which personalized recommendations for resilience-building strategies are introduced. Sessions 2 and 3 are 90-minute group sessions that use game-based challenges to help participants consolidate and apply resilience skills.

Preliminary findings suggest that the program is effective as a universal intervention and may be particularly beneficial for students with lower resilience or higher distress, with strongly positive student feedback. To further improve accessibility and engagement, this study digitalizes Session 1 into an interactive online component to scale up Mission ReST and support broader dissemination in other youth-serving settings.

AIMS AND OBJECTIVES

This study aims to (1) Develop a digitalized individual component of an existing personalized resilience-building program for university students, namely Session 1 of Mission ReST, with an AI-based recommendation system embedded, (2) Assess the feasibility, acceptability, and appropriateness of the digitalized individual component, and (3) Compare recruitment, adoption, rates of full program completion, and student outcomes between digital versus in-person delivery of the individual component over a 6-month implementation period.

METHOD

  1. INTERVENTION CONDITIONS Mission ReST is a psychoeducational intervention grounded in socialization to the resilience model and a library of 29 evidence-based resilience-building strategies targeting three core domains: negative self-concept, emotional dysregulation, and interpersonal functioning. In the experimental arm, these materials are delivered through an interactive web app. Based on users' assessment responses (i.e., multiple choice and free-text questions), an integrated AI-based recommender system using a hybrid filtering approach will identify and deliver suitable strategies. The active comparator arm involves in-person delivery of structurally and time-equivalent modules. Instead of AI-based recommendation, a trained facilitator will deliver the strategies after hearing the user's concerns.

  2. STUDY DESIGN Effectiveness of the digitalized version will be evaluated against the in-person delivery mode using a pragmatic, preference-based, open-label, non-randomized trial over a 6-month implementation period. This design prioritizes external validity and provides insight into program effectiveness, system capacity, dissemination, and scalability. The preference-based approach also allows assessment of delivery preferences and participation trends, aligns with evidence supporting flexible delivery modes for young people's mental health interventions, and reflects the trauma-informed care principle of offering choice.

  3. PARTICIPANTS AND PROCEDURES Undergraduates at PolyU between ages 18-24 years meeting the eligibility criteria will be recruited. Consistent with pragmatic trial methodology, which supports broad inclusion, ongoing recruitment efforts, and the scalability of digital delivery of Session 1, at least 400 students will be recruited during the implementation period.

    After providing consent to participate, students will provide baseline data on demographic information (age, gender, study discipline), current mental health status (DASS-21 for anxiety, depression, and stress), perceived resilience (BRS), and disturbances in self-organization (ITQ-DSO). Students may then choose to complete Session 1 either in person with a Mission ReST trainer or through the online digital component. Delivery-mode preference and Session 1 completion will be recorded, after which both arms of students will proceed to the two subsequent in-person group sessions. Three attempts will be made to contact and schedule the students to join the group sessions; non-response from three attempts is considered loss to dropout. Students will complete the outcome measures again immediately after full program completion (i.e., end of Session 3). All surveys will be completed online using Qualtrics.

  4. OUTCOME MEASURES Primary outcomes include implementation and feasibility metrics (recruitment and retention rate and satisfaction for both delivery mode over the implementation period). Secondary outcomes include baseline and post-intervention data on resilience (BRS), depression, anxiety, and stress (DASS-21), and disturbances in self-organization (ITQ-DSO). Baseline demographic information and adverse childhood experiences (ACEs) will also be collected to characterize the sample.

  5. DATA ANALYSIS Implementation and feasibility metrics will be summarized using descriptive statistics, including characteristics of screened and enrolled students, and their preference for and adoption of digital versus in-person delivery of Mission ReST Session 1. Completion, attrition, and group differences will be analyzed using t-tests, ANOVA, or chi-square tests as appropriate. To assess effectiveness between groups, changes in BRS, DASS-21 and ITQ-DSO scores from pre- to post-intervention will be examined using factorial repeated-measures ANOVA. Differences by delivery mode will be further explored using multiple linear regression with gain scores, adjusting for age, gender, and baseline scores. Intention-to-treat principles will be applied, with missing data addressed through multiple imputation. Sensitivity analyses will test alternative imputation methods, complete-case analysis, and subgroup effects by student characteristics.

ETHICAL CONSIDERATIONS

Approval has been obtained from the Human Subjects Ethics Sub-Committee of the University (HSEARS20251216001). Students will provide written informed consent to participate and will also sign the Confidentiality and Service Agreements. All Mission ReST trainers have received training in trauma-informed care and in identifying and supporting students experiencing mental distress. ReST Hub has an established crisis management protocol and works closely with University Health Services and PolyU Counselling and Wellness. Students at imminent risk will be immediately referred for professional support through the existing response system, and the PI will be notified. Data confidentiality will be strictly protected, with identifiable information stored separately from research data and all files kept securely in encrypted and locked storage. Only research team members will have access to the raw data.

