Mental Health Help-seekingNCT06707935
Mental Health Help-seeking Promotion in Older Adults
A study testing Descriptive social norm nudges, Pictorial social norm nudges and Service as usual in people with Mental Health Help-seeking, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.
Trial summary
The present study aims to examine the effectiveness of descriptive social norm nudges and pictorial social norm nudges in improving mental health help-seeking intention compared to educational information. Read more about this study
- Who is it for?
- Ages 60 years and olderHealthy volunteers can take part
- Conditions the study is for
- Mental Health Help-seeking
- What is being tested?
- Descriptive social norm nudges, Pictorial social norm nudges and Service as usual
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 540 participants
- Where
- 1 siteHong Kong
- Study dates
- 1 Dec 2024to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- aged 60 years or above at the time of the baseline assessment
- have no severe mental disorder or cognitive impairment
- have no severe visual impairment
- be able to read Chinese
- have a smartphone with an instant communication application to receive text and images
Who cannot join
- have severe difficulty in reading and communication
- show imminent suicidal risk at any stage of the study
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Is a Picture Worth a Thousand Words: A Participatory Approach to Codesign Descriptive and Pictorial Social Norm Nudges and a Randomised Controlled Trial (RCT) to Examine Their Effectiveness in Improving Mental Health Help-seeking Intention
The present study aims to examine the effectiveness of descriptive social norm nudges and pictorial social norm nudges in improving mental health help-seeking intention compared to educational information.
Read the detailed description
This study is a three-arm randomised controlled trial (RCT) in 540 older adults aged 60 years and above recruited through NGOs, testing the utility of revised TPB with baseline data, and the effectiveness of descriptive social norm-nudges (intervention group 1) and pictorial social norm- nudges (intervention group 2) comparing to traditional mental health education (control). Participants will be evenly randomised and receive 1 message/picture per day consecutively for 2 weeks. Researchers blind to group allocation will interview participants at baseline (T0), 2 weeks (post-intervention, T1), and 12 weeks (follow-up, T2). The primary outcomes are changes in subjective norms and help-seeking intention assessed using a revised Chinese version of the theory of planned behaviour questionnaire (C-TPB); secondary outcomes include perceived behavioural control, help-seeking attitude, perceived barriers to help-seeking (C-TPB subscales), and mental health assessed by PHQ-9, GAD-7 and UCLA-3.
- Conditions
- Mental Health Help-seeking
- Being tested
- Descriptive social norm nudges, Pictorial social norm nudges, Service as usual
- Keywords
- co-design, nudge, behavioural economics, mental health, help-seeking
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Descriptive social norm nudgesBehavioural
A set of messages with descriptive social norm nudges sent to participants.
Pictorial social norm nudgesBehavioural
A set of messages with pictorial social norm nudges sent to participants.
Service as usualBehavioural
Traditional mental health education information disseminated to participants.
| Study group | Role | What they receive |
|---|---|---|
| Descriptive social norm nudges | Experimental | Participants receive messages with social norm nudges presented in the word form. Receives: Behavioral: Descriptive social norm nudges |
| Pictorial social norm nudges | Experimental | Participants receive messages with social norm nudges presented in graphic form. Receives: Behavioral: Pictorial social norm nudges |
| Active control | Active comparator | Participants receive messages with generic mental health knowledge or information. Receives: Behavioral: Service as usual |
What is being measured
The primary outcome is the main question the study is designed to answer.
Subjective norms toward mental health help-seeking
Subjective norms toward mental health help-seeking will be measured by six items adapted from the validated Chinese version of the TPB questionnaire (C-TPB) . The three items will measure descriptive norms describing what society, in general, does when facing mental health challenges, and the other three items will measure social norms describing what the significant others of the participant would do. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of subjective norms about mental health help-seeking.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Mental health help-seeking intention
Mental health help-seeking intention will be measured on a 3-item subscale of C-TPB. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of help-seeking intention.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Secondary outcomes (6)
Perceived behavioural control
Perceived behavioural control will be measured on a 3-item subscale of the C-TPB. Responses are rated on a 6-point Likert scale, with higher scores indicating higher levels of behavioural control.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Help-seeking attitude
Help-seeking attitude will be measured on a 5-item subscale of C-TPB, items will be measured on a 6-point semantic differential scale, with higher scores indicating a more positive attitude towards help-seeking.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Perceived barriers to help-seeking
Perceived barriers to help-seeking will be measured by a 6-item scale adapted from the Chinese American Psychiatric Epidemiological study (CAPES), responses are rated on a 6-point Likert scale, with higher scores indicating more significant perceived barriers to help-seeking.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Depressive symptoms
Depressive symptoms will be measured with the Patient Health Questionnaire (PHQ-9). It is a 9-item instrument that incorporates depression diagnostic criteria with other leading major depressive symptoms and rates the frequency of the symptoms, factoring into the scoring severity index. PHQ-9 scores of 5-9, 10-14, 15-19, 20 and above represent mild, moderate, moderately severe, and severe depression, respectively.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Anxiety symptoms
Anxiety will be measured with the Generalised Anxiety Disorder 7-item scale (GAD-7). It is a 7-item scale; responses to each item are rated on a 4-point Likert scale and range from 0 to 3. It taps on the most prominent diagnostic features for GAD, and scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate, and severe anxiety, respectively.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Loneliness
Loneliness will be measured with the UCLA Loneliness Scale (UCLA-3). It is a 3-item scale measuring an individual's perceived loneliness. Each item is evaluated with scores ranging from 0 (never) to 3 (often), the total score is the sum of all items, and a higher score indicates a higher level of perceived loneliness.
