Community-based Mental Wellness Project for Adolescents and Adults: Joyful Parenting Pilot Project RCT Study
Phase: NA
Conditions: Mental Well-being, Happiness
Sponsor: The University of Hong Kong

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
STUDY PROTOCOL of Joyful Parenting Pilot Project RCT Study 
1. General Information  
• 
Protocol title: Community-based Mental Wellness Project for Adolescents and Adults: 
Joyful Parenting Pilot Project RCT Study 
• 
Name of the sponsor: Health Care and Promotion Fund, Food and Health Bureau  
• 
Name of the principal investigator: Dr. Sun Yuying, Grace  
• 
Title of the principal investigator: Post-doctoral Fellow, School of Public Health, Li Ka 
Shing Faculty of Medicine, The University of Hong Kong 
• 
Name of the Co-investigators: Dr. Wang Man Ping, Kelvin; Dr. Ho Sai Yin, Daniel; Prof. 
Lam Tai Hing 
• 
NCT number: NCT03282071 
• 
Document date: Version no.02 dated 2017.06.01 
 
2. Background 
This project adopts the five elements of Seligman’s well-being theory (Seligman, 2002 & 
2011). PERMA includes five pillars of well-being that can help people reach a life of 
fulfillment, happiness and meaning: Positive emotions (P), Engagement (E), Positive 
relationships (R), Meaning (M) and Accomplishment (A). “Joyful@HK” was launched as a 
territory-wide intervention and mental health promotion campaign in Hong Kong. Three main 
elements are being advocated: sharing, mind, and enjoyment (SME). The elements being 
promoted in Joyful@HK reflect the principles of positive psychology and the positive 
interventions supported by evidence of efficacy (Sheldon and Lyubomirsky, 2006; Sin and 
Lyubomirsky, 2009; Gander et al., 2012).  
 
The Joyful Parenting Pilot Project is organized by the Hong Kong Family Welfare Society 
and is funded by Health Care and Promotion Fund. The main targets are 120 parents and at 
least 240 family members. The project will organize two-session interactive talks for parents 
to promote praise and appreciation, positive thinking, enjoyable parenting (Mind) and 
knowledge of adult mental health problem (in particular the mixed anxiety and depressive 
disorder) and mental well-being; and one family gathering activity to promote and practice 
quality family communication (Enjoyment and Sharing). One wisdom sharing session will be 
organized for social workers and service practitioners to promote best practice at the end. 
School of Public Health, The University of Hong Kong will evaluate the effectiveness of the 
Joyful Parenting Pilot Project.   
 
Evidence of effectiveness from our previous project: The Effective Parenting Programme 
conducted from August 2010 to June 2012 with collaboration of Caritas- Hong Kong that 
aimed to increase parent’s use of emotion management techniques, improve their emotional 
well-being, parent-child relationship and family 3Hs. Low   brief interventions were delivered 
by the social workers and randomized controlled trial was used to evaluate the programme 

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
effectiveness. A total of 412 parents with children in Primary 1-3 participated in the 
programme. At 3, 6 and 12-month follow up, the intervention group reported greater increases 
in the use of emotion management strategies during parent-child interactions (Cohen’s f = 
13.5- 32.67, all p< 0.001), with small to medium effect size (0.19- 0.29), and lower negative 
affect (Cohen’s f = 6.83- 14.87) and greater positive affect (Cohen’s f = 5.20- 14.15), 
subjective happiness (Cohen’s f = 15.62- 23.68), satisfaction with the parent-child 
relationship (Cohen’s f = 6.55-15.22), and family harmony (Cohen’s f = 17.25-18.43), 
compared to the control group, with small to medium effect size (0.12- 0.26). (Fabrizio, C. S. 
et al., 2015) It suggests such programmes can provide a successful, sustainable, preventive, 
behaviorally-based emotion management model for Chinese mothers. 
 
3. Objectives 
3.1 Process evaluation:  
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To assess the satisfaction level of parents towards the Joyful Parenting Pilot Project 
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To collect community partners’ feedbacks and components on improving future 
community- based mental wellness programmes 
 
3.2 Outcome evaluation:  
- 
To promote the concept of Sharing, Mind and Enjoyment (SME); to increase the 
knowledge and understanding about mental health for adolescents and adults. 
 
4. Selection and Withdrawal of subjects  
4.1 Subject Inclusion criteria 
(1) Parents: 
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Parents aged 18-59 (including single parents)  
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Chinese speaking 
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Able to complete questionnaires/ focus groups 
 
(2) Their family members: 
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Family members of parents who participated in the Joyful Parenting Pilot Project 
- 
Chinese speaking 
- 
Able to complete questionnaires/ focus groups 
 
(3) Community partners  
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Staffs of Family Service Units under Hong Kong Family Welfare Society in 
partnership with HKU research team to organize, plan, or implement the project  
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Adults aged 18 or above 
- 
Chinese speaking 
- 
Able to complete questionnaires/ individual in-depth interviews 
 
4.2 Subject exclusion criteria 

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
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Those who cannot read Chinese 
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Those who suffered from severe mental illness 
 
