A Psychological Intervention to Enhance Resilience in Mainland New Immigrants to Hong Kong

Study Overview
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Brief Summary
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Background: Resilience is important for successful adaptation. The investigators' resilience intervention was effective in enhancing resilience, emotional functioning, and adaptation in Mainland immigrants. In the present proposal, the investigators will work with the International Social Service to scale up application of this intervention in immigrants, and develop the training infrastructure to ensure that the evidence-based intervention can be sustained despite turnover of interventionists. Objectives: We will conduct a randomized controlled trial to compare the resilience intervention with the resilience + information intervention (a compound module) among 200 new immigrants, The resilience intervention will enhance participants' resilience by 5%, and decrease their depressive symptoms by 20% and adaptation difficulties by 10% after the completion of the intervention, The resilience + information intervention will have higher increases in resilience and more decreases in depressive symptoms and adaptation difficulties compared to the resilience intervention, and To establish a sustaining mechanism which ensures that these two interventions can continue to be used in routine services. Project design: Well-trained social workers will deliver the intervention. Participants will complete programme evaluation. A train-the-trainer workshop and training materials will be prepared to transfer knowledge to social workers who are future trainers.

Detailed Description
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The intervention programme has been developed, manualized, and rigorously tested in our previous study (1). This programme is largely a replica of our original programme. Two social workers will deliver the resilience intervention. One of the two interventionists who delivered the intervention in our empirical study is still available. One more social worker will be selected from recently trained interventionists to deliver this intervention. This resilience intervention (see Supplement 2) consists of 4 sessions, each lasting for 2 hours, finished within two weeks. This intervention is built on the international and local evidence about positive characteristics that promote successful immigration and effective strategies that enhance psychological well-being. We will promote this intervention programme in new immigrants, and recruit participants by open recruitment, contacting current service users of the community agency, referral and cold call. Orientation gatherings will be organized to screen for eligible immigrants. The resilience + information intervention consists of 4 sessions, each lasting for 2.5 hours, finished within two weeks. In each session, the resilience section will last for 2 hours (identical to the resilience intervention), and the information intervention will be half an hour. Similar to our previous information intervention, this information section will cover transportation, housing, medical service, education, and employment, the important information helpful for the immigrants' adaptation. Participants will receive four sessions, either the resilience intervention or the resilience + information intervention. Unlike most programmes that have not been developed in the community, we have identified some key strategies to reduce attrition during the intervention. Before each session, social workers will call participants to remind them of the coming session. During the intervention, we will provide child care upon participants' request. For those who are unable to attend a specific sessions, social workers will conduct a make-up on the content, and provide general encouragement that attendance of further sessions will bring important gains. During the follow-up period, social workers will send reminder postcards to participants. At the end of the intervention, participants will obtain a certificate in recognition of their participation in this programme. Evaluation will be conducted before the first session (pre-intervention) and immediately after the intervention (post-intervention).

Official Title
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A Psychological Intervention to Enhance Resilience in Mainland New Immigrants to Hong Kong

Conditions
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Resilience

Intervention / Treatment
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* Behavioral: Resilience
* Behavioral: Information


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Immigrants who arrived in Hong Kong from Mainland China less than 3 years ago have least a primary school education Exclusion Criteria: N/A

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resilience<br>Participants will receive four sessions covering Resilience intervention content | Behavioral: Resilience<br>* Self-efficacy, optimism, altruism, goal setting<br>|
| Active Comparator: Resilience+Information<br>Participants will receive four sessions covering Resilience intervention and Information intervention contents. | Behavioral: Resilience<br>* Self-efficacy, optimism, altruism, goal setting<br>Behavioral: Information<br>* Information and resources about education, medical care, housing, employment, and community facilities available in Hong Kong and Mainland China<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resilience as assessed by Connor-Davidson Resilience Scale |  | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depressive symptoms as assessed by Patient-Health Questionnaire-9 |  | 1 month | 
| Adaptation difficulties as assessed by Sociocultural Adaptation Scale |  | 1 month | 
| Knowledge measured using the items developed in our previous study | Knowledge on services and resources regarding transportation, housing, medical service, education, and employment | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Self-efficacy, optimism, altruism, goal setting