Measured: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Nov 2024
- Study start1 Dec 2024
- Primary completion31 Aug 2026
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Mental Health Help-seekingStudies of the same condition, open and under way.
- More trials run by The Hong Kong Polytechnic UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 540 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The Hong Kong Polytechnic University
- Sponsor type
- University, hospital or other
- Collaborators
- The University of Hong Kong
- Responsible party
- Principal investigator, LIU Tianyin Bridget, The Hong Kong Polytechnic University
- Investigators
- Tianyin Liu, PhD, Principal investigator, The Hong Kong Polytechnic University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06707935
- Sponsor's protocol ID
- HSEARS20231109001
- Status last verified
- Sep 2026
- First submitted
- 25 Nov 2024
- Last updated
- 16 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Liu T, Liu KHK, Leung DKY, Zhang W, Kwok WW, Wong GHY, Lum TYS. Using Co-Designed Norm-Based Nudges to Promote Mental Health Help-Seeking Intentions Among Older Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2026 Jul 21;15:e103455. doi: 10.2196/103455.
PubMed 42480100
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Is a Picture Worth a Thousand Words: A Participatory Approach to Codesign Descriptive and Pictorial Social Norm Nudges and a Randomised Controlled Trial (RCT) to Examine Their Effectiveness in Improving Mental Health Help-seeking Intention
- ClinicalTrials.gov ID
- NCT06707935
- Acronym / sponsor ID
- HSEARS20231109001
- Conditions
- Mental Health Help-seeking
- Keywords
- co-design, nudge, behavioural economics, mental health, help-seeking
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 540 participants (estimated)
- Lead sponsor
- The Hong Kong Polytechnic UniversityUniversity, hospital or other
- Collaborators
- The University of Hong Kong
- Study start
- 1 Dec 2024 (actual)
- Primary completion
- 31 Aug 2026 (actual)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 27 Nov 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The present study aims to examine the effectiveness of descriptive social norm nudges and pictorial social norm nudges in improving mental health help-seeking intention compared to educational information.
Detailed description
This study is a three-arm randomised controlled trial (RCT) in 540 older adults aged 60 years and above recruited through NGOs, testing the utility of revised TPB with baseline data, and the effectiveness of descriptive social norm-nudges (intervention group 1) and pictorial social norm- nudges (intervention group 2) comparing to traditional mental health education (control). Participants will be evenly randomised and receive 1 message/picture per day consecutively for 2 weeks. Researchers blind to group allocation will interview participants at baseline (T0), 2 weeks (post-intervention, T1), and 12 weeks (follow-up, T2). The primary outcomes are changes in subjective norms and help-seeking intention assessed using a revised Chinese version of the theory of planned behaviour questionnaire (C-TPB); secondary outcomes include perceived behavioural control, help-seeking attitude, perceived barriers to help-seeking (C-TPB subscales), and mental health assessed by PHQ-9, GAD-7 and UCLA-3.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Descriptive social norm nudges | Experimental | Behavioral: Descriptive social norm nudgesParticipants receive messages with social norm nudges presented in the word form. |
| Pictorial social norm nudges | Experimental | Behavioral: Pictorial social norm nudgesParticipants receive messages with social norm nudges presented in graphic form. |
| Active control | Active comparator | Behavioral: Service as usualParticipants receive messages with generic mental health knowledge or information. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- aged 60 years or above at the time of the baseline assessment
- have no severe mental disorder or cognitive impairment
- have no severe visual impairment
- be able to read Chinese
- have a smartphone with an instant communication application to receive text and images
Key exclusion criteria (2 listed)
- have severe difficulty in reading and communication
- show imminent suicidal risk at any stage of the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Descriptive social norm nudgesA set of messages with descriptive social norm nudges sent to participants. | Behavioural | Descriptive social norm nudges |
| Pictorial social norm nudgesA set of messages with pictorial social norm nudges sent to participants. | Behavioural | Pictorial social norm nudges |
| Service as usualTraditional mental health education information disseminated to participants. | Behavioural | Active control |
Primary outcome
Subjective norms toward mental health help-seeking
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Subjective norms toward mental health help-seeking will be measured by six items adapted from the validated Chinese version of the TPB questionnaire (C-TPB) . The three items will measure descriptive norms describing what society, in general, does when facing mental health challenges, and the other three items will measure social norms describing what the significant others of the participant would do. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of subjective norms about mental health help-seeking.
Mental health help-seeking intention
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Mental health help-seeking intention will be measured on a 3-item subscale of C-TPB. Responses will be rated on a 6-point Likert scale, with higher scores indicating higher levels of help-seeking intention.
6 secondary outcomes
Perceived behavioural control
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Help-seeking attitude
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Perceived barriers to help-seeking
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Depressive symptoms
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Anxiety symptoms
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Loneliness
Time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2026.
- Derived from this study: PubMed 42480100Liu T, Liu KHK, Leung DKY, Zhang W, Kwok WW, Wong GHY, Lum TYS. Using Co-Designed Norm-Based Nudges to Promote Mental Health Help-Seeking Intentions Among Older Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2026 Jul 21;15:e103455. doi: 10.2196/103455.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Tianyin Liu, PhD principal investigator
The Hong Kong Polytechnic University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Descriptive social norm nudges, Pictorial social norm nudges and Service as usual in people with Mental Health Help-seeking, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Subjective norms toward mental health help-seeking (time frame: Baseline (T0), post-intervention (T1, two weeks after T0), and to 12 weeks after the baseline (T2)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06707935, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2026.