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Trial registered on ANZCTR
Registration number
ACTRN12620000088943
Ethics application status
Approved
Date submitted
14/01/2020
Date registered
3/02/2020
Date last updated
21/10/2021
Date data sharing statement initially provided
3/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Culturally-adapted Resourceful Adolescent Program to improve the mental health of adolescents in Vietnam
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Scientific title
Addressing an unrecognised public health problem in Vietnam: a clustered randomised controlled trial of the culturally adapted Resourceful Adolescent Program to improve adolescent mental health
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Secondary ID [1]
300203
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GNT1158429
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Universal Trial Number (UTN)
U1111-1246-4079
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mental health
315760
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Condition category
Condition code
Mental Health
314040
314040
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0
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Depression
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Mental Health
314065
314065
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention name - Happy House
The Resourceful Adolescent Program for adolescents (RAP-A) is a school-based program designed to promote factors that protect against adolescent depression and other mental health problems. It is a strengths-based program, focussed on developing strengths rather than on the pathology. The intervention for this trial is Happy House, the culturally-adapted RAP-A for adolescents in Vietnam. Happy House will be delivered through six workshop-style sessions, with a focus on the main components of RAP-A: personal strengths, managing stress, cognitive style, problem solving, support networks and interpersonal relationships.
The intervention is targeted at Year 10 students at selected schools in Hanoi, Vietnam. It is in addition to the usual school curriculum. The sessions will be delivered by core facilitators: teachers from the selected schools and members of the research team in Vietnam. The RAP authors will provide a training course in English for the research team. Then, the research team will train the core facilitators about the RAP-A principles and how to facilitate the sessions in Vietnamese. Both training courses will run for 2 days, ~8 hours/day, and the training will be conducted roughly 3 weeks before the intervention will begin. Training materials will be designed and developed specifically for this study. The core facilitators will be provided with a Group Leader’s Manual, which has detailed information about how to run each session, as well as all materials and equipment for the sessions (e.g. paper, pens, visual aids, videos, etc.). The Group Leader's Manual is based on the manual developed by the original RAP authors (http://www.rap.qut.edu.au/), but has been adapted for this study and cultural setting.
Year 10 classes in Vietnam typically have 35-45 students. In each class, students participating in the intervention will be split into two groups. Thus, the intervention will be run in groups of ~15-20 students. Happy House involves 6 x 90-minute sessions, once a week for six weeks. The sessions are delivered face-to-face by the core facilitators, in classrooms at the selected schools. Participants will receive a Student Workbook to use during the sessions. Similarly to the Group Leader's Manual, the Student Workbook is based on the manual developed by the original RAP authors (http://www.rap.qut.edu.au/), but has been adapted for this study and cultural setting. Between each session, students will be sent text messages, to reinforce key parts of the program.
Adherence will be assessed by the core facilitators, who will record the participants’ attendance at each session. Fidelity will be reported by the research team if any changes are made when implementing the protocol.
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Intervention code [1]
316477
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Behaviour
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Intervention code [2]
316493
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Prevention
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Comparator / control treatment
Participants in the control group will only receive the usual school curriculum.
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Control group
Active
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Outcomes
Primary outcome [1]
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Depression, assessed using the Centre for Epidemiologic Studies Depression Scale Revised (CESD-R)
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Assessment method [1]
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Timepoint [1]
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Six months post-intervention
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Secondary outcome [1]
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Mental wellbeing, assessed using the Mental Health Continuum Short Form (MHC-SF)
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Assessment method [1]
378573
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Timepoint [1]
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Within two weeks post-intervention and six months post-intervention
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Secondary outcome [2]
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Coping self-efficacy, assessed using the Coping Self-Efficacy Scale (CSF)
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Assessment method [2]
378575
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Timepoint [2]
378575
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Within two weeks post-intervention and six months post-intervention
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Secondary outcome [3]
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School connectedness, assessed using the School connectedness Scale developed by the National Longitudinal Study of Adolescent Health
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Assessment method [3]
378576
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Timepoint [3]
378576
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Within two weeks post-intervention and six months post-intervention
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Secondary outcome [4]
378577
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Anger management, assessed using the Behavioral Anger Response Questionnaire (BARQ)
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Assessment method [4]
378577
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Timepoint [4]
378577
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Within two weeks post-intervention and six months post-intervention
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Secondary outcome [5]
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CESD-R score
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Assessment method [5]
378699
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Timepoint [5]
378699
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Within two weeks post-intervention.