5. Research design 
5.1 Subject recruitment 
Four family service units under Hong Kong Family Welfare Society will be randomized into 
two intervention family service units and two control family service units. Cluster randomized 
controlled trial design will be adopted. 
Four family service units of Hong Kong Family Welfare Society will recruit parents and their 
family members who are eligible to the study under inclusion criteria as intervention subjects 
and control subjects. Two intervention family service units will be responsible for the 
implementation of the intervention and recruitment of intervention subjects, while two control 
family service units will be responsible for the recruitment of control subjects of the study.  
Staffs of Hong Kong Family Welfare Society as our community partners will also be recruited 
for the individual in-depth interviews in order to evaluate the community engagement 
approach of this project to improve future public health practice. 
5.2 Intervention arms  
The evaluation will include 2 arms (each having 60 parents and at least 120 family members) 
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2 Intervention family service units: Two-session interactive talks and one family 
gathering activity 
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2 Waitlist control family service units: Waitlist control receiving no intervention 
during evaluation period. Preferably these family service units should have similar 
characteristics with the intervention family service units. They will be provided with 
the intervention after the evaluation period. 
5.3 Assessments 
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T1: Before the intervention (baseline) 
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T2: Immediate post intervention 
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T3: One-month follow-up after baseline 
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T4: Three-month follow-up after baseline 
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The above timing is for the intervention family service units. Each control family 
service units will complete the T1, T3 and T4 assessments about the same time as the 
matched intervention family service units. 
 
5.4 Process Evaluation (Table 1)  
The opinion of parents and their family members in the intervention group will be 
assessed quantitatively (questionnaire surveys) and qualitatively (focus group 
interviews) 
 

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
a) T2 (Immediate post intervention)  
The satisfaction, ratings and opinions on the interactive talks of parents in the 
intervention group will be assessed quantitatively (questionnaire surveys) 
▪ Parents 
• 
Quantitative: questionnaire survey in family service units 
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All parents from the intervention family service units: n=60 
 
b) T3 (1-month follow-up after baseline)  
The satisfaction, ratings and opinions on the interactive talks of parents in the 
intervention group will be assessed quantitatively (questionnaire surveys). Process 
evaluation among parents at T3 is embedded into outcome evaluation (refer to outcome 
evaluation below) 
▪ Parents 
• 
Quantitative: questionnaire survey in family service units 
- 
All parents from the intervention family service units: n=60 
 
c)  T4 (3-month follow-up after baseline)  
The satisfaction, ratings and opinions on family gathering activities will be assessed 
quantitatively (questionnaire surveys) and qualitatively (focus group interviews). 
Quantitative evaluation among parents and their family members at T4 is embedded 
into outcome evaluation (refer to outcome evaluation below) 
 
▪ Parents 
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Quantitative: questionnaire survey in family service units 
- 
All parents from the intervention family service units: n=60 
• 
Qualitative: focus group interviews in family service units  
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At least 4 groups will be conducted for the parents and/or their family 
members 
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Each group has 8- 12 participants.  (n=32-48) 
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The interviews will be audio-recorded 
- 
Each interview is conducted by 1 interviewer and 1 assistant 
 
▪ Family members 
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Quantitative: questionnaire survey in family service units 
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All family members from the intervention family service units: n=120 
 
▪ Community partners 
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Qualitative: in-depth individual interviews in family service units  

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
 
- 
At least 4 individual interviews will be conducted for the community 
partners (n=4) 
- 
The interviews will be audio-recorded 
- 
Each interview is conducted by 1 interviewer and 1 assistant 
 
Table 1. Outline of process evaluation 
Target 
Timeline 
Process evaluation (intervention group) 
Quantitative 
Qualitative 
Parents 
T2 
- Immediately after 1st session 
interactive talk  
- 2 family service units 
- 60 parents (30 parents from 
each service unit) 
N/A 
T3 
- Immediately after 2nd 
interactive talk  
- 2 family service units 
- 60 parents (30 parents from 
each service unit) 
N/A 
T4 
- Immediately after family 
gathering activity  
- 2 family service units 
- 60 parents (30 parents from 
each service unit) 
- At least 4 focus groups 
- 8-12 participants per group 
- n=32-48 
Family 
members 
T4 
- Immediately after family 
gathering activity  
- 2 Family service units  
- 120 family members 
N/A 
Community 
partners 
T4 
N/A 
- At least 4 individual 
interviews  
- n=4 
 