Study Type

Interventional

Enrollment (Estimated)

400

Phase

  • 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 Locations

  • Hong Kong
      • Hong Kong, Hong Kong
        • School of Nursing, The Hong Kong Polytechnic University

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

Ages Eligible for Study

18 years to 24 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Undergraduate at PolyU
  • Able to provide informed consent
  • Report normal to moderate levels of distress as measured by DASS-21

Exclusion Criteria:

  • Severe or higher levels of mental distress as measured by DASS-21
  • Self-report diagnosis of mental illness
  • Currently receiving professional mental health services

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: Prevention
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Digitalized, AI-based web app

In the experimental arm, materials of the resilience-building psychoeducation are delivered through an interactive web app. Based on users' assessment responses (i.e., multiple choice and free-text questions), an integrated AI-based recommender system using a hybrid filtering approach will identify and deliver suitable resilience-building strategies.
Behavioral: Digitalized Session 1 of Mission ReST

The interactive web app is integrated with an AI-based recommender system using a hybrid filtering approach that will identify and deliver suitable strategies based on users' assessment responses (i.e., multiple choice and free-text questions).
Active Comparator: In-person delivery

In the active comparator arm, the structurally and time-equivalent modules are delivered by trained facilitators.
Behavioral: In-person delivery of Mission ReST Session 1

Structurally and time equivalent to the digital version of Mission ReST Session 1, delivered by a trained facilitator after assessing the participant's concerns and responses.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility of the digitalized individual components
Time Frame: From baseline to end of intervention at 6 weeks

Proportion of eligible individuals who consent, participate, and complete the intervention
From baseline to end of intervention at 6 weeks
Acceptability of the digitalized individual components
Time Frame: From baseline to end of intervention at 6 weeks

Quantitative measure of participant satisfaction based on a 5-point Likert scale ranging from "1=Very Dissatisfied" to "5=Very Satisfied," and qualitative description of participants' perspectives on acceptability of the intervention.
From baseline to end of intervention at 6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Resilience
Time Frame: From baseline to end of follow-up assessment at 10 weeks

The Brief Resilience Scale (BRS), a 6-item self-report questionnaire that measures perceived ability to bounce back from adversity will be used. Responses are provided on a 5-point Likert scale ranging from "strongly disagree=1" to "strongly agree=5." Scores are calculated based on the average of the 6 items, with cut-offs defined as low resilience (1-2.99), normal (3-4.30), and high (4.31-5.0). The Chinese BRS demonstrated good internal consistency, criterion validity, and construct validity when applied in university undergraduate students (Fung, 2020).
From baseline to end of follow-up assessment at 10 weeks
Depression, anxiety, and stress
Time Frame: From baseline to end of follow-up assessment at 10 weeks

The Depression Anxiety and Stress scale (DASS-21; Henry & Crawford, 2005) will be used to assess depression, anxiety, and stress levels. The scale comprises 21 items (seven items each), each rated on a 4-point scale from 0 ('Did not apply to me at all') to 3 ('Applied to me very much or most of the time'). The DASS-21 has demonstrated sound psychometric properties across a range of clinical and non-clinical populations, including good internal consistency and concurrent validity with the original DASS-42 (Antony et al., 1998).
From baseline to end of follow-up assessment at 10 weeks
Disturbances in self-organization
Time Frame: From baseline to end of follow-up assessment at 10 weeks

The Disturbances in Self-Organization subscale of the International Trauma Questionnaire (ITQ; Cloitre et al., 2018) will be used to assess affective dysregulation, negative self-concept, and disturbed relationships. The ITQ has demonstrated good psychometric properties in Hong Kong University student samples (Ho, Karatzias, et al., 2019).
From baseline to end of follow-up assessment at 10 weeks

Collaborators and Investigators

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

Sponsor

The Hong Kong Polytechnic University

Investigators

  • Principal Investigator: Grace WK Ho, PhD, The Hong Kong Polytechnic 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.

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 (Estimated)

November 1, 2026

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

July 17, 2026

First Submitted That Met QC Criteria

September 25, 2026

First Posted (Actual)

October 1, 2026

Study Record Updates

Last Update Posted (Actual)

October 1, 2026

Last Update Submitted That Met QC Criteria

September 25, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • HSEARS20251216001

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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