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Secondary outcome [6]
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Health risk behaviours, assessed using 14 questions derived from the Youth Risk Behavior Survey 2019.
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Assessment method [6]
379067
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Timepoint [6]
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Within two weeks post-intervention and six months post-intervention
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Eligibility
Key inclusion criteria
Grade 10 student
Studying in a selected class
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Minimum age
14
Years
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Maximum age
17
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Students whose parents do not give permission for them to participate.
Students who do not wish to participate.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
An independent statistician randomly assigned schools to the intervention and control arms, using number containers.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Sequence generation was done by simple randomisation using a randomisation table created using computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size and cluster number were calculated in Stata V16. 1,004 adolescents (each study arm: 502 adolescents) are needed to detect a difference in the primary outcome (CESD-R score => 16) of 41% in the control group and 31% in the intervention group (power of 90%, significance level of 0.05).
Descriptive analyses will be conducted to describe the participants' characteristics. Differences in the primary and secondary outcomes between the intervention and control arms will be estimated using individual-level analyses, adjusting for clustering. Mixed-effect logistic regression (primary outcome) and mixed-effect linear and logistic regression models (secondary outcomes) will be conducted to estimate the effects of the intervention on the outcomes. Covariates and prognostic factors will be taken into account, and random effects for class and school and a fixed effect for the trial arm will be incorporated.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2020
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Actual
6/10/2020
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Date of last participant enrolment
Anticipated
31/03/2020
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Actual
24/10/2020
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Date of last data collection
Anticipated
31/12/2020
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Actual
22/05/2021
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Sample size
Target
1204
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Accrual to date
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Final
1084
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Recruitment outside Australia
Country [1]
22207
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Viet Nam
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State/province [1]
22207
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Hanoi
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Funding & Sponsors
Funding source category [1]
304634
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Government body
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Name [1]
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Australian National Health and Medical Research Council
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Address [1]
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414 La Trobe Street, Melbourne, VIC, 3000
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Country [1]
304634
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Australia
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Funding source category [2]
304640
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Government body
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Name [2]
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NAFOSTED
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Address [2]
304640
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4th floor, 39 Tran Hung Dao, Hang Bai, Hoan Kiem, TP. Ha Noi.
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Country [2]
304640
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Viet Nam
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Primary sponsor type
University
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Name
Monash University
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Address
553 St Kilda Road, Melbourne, VIC, 3004
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Country
Australia
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Secondary sponsor category [1]
304932
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University
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Name [1]
304932
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Queensland University of Technology
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Address [1]
304932
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GPO Box 2434
Brisbane, QLD 4001
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Country [1]
304932
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Australia
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Secondary sponsor category [2]
304955
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University
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Name [2]
304955
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Hanoi University of Public Health
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Address [2]
304955
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1A Duc Thang Road, Duc Thang Ward, North Tu Liem district, Hanoi, Vietnam
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Country [2]
304955
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Viet Nam
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Other collaborator category [1]
281129
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Government body
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Name [1]
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Vietnam Ministry of Education and Training
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Address [1]
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No 35, Dai Co Viet, Ha Noi, Vietnam
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Country [1]
281129
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Viet Nam
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305072
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Institutional Review Board of the Hanoi University of Public Health
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Ethics committee address [1]
305072
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1A Duc Thang Road, Duc Thang Ward, North Tu Liem district, Hanoi, Vietnam
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Ethics committee country [1]
305072
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Viet Nam
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Date submitted for ethics approval [1]
305072