5.5 Outcome Evaluation (Table 2)  
Background, sharing, mind and enjoyment related behavioral indicators, family relationship, 
well-being and subjective changes of parents in intervention group and control group will be 
assessed quantitatively (questionnaire survey) 
 
a) T1 (baseline) evaluation:  
▪ Parents  

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
• Quantitative: questionnaire survey in family service units 
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All parents from the intervention family service units: n=60 
• 
Items: background, mental health knowledge, SME-related behavioral 
indicators, family relationship, mental well-being 
 
b) T2 (immediate post intervention): 
▪ Parents  
• 
Quantitative: questionnaire survey in family service units 
- 
All parents from the intervention family service units: n=60 
• 
Items: background, awareness and attitude change, intention of behavioral 
change 
 
c) T3 (1-month after baseline) evaluation 
▪ Parents  
• 
Quantitative: questionnaire survey in family service units 
- 
All parents from the intervention family service units: n=60 
• 
Items: background, mental health knowledge, SME-related behavioral 
indicators, family relationship, mental well-being, subjective changes 
 
d) T4 (3-month after baseline) evaluation (embedded in the above T4 process evaluation) 
▪ Parents  
• 
Quantitative: questionnaire survey in family service units 
- 
All parents from the intervention family service units: n=60 
• 
Items: background, mental health knowledge, SME-related behavioral 
indicators, family relationship, mental well-being, subjective changes 
 
e) Qualitative outcome evaluation  
▪ Parents 
• 
Qualitative focus group interviews in family service units  
- 
At least 4 groups will be conducted for the parents 
- 
Each group has 8- 12 participants.  (n=32-48 participants) 
- 
The interviews will be audio-recorded 
- 
Each interview is conducted by 1 interviewer and 1 assistant 
▪ Community partners 
• 
Qualitative in-depth individual interviews in family service units  
- 
At least 4 individual interviews will be conducted for the community partners 
- 
The interviews will be audio-recorded 
- 
Each interview is conducted by 1 interviewer and 1 assistant 
 

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
 
Table 2. Outline of outcome evaluation 
 
Target 
Outcome evaluation 
Intervention Group 
Control Group 
Parents  
- T1, T2, T3, T4 surveys 
- 2 Family Service Units 
- 60 parents 
 (30 parents from each 
service unit) 
- T2, T3, T4 survey 
includes 
process 
evaluation 
 
- T1, T3, T4 surveys 
- 2 Family Service Units 
- 60 parents  
(30 parents from each 
service unit) 
 
Family members 
- 2 Family Service Units 
-At least 120 family 
members  
- T3 survey includes 
process evaluation 
- 4 Focus groups (n=32-
48) 
 - T4 survey includes 
process evaluation 
 
- 2 Family Service Units 
-At least 120 family 
members  
 
 
Community partners 
Individual 
in-depth 
interviews 
- 2 Family service units 
 
Individual 
in-depth 
interviews 
- 2 Family service units 
 
 
6. Statistics 
Descriptive findings will be presented as means and proportions with 95% confidence interval. 
Standard statistical methods for RCT (e.g. intention to treat) and subgroup analysis will be set 
a priori in the protocol which will be registered in clinicaltrial.gov. Missing data will be 
handled using ITT, LOCF or multiple imputation depending on the patterns of missing data. 
Clustering effect if any will be handled with statistical models (e.g. multi-level analysis) and 
regression models will be used to estimate the effect sizes of interventions.  
 
7. Ethics 
An invitation letter detailing the study will be given to the participants, explaining the 
arrangements of the voluntary surveys. Participants may discontinue participation at any time 

Community-based Mental Wellness Project for Adolescents and Adults:  
Joyful Parenting Pilot Project RCT Study 
 
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Protocol, Joyful Parenting Project, Version no.02 dated 2017.06.01 
 
without penalty or loss. The voluntary nature of participation will be emphasized and passive 
consent for participation will be sought. 
 
8. Data handling and data keeping 
All data collected during the course of research will be kept strictly confidential. Data will be 
handled and stored in locked cabinet and password-protected computers during and after 
completion of the study. The investigator (Dr. Sun Yuying) and her appointed staff will be 
responsible for safekeeping the data. Only the research team and appointed staff will have 
access to the data during/after the study. The personal data will be kept for 3 years from the 
end of the study. 
 
9. Compliance with the ICH-GCP 
This protocol has complied with the ICH-GCP.  
 
10. References 
Fabrizio, C. S., Lam, T. H., Hirschmann, M. R., Pang, I., Yu, N. X., Wang, X., & Stewart, S. 
M. (2015). Parental emotional management benefits family relationships: A randomized 
controlled trial in Hong Kong, China. Behaviour Research and Therapy, 71, 115-124. 
 
Gander, F., Proyer, R.T., Ruch, W. et al., 2012. Strength-based positive interventions: Further 
evidence for their potential in enhancing well-being and alleviating depression. Journal 
of Happiness Studies, 14(4), pp.1241-1259. 
 
Seligman M. E. P. (2002). Authentic Happiness. New York, NY: Simon and Schuster. 
 
Seligman M. E. P. (2011). Flourish. New York, NY: Free Press. 
 
Sheldon, K.M. and Lyubomirsky, S., 2006. How to increase and sustain positive emotion: The 
effects of expressing gratitude and visualizing best possible selves. The Journal of 
Positive Psychology 1(2), pp.73-82. 
 
Sin, N.L. and Lyubomirsky, S., 2009. Enhancing well-being and alleviating depressive 
symptoms with positive psychology interventions: a practice-friendly meta-analysis. 
Journal of Clinical Psychology, 65(5), pp.467-487.