Examination of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Study Protocol of a 3-Arm Cluster Randomized Controlled Trial

Abstract

Background Anxiety disorders are the most common mental disorders worldwide. In Hong Kong, 7% of adolescents are diagnosed with anxiety disorders, and 1 in every 4 secondary school students reports clinical-level anxiety symptoms. However, 65% of them do not access services. Long waitlists in public services, the high cost of private services, or the fear of being stigmatized can hinder service access. The high prevalence of anxiety and low intervention uptake indicate a pressing need to develop timely, scalable, and potent interventions suitable for adolescents. Single-session interventions (SSIs) have the potential to be scalable interventions for diagnosable or subclinical psychopathology in adolescents. Providing precise and context-adapted intervention is the key to achieving intervention efficacy. Objective This study aims to compare the effectiveness of three SSIs: single-session intervention of growth mindset on negative emotions (SIGMA), SSI of growth mindset of personality (SSI-GP), and active control, in reducing adolescent anxiety. Methods Adolescents (N=549, ages 12-16 years) from secondary schools will be randomized to 1 of 3 intervention conditions: the SIGMA, SSI-GP, or active control. The implementation of each intervention is approximately 45 minutes in length. Adolescent participants will report anxiety symptoms (primary outcome), perceived control, hopelessness, attitude toward help-seeking, and psychological well-being at preintervention, the 2-week follow-up, and the 8-week follow-up. A pilot test has confirmed the feasibility and acceptability of SIGMA among adolescents. We hypothesized that SIGMA and SSI-GP will result in a larger reduction in anxiety symptoms than the control intervention during the posttest and 8-week follow-up period. We also predict that SIGMA will have a more significant effect than SSI-GP. We will use the intention-to-treat principle and linear regression-based maximum likelihood multilevel models for data analysis. Results This study will be conducted from December 2022 to December 2023, with results expected to be available in January 2024. Conclusions This protocol introduces the implementation content and strategies of growth mindset SSIs (consists of 2 forms: SIGMA and SSI-GP) among school students. The study will provide evidence on the efficacy of different growth mindset SSIs for adolescent anxiety. It will also establish implementation strategies for self-administrative SSIs among school students, which can serve as a pioneer implementation of a scalable and self-accessible brief intervention to improve the well-being of young people. Trial Registration ClinicalTrials.gov NCT05027880; https://clinicaltrials.gov/ct2/show/NCT05027880 International Registered Report Identifier (IRRID) PRR1-10.2196/41758

Effects of A Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Symptoms: A Three-Arm Waitlist Randomised Controlled Trial (Preprint)

“…According to the literature on promoting SSI effectiveness [19,31,32] and our experience in developing SSIs in the Chinese culture [22], the PC-SMILE was designed with five important features to ensure efficacy.…”

“…In contrast, those who hold a more fixed mindset may shy away from challenges or fail to meet their potential [19,20]. A growth mindset intervention's core content teaches that people's attributes, such as intelligence, personality, or emotions, can change and that people can improve through the actions they take (e.g., making an effort, changing strategies, learning from failures, and asking for help) [19,21,22]. Emphasising the potential to change in mindset interventions of 30 minutes to one hour resulted in different change effect sizes, from d = 0.1 in changing school performance in a large-scale national study among heterogenous participants [23] to d = .59 in randomised control trials on reducing anxiety [14].…”

“…Well-crafted growth mindset interventions promoting a core growth mindset are crucial to securing the effects of the intervention [19]. Existing interventions have focused on growth mindsets for intelligence [19,23], personality [14,24], and emotion [22] to promote school performance and resilience and to reduce mental health symptoms. Although these domain-specific growth mindset interventions have achieved positive improvements, there has never been an integrated intervention addressing multiple core growth mindsets.…”

“…Although there is evidence of the importance of parents and children's mindsets in internalising symptoms, we have identified three important research gaps which will be tackled in the present study. First, current interventions usually focus on fixed mindsets of a single domain -such as intelligence, personality, or emotion [14,22] -but have rarely used a few relevant mindset domains in one intervention, which are closely related to youth mental health. An integrated mindset intervention is very likely to strengthen intervention efficacy, especially for brief interventions.…”

Single-session intervention on growth mindset on negative emotions for university student mental health (U-SIGMA): a protocol of two-armed randomized controlled trial

“…These findings provide strong empirical support that fostering belief-inchange of negative emotions is likely to promote mental health among university students. Based on the findings from these studies, a Single-session Intervention of Growth Mindset for Adolescents (SIGMA) was designed to examine its effectiveness among secondary school students [26].…”