More Appreciation and Less Criticism Project

The University of Hong Kong (HKU)

Status: Completed

Conditions: Parenting; Family; Family Research

Treatments: Behavioral: More Fruit and Vegetable; Behavioral: More appreciation; Behavioral: Less criticism

Study type: Interventional

Funder types: Other

Identifiers

NCT04445818

HKUSPH-MALC

Details and patient eligibility

About

The project "More Appreciation and Less Criticism Project" (MALC) is a collaboration between the Tung Wah Group of Hospitals (TWGHs) and the School of Public Health of The University of Hong Kong (HKUSPH), funded by The Hong Kong Jockey Club Charities Trust. The objectives are to develop and test theory-driven group programmes to increase parents' intention and actual behaviours to express more appreciation or less criticism when interacting with their children, thereby enhancing family harmony and happiness.

Full description

This study is a cluster randomized controlled trial (RCT) with three arms: More Appreciation (MA), Less Criticism and Fruit and Vegetable (FV) group. Clusters, mostly schools, are the unit of random allocation to one of the three arms. Participants from all three arms will be assessed a total of four times, i.e. baseline (before the intervention workshop; (T1), immediate post-workshop (T2), 2-week post-workshop (T3) and 6-week post-workshop (T4).

"Fruit and vegetable consumption" is a subsidiary study to the More Appreciation and Less Criticism (MALC) Project. The study will take advantage of the cluster RCT design adopted by the MALC study, and aims at testing the active HAPA-based intervention (increasing fruit and vegetable intervention) delivered to the MALC control group. The fruit and vegetable group will serve as the intervention arm, and the groups that received interventions regarding increasing appreciation or decreasing criticism, served as the control arms.

Enrollment: 803 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Parents who are Cantonese-speaking, able to complete study questionnaire, and who have children attending p.4 to p.6 will be included.

Exclusion criteria

• Parents with active psychiatric problems, suicidal ideations, personality disorders, emotional problems, and mental retardartion will be excluded from the study.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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803 participants in 3 patient groups

More Appreciation

Experimental group

Description:

A 6-minute engaging video will be shown, illustrating examples where a mother initially withholds her appreciation for her son's effort in school and later express it. The video will also capture the effect on the child and the family. Attributional discussion questions will follow to elicit positive outcomes of expressing appreciation and the negative outcomes of withholding appreciation (e.g., What may be the long-term effects of showing appreciation on your child, family, or on yourself?). Key points will be summarised and reinforced to enhance behavioural intention (Schwarzer \& Luszczynska, 2008). Then the participants will be asked to plan by indicating when (e.g., Saturday afternoon), what (e.g., child helping a younger sibling prepare for a dictation test), and how (e.g., "I can see that you gave up your leisure time to help your sister with the spelling. Thank you!") they would express appreciation to their children.

Treatment:

Behavioral: More appreciation

Less Criticism

Experimental group

Description:

Participants will watch a 6-minute video showing examples of a father criticising his son, which will be replaced by positive communication later, and the different reactions evoked in the child and the family. Then, participants will have an attributional discussion on the negative effects of criticism (e.g., negative effect on self-worth and motivation) and positive outcomes of using constructive feedback (e.g., promptly identifying undesirable behaviours without relating to personal traits or abilities). In small groups, they will work out alternatives (i.e., constructive feedback; termed "positive reminder" in the intervention) to criticism, and each plan and write down when (e.g., after school), what (e.g., low test marks), and how (e.g., "How do you prepare for the tests?)

Treatment:

Behavioral: Less criticism

Fruit and Vegetable

Experimental group

Description:

This workshop will emphasise the importance of consuming at least 5 portions of fruit and vegetable daily for a healthy diet, and aim to boost participants' self-efficacy in achieving this. Participants will be presented with examples of one portion of fruit or vegetable, and then create their own recipes. They will also consider how to overcome obstacles of consuming more portions. Each participant will set goals and write down plans on when, where, what, and how they would increase their fruit and vegetable intake of their children and family as a whole.

Treatment:

Behavioral: More Fruit and Vegetable