Project KING: To Strengthen Parent-child Relationship and Adaptation
Condition: Emotions; Family Conflict; Adaptation
Study type: Interventional

Summary: 
      This study aims at improving the emotional regulation strategies, enhancing the parent-child
      relationship and preventing family conflict among newly arrived and cross-boundary families
      in Hong Kong. We will provide one of the interventions to the participants: (a) the emotion
      regulation arm, which aimed at improving the emotion management skill for parent and child;
      or (b) the information provision arm, which aimed at providing information about Hong Kong,
      such as education, community resources, medical care, employment, housing, and job-seeking.
      We aim to recruit 200 parent-child pairs to participate in the study. The participants will
      be randomly assigned into an emotion regulation arm or an information provision arm. The
      ratio of the two arms is 3:2. Specifically, 120 and 80 parent-child pairs will be assigned to
      the emotion regulation arm and the information provision arm, respectively. The two
      intervention arms will provide four 2-hour weekly sessions to the participants. Before the
      intervention (T1), immediately after the intervention (T2), and one month after completing
      the intervention (T3), the participants will finish the assessments to evaluate the
      effectiveness of the intervention.
    

Detailed description: 
      1. Context of the study About 123 people migrate from Mainland China to Hong Kong to
           reunite with family every day. Migration from Mainland China to Hong Kong can be highly
           stressful. Newly arrived mothers and their children experience adaptation-related
           stressors, such as lifestyle changes, unhealthy housing conditions, and family financial
           restrictions, and they tend to experience high levels of psychological distress.

           Among the migrant population in Hong Kong, a particular group is known as cross-boundary
           children who engage in everyday-migration. Most cross-boundary children live in Shenzhen
           with their parents, who are not Hong Kong citizens. To attend school in Hong Kong, these
           children have to cross the border checkpoints connecting Hong Kong with mainland China
           every day. Families with cross-boundary children experience adaptation-related
           stressors, such as language difficulties, economic burden, and unclear citizenship
           status. These families have weaker social support networks in Shenzhen and seldom use
           community services in Hong Kong. Thus, cross-boundary families face multiple challenges
           and stressors due to their situation, which also puts them at a high risk of mental
           health problems.

        2. Target of emotion regulation Newly arrived and cross-boundary families face similar
           problems, such as discrimination, acculturative stress, mental health problems (e.g.,
           depression). All these problems can result in family conflict between parents and child.
           For example, early interviews have revealed that conflict over schoolwork and academic
           performance between children and parents could threaten overall family harmony.
           Frustrated with their lack of emotion regulation strategies, the children and parents
           often vented their anger and anxiety on each other, which sometimes led to physical
           abuse.

           Previous studies have demonstrated that the identification, comprehension, expression,
           regulation, and use of emotions are important predictors of individual adaptation and
           are positively correlated with mental health (e.g., happiness and social functioning).
           Parents' emotional regulation and mental health can influence their children's emotional
           socialization by means of diffusion through the family emotional climate. Thus, a
           community-based intervention focused on emotion regulation might help decrease these
           conflicts and enhance family harmony.

        3. Cultural and contextual considerations in the intervention feature Family system theory
           states that families function as interdependent individual systems in which each member
           can impact others. It has been found that children's emotional problems are related to
           the stressful experiences and emotional symptoms of their parents. Therefore, we
           involved both parents and children concurrently in the intervention to maximize the
           intervention benefits. The parallel-group model is widely advocated in family-based
           intervention, but its implementation has a certain degree of difficulty. A
           parallel-group comprises two concurrent, but separate intervention groups (e.g., a child
           group together with a parent group); participants from the two groups engage in similar
           activities in different rooms with corresponding goals and contents. Compared with an
           intervention for individuals alone, involving family members in a family-based
           intervention can lead to greater benefits. Separating parents from children could
           prevent children from their parents' over-control and let each group deal with their own
           problems. The parallel-group model has been used to deal with different problems in
           parents and children. For example, a parent-child parallel-group helped improve the
           psychological functioning of depressed mothers, the mothers' caregivers, and children in
           Latino immigrant families. Therefore, the parent-child parallel group is considered an
           appropriate format for addressing the needs of cross-boundary families Two intervention
           studies evaluated the effectiveness of emotional regulation strategies on the
           parent-child relationship. The parental emotional management program increased emotional
           management strategy during the parent-child interaction, positive affect, subjective
           happiness, satisfaction with the parent-child relationship, and family harmony and
           decreased negative emotion among mothers of 6-8 years child in Hong Kong. However, this
           study did not include children in the intervention. A parent-child parallel emotional
           regulation group intervention improved the positive affect, resilience, and family
           harmony and reduced depressive symptoms among both parents and children. However, this
           study did not include the control group and had a small sample size.

           In sum, the present study aims to test the effectiveness of an emotion regulation
           parallel-group intervention on strengthening parent-child relationship and adaptation in
           newly arrived and cross-boundary families in Hong Kong.

        4. Procedure We aim to recruit 200 parent-child pairs to participate in the study. The
           participants will be randomly assigned into one of the following arms: a) the
           relationship enhancement arm, which aims at improving emotional regulation skills among
           parent and child; b) the information provision arm, which aims at providing information
           about Hong Kong, such as education, community resources, medical care, employment,
           housing, and job-seeking. The ratio of the two arms is 3:2. Specifically, 120 and 80
           parent-child pairs will be assigned to the relationship enhancement arm or the
           information provision arm, respectively. The two intervention arms will provide four
           2-hour weekly sessions to the participants. The participants will finish the assessments
           at baseline (T1), immediately after the intervention (T2), and one month after
           completing the intervention (T3).
    

Intervention name(s): Emotion regulation; Information provision
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Emotion regulation arm will provide the parents and children with four 2-hour weekly sessions. For the parents, the main topics include raising awareness of emotions (e.g., learning emotions theories), developing skills to manage emotions (e.g., attention deployment, cognitive changes, response modification), and facilitating parent-child relationship (e.g., gratitude). For children, the main topics are similar to that in parents' intervention. In this arm, we give more specific examples and simple explanations to the children.; Information provision arm will provide the parents and children with four 2-hour weekly sessions. For the parents, the main topics in these four sessions include learning the general information about Hong Kong such as education and medical care, housing condition, employment and training. For children, the main topics include learning the general information about Hong Kong, such as education, community facility, and learning method.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Both parents and children will be included in the intervention. The research team will conduct parallel intevention to parents and children in separate groups at the same time.
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: new immigrants; cross-boundary family; parallel group intervention