Clinical trial NCT06112483: SWELE Program: An Unstructured Outdoor Play With Mindfulness-based Interventions to Promote Mental Health Among Students With Special Education Needs
Official title: SWELE Programme: An Unstructured Outdoor Play With Mindfulness-based Interventions to Promote Mental Health Among Children and Adolescents With Special Education Needs
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Specific Learning Disorder
Intellectual Disability, Mild to Moderate
Autism Spectrum Disorder
Attention Deficit Hyperactivity Disorder
Physical Disability
Keywords: Unstructured play
Mindfulness-based interventions
Special education needs
Children and adolescents
Emotional
Anxiety
Depression
Self-regulation
Lead sponsor: Chinese University of Hong Kong
Sponsor class: OTHER
First posted: 2023-11-01
Enrollment: 1064
Sex: ALL
Minimum age (years): 6
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Children and adolescents aged 6-18 years old with mild to moderate physical and intellectual disabilities (SEN students) from six selected special schools. They will be recruited and participated the SWELE Programme.

Brief summary: This is an observational study with the aim of SWELE Programme is to raise mental health knowledge and awareness by implementing a play-based approach on Supporting Wellness in E-Child Learning Environments (SWELE) programme combining unstructured outdoor play activities with mindfulness-based interventions to promote mental health in children and adolescents with special education needs (SEN), in the context of the COVID-19 pandemic.

This is a 16-week SWELE programme and it will be conducted in two batches. Each batch has three special schools. The main activities include: One training workshop for three groups in each special school: 1) Scout Leaders (special schools' teachers), 2) SEN students (scouts in the school) to become Youth Mental Health Ambassadors and 3) for parents, school social workers, school nurses, schoolteachers and stakeholders; 30 minutes unstructured outdoor play with mindfulness activities 2 times per week for 16 weeks

After participated the SWELE programme, the primary outcomes include reducing anxiety symptoms, reducing negative emotions, improving social skills in peer relationships; and changing in playfulness level among SEN children and adolescents.

Main activities of SWELE programme:

* Unstructured outdoor free play integrated into the school's extra-curricular activities (Youth Mental Health Ambassadors) to promote SEN students' mental health for objectives 1-4.
* Use mindfulness-based podcasts, mindfulness games, mindfulness art for objectives 1-2.
* Through meditation and deep breathing technique, storytelling with relaxing waves piano music, yoga and mindful art for objectives 1-2.
* Training Workshops (Training of trainers) for Scout Leaders who will implement SWELE program in each special school.
* Youth Mental Health Ambassador Program for SEN students who are enrolled in Scout Club in each special school; SWELE training workshops for parents and schoolteachers will also be held in each special school for objectives 1-4.
* Examples of unstructured play might be creative play alone or with others, including artistic or musical games. imaginative games - for example, making cubbyhouses with boxes or blankets, dressing up or playing make-believe, exploring new or favorite spaces like school backyards, parks, playgrounds and so on.

Detailed description: Intervention: SWELE Program:

How does this SWELE programme combine unstructured outdoor play with mindfulness-based interventions is different from other existing services in the community? This 16-week programme focuses on Supporting Wellness in E-Child Learning Environments (SWELE) programme by combining unstructured outdoor play with mindfulness-based interventions to promote mental health in SEN students, in the context of the COVID-19 pandemic. There is no such SWELE programme to promote mental health for SEN students in Hong Kong, especially in the context of COVID-19 pandemic. Six special schools have been recruited and they would participate the SWELE programme.

A playful approach of unstructured play has also been found effective on promoting positive emotions and emotional competence among early adolescents. Unstructured Outdoor Play coupled with Mindfulness-based Interventions via SWELE programme to Promote Mental Health for children and adolescents with SEN during COVID-19 pandemic. Very limited unstructured outdoor play-based programme integrated into the extra-curricular activities in the special schools in Hong Kong.

The COVID-19 pandemic has resulted in increased anxiety and stress among children and adolescents in Hong Kong. In order to help alleviate these symptoms, the project team of the SWELE program is collaborating with The Scout Association of Hong Kong on a 16-week SWELE programme to promote SEN students' mental health. The mindfulness-based interventions focus on social-emotional learning activities in schools. Without intentional social-emotional development, SEN students may not learn how to process their emotions and connect with other in healthy ways. That is where mindfulness can come in. What is mindfulness? Mindfulness involves both an awareness and an acceptance of both the world around us and our internal experiences. Mindful people tend to focus more on the present instead of reflecting on the past or future, and they cultivate a curiosity towards their thoughts, emotions, or physical sensations.

The new knowledge generates from the findings of this mental health promotion project are important for raising the public's awareness about the impact on SEN student's mental health and advancing our understanding of the COVID-19 pandemic's impacts on service disruption and transition and subsequently on concerning SEN students' mental health. Thus, school health policy and strategies should be developed appropriately in promoting SEN

Eligibility criteria: Inclusion Criteria

SEN students:

1. are studying in a special school;
2. can speak and understand Cantonese
3. have no diagnosis of any cardiovascular disease
4. can provide parental consent

Exclusion Criteria

SEN students:

1. are not studying in a special school;
2. do not speak and understand Cantonese
3. have been diagnosed with cardiovascular disease
4. do not provide parental consent

Primary outcomes:
measure: Change scores from baseline to 16 weeks in SEN students' mood using the Mood Scale
timeFrame: 16 weeks
measure: Change scores from baseline to 16 weeks in SEN students' anxiety symptoms using the Chinese version of the short-form State-Trait Anxiety Inventory (STAI-S-6 & STAI-T-7)
timeFrame: 16 weeks
measure: Change scores from baseline to 16 weeks in SEN students' behavior regulations (classroom self-regulation and social skills) using the Child Behavior Rating Scale (CBRS)
timeFrame: 16 weeks
measure: Change scores from baseline to 16 weeks in SEN students' playfulness using the Children's Playfulness Scale (CPS)
timeFrame: 16 weeks
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
affiliation: Chinese University of Hong Kong
name: Regina Lee, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lee RLT, Lane S, Brown G, Leung C, Kwok SWH, Chan SWC. Systematic review of the impact of unstructured play interventions to improve young children's physical, social, and emotional wellbeing. Nurs Health Sci. 2020 Jun;22(2):184-196. doi: 10.1111/nhs.12732.