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15/10/2019
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Approval date [1]
305072
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15/11/2019
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Ethics approval number [1]
305072
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488/2019/YTCC-HD3
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Ethics committee name [2]
305092
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Monash University Human Research Ethics Committee
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Ethics committee address [2]
305092
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Monash University, Wellington Road, Clayton, VIC, 3800
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Ethics committee country [2]
305092
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Australia
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Date submitted for ethics approval [2]
305092
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25/11/2019
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Approval date [2]
305092
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Ethics approval number [2]
305092
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Summary
Brief summary
Mental health problems are more prevalent among adolescents in low- and lower-middle income countries (LALMIC), where most of the world’s young people live, than in high-income countries. As yet, there is little recognition of mental health, and few mental health programs or services exist for adolescents in these settings. We have demonstrated that in Vietnam, one in seven young people attending secondary school had experienced suicidal thoughts or plans in the previous year, over a third (34%) had experienced feelings of helplessness and hopelessness, and about three quarters (74%) had engaged in a health risk behaviour. Health risk behaviours were significantly more common among those with mental health problems. We have also shown that exposure to multiple forms of violence is the main risk factor for symptoms of common mental disorders, suicidal ideas, poor health-related quality of life and risk taking behaviours among adolescents in Vietnam, but is unrecognised and under-addressed. There is an urgent need for an evidence-based, comprehensive, universal mental health intervention to address the high prevalence of mental health problems among young people in Vietnam. The study aims to improve the mental health of adolescents in Vietnam. It is predicted that the Resourceful Adolescent Program for adolescents (RAP-A) adapted to Vietnam (renamed Happy House) will reduce mental health problems among adolescents in Vietnam. Grade 10 students from eight randomly chosen schools in Hanoi, Vietnam will be invited to participate. Four schools will be allocated to the intervention (Happy House), and four schools will be the controls (attend normal classes). The Happy House program involves six 90-minute sessions run by core facilitators. The program focuses on six core components: personal strengths, managing stress, cognitive style, problem solving, support networks and interpersonal relationships. Participants will complete a questionnaire before the intervention, two weeks after the intervention and then six months after that. Participants in the control group will complete the same questionnaires. The main outcome tested will be a depression score, measured using the Centre for Epidemiologic Studies Depression Scale Revised (CESD-R). We will also look at mental wellbeing, coping self-efficacy, school connectedness and anger management, and health risk behaviors.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Thach Tran
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Address
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Global and Women's Health
Public Health and Preventive Medicine, Monash University
Level 4 553 St Kilda Road
Melbourne VIC 3004, Australia
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Country
99114
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Australia
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Phone
99114
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+61 3 9903 0626
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Fax
99114
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Email
99114
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[email protected]
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Contact person for public queries
Name
99115
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Thach Tran
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Address
99115
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Global and Women's Health
Public Health and Preventive Medicine, Monash University
Level 4 553 St Kilda Road
Melbourne VIC 3004, Australia
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Country
99115
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Australia
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Phone
99115
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+61 3 9903 0626
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Fax
99115
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Email
99115
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[email protected]
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Contact person for scientific queries
Name
99116
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Thach Tran
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Address
99116
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Global and Women's Health
Public Health and Preventive Medicine, Monash University
Level 4 553 St Kilda Road
Melbourne VIC 3004, Australia
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Country
99116
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Australia
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Phone
99116
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+61 3 9903 0626
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Fax
99116
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Email
99116
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All individual participant data collected during the trial will be shared after de-identification
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When will data be available (start and end dates)?
Data will be available from 31/12/2021, with no determined end date
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Available to whom?
Anyone who wishes to access the data will be able to
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Available for what types of analyses?
The data will be available for analyses of any purpose
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How or where can data be obtained?
Data will be available via the following link:
https://monash.figshare.com/
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
School-based, two-arm, parallel, controlled trial of a culturally adapted resilience intervention to improve adolescent mental health in Vietnam: Study protocol.
2020
https://dx.doi.org/10.1136/bmjopen-2020-039343
N.B. These documents automatically identified may not have been verified by the study sponsor.
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