This study evaluates the effectiveness of "ReFrame-R," a communication training program designed to help older adults in Hong Kong navigate intergenerational challenges. By focusing on enhancing communication competence and clarifying role boundaries within parent-child relationships, the research seeks to determine if this specialized intervention can improve the mental well-being of both older and younger generations. The study asks whether participating in the "ReFrame-R" curriculum leads to measurable improvements in how families interact, hypothesizing that older adults in the training group will demonstrate significantly better communication quality and a stronger sense of meaning compared to those in a control group. This study also aims to evaluate the program's overall feasibility and acceptability.
Cantonese-speaking older adults
have regular contact with adult children
can comprehend traditional Chinese
known mental health diagnosis
mild or higher depressive symptoms (scored ≥5 on the Patient Health Questionnaire [PHQ-9; Kroenke et al., 2001; Manea et al., 2015])
communication difficulties
Parallel
ReFrame-R
BehavioralThe ReFrame-R program is adapted from an established Motivational Interviewing (MI) protocol for laypersons (Kline et al., 2022). Grounded in Family Systems Theory, the curriculum specifically addresses over-functioning and under-functioning dynamics often found in older parent-adult child dyads and the cultural specific context of Hong Kong. Unlike general communication workshops, this program emphasizes role boundaries within parent-adult child relationship.
Perceived communication competence
Participants' self-perceived communication competence is assessed using an 11-item scale adapted from the Family Communication Scale (FCS). The scale consists of 10 items adapted from the original FCS to measure perceived ability to engage in positive communication with adult children, plus an additional item regarding overall communicagtion competence. Each item is rated on a 5-point scale (1-5), with a total score ranging from 11 to 55. Higher scores indicate a higher level of perceived communication competence.
Meaning in life
The 10-item Meaning in Life Questionnaire (MLQ; Steger et al., 2006) is used. It consists of two subscales: presence of meaning (5 items) and search of meaning (5 items). Each subscale is rated on a 7-point scale, with summed scores are calculated (ranged 5-35 for each). Higher scores indicate stronger sense of purpose and motivation to find meaning, respectively.
Self-efficacy
Participants' self-efficacy will be assessed using the 6-item General Self-Efficacy Scale (GSE-6; Romppel et al., 2013). It is typically rated on a 4-point scale from 1 to 4. Total scores range from 6 to 24, with higher scores reflecting greater perceived self-efficacy.
Well-being
The 5-item WHO Well-Being Index will be adopted for measuring participants' subjective well-being (Bech, 1998; Kong et al., 2016), rated on a 7-point scale. The WHO-5 score ranges from 0 to 25, zero representing worst possible mental well-being and 25 representing best possible mental well-being.
Role boundaries
We used a 5-item scale adapted from the Control subscale of the Parent-Adult Child Relationship Questionnaire's Relationship with Father component (PACQF; Peisah et al., 1999). While the original scale assess children's perceptions of parental conrtol, this adapted version is a self-report measure for parent to assess their attempt to maintain power, influence, or dominance over their adult children. Each item is rated on a 5-point scale, with a total score ranging 5-25. Higher scores indicater higher levels of parent control, reflecting weaker awareness of role boundaries in parent-adult children relationship.
Family functioning
The 5-item Family Adaption, Partnership, Growth, Affection, Resolve questionnaire (Family APGAR; Chan et al., 1988; Smilkstein, 1978) is used. This scale assesses participants' satisfaction with five aspects of family function. Each item is rated on a 3-point scale (0-2), with a total score ranged from 0 to 10. Higher scores indicate better family functioning.
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