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  • Mediation of short and longer term effects of an intervention program to enhance resilience in immigrants from Mainland China to Hong Kong

    Yu, Nancy X.; Lam, T. H.; Liu, Iris K.F.; Stewart, Sunita M.

    Published in: Frontiers in Psychology

    Published: 01/11/2015

    Document Version: Final Published version, also known as Publisher’s PDF, Publisher’s Final version or Version of Record

    License: CC BY

    Publication record in CityU Scholars: Go to record

    Published version (DOI): 10.3389/fpsyg.2015.01769

    Publication details: Yu, N. X., Lam, T. H., Liu, I. K. F., & Stewart, S. M. (2015). Mediation of short and longer term effects of an intervention program to enhance resilience in immigrants from Mainland China to Hong Kong. Frontiers in Psychology, 6(NOV), [1769]. https://doi.org/10.3389/fpsyg.2015.01769

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    Download date: 10/09/2020

    https://scholars.cityu.edu.hk/en/publications/mediation-of-short-and-longer-term-effects-of-an-intervention-program-to-enhance-resilience-in-immigrants-from-mainland-china-to-hong-kong(5f16acc7-c3c7-4cb0-b770-99fa6de61b12).html https://doi.org/10.3389/fpsyg.2015.01769 https://scholars.cityu.edu.hk/en/persons/xiaonan-nancy-yu(14f15587-e0d5-4e69-ac35-495038c38469).html https://scholars.cityu.edu.hk/en/publications/mediation-of-short-and-longer-term-effects-of-an-intervention-program-to-enhance-resilience-in-immigrants-from-mainland-china-to-hong-kong(5f16acc7-c3c7-4cb0-b770-99fa6de61b12).html https://scholars.cityu.edu.hk/en/publications/mediation-of-short-and-longer-term-effects-of-an-intervention-program-to-enhance-resilience-in-immigrants-from-mainland-china-to-hong-kong(5f16acc7-c3c7-4cb0-b770-99fa6de61b12).html https://scholars.cityu.edu.hk/en/journals/frontiers-in-psychology(15b2fdfd-5ce5-405a-ab79-75e136d29d8c)/publications.html https://scholars.cityu.edu.hk/en/journals/frontiers-in-psychology(15b2fdfd-5ce5-405a-ab79-75e136d29d8c)/publications.html https://doi.org/10.3389/fpsyg.2015.01769

  • ORIGINAL RESEARCH published: 27 November 2015

    doi: 10.3389/fpsyg.2015.01769

    Frontiers in Psychology | www.frontiersin.org 1 November 2015 | Volume 6 | Article 1769

    Edited by:

    Francesco Pagnini,

    Catholic University of Milan, Italy

    Reviewed by:

    Guenter Karl Schiepek,

    Paracelsus Private Medical University

    of Salzburg, Austria

    Eleonora Volpato,

    Fondazione Don Gnocchi, Italy

    *Correspondence:

    T. H. Lam

    hrmrlth@hkucc.hku.hk

    Specialty section:

    This article was submitted to

    Psychology for Clinical Settings,

    a section of the journal

    Frontiers in Psychology

    Received: 12 June 2015

    Accepted: 04 November 2015

    Published: 27 November 2015

    Citation:

    Yu NX, Lam TH, Liu IKF and

    Stewart SM (2015) Mediation of Short

    and Longer Term Effects of an

    Intervention Program to Enhance

    Resilience in Immigrants from

    Mainland China to Hong Kong.

    Front. Psychol. 6:1769.

    doi: 10.3389/fpsyg.2015.01769

    Mediation of Short and Longer Term Effects of an Intervention Program to Enhance Resilience in Immigrants from Mainland China to Hong Kong

    Nancy X. Yu 1, 2, T. H. Lam 2*, Iris K. F. Liu 3 and Sunita M. Stewart 4

    1Department of Applied Social Sciences, City University of Hong Kong, Hong Kong, Hong Kong, 2 School of Public Health,

    The University of Hong Kong, Hong Kong, Hong Kong, 3 International Social Service Hong Kong Branch, Hong Kong, Hong

    Kong, 4Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Few clinical trials report on the active intervention components that result in outcome

    changes, although this is relevant to further improving efficacy and adapting effective

    programs to other populations. This paper presents follow-up analyses of a randomized

    controlled trial to enhance adaptation by increasing knowledge and personal resilience

    in two separate brief interventions with immigrants from Mainland China to Hong Kong

    (Yu et al., 2014b). The present paper extends our previous one by reporting on the

    longer term effect of the interventions on personal resilience, and examining whether

    the Resilience intervention worked as designed to enhance personal resilience. The

    four-session intervention targeted at self-efficacy, positive thinking, altruism, and goal

    setting. In this randomized controlled trial, 220 immigrants were randomly allocated to

    three arms: Resilience, Information (an active control arm), and Control arms. Participants

    completed measures of the four active components (self-efficacy, positive thinking,

    altruism, and goal setting) at baseline and immediately after the intervention. Personal

    resilience was assessed at baseline, post-intervention, and 3- and 6-month follow-ups.

    The results showed that the Resilience arm had greater increases in the four active

    components post-intervention. Changes in each of the four active components at the

    post-intervention assessment mediated enhanced personal resilience at the 3-month

    follow-up in the Resilience arm. Changes in self-efficacy and goal setting showed the

    largest effect size, and altruism showed the smallest. The arm effects of the Resilience

    intervention on enhanced personal resilience at the 6-month follow-up were mediated

    by increases of personal resilience post-intervention (Resilience vs. Control) and at the

    3-month follow-up (Resilience vs. Information). These findings showed that these four

    active components were all mediators in this Resilience intervention. Our results of the

    effects of short term increases in personal resilience on longer term increase in personal

    resilience in some models suggest how changes in intervention outcomes might persist

    over time.

    Keywords: resilience, randomized controlled trial, intervention, mediation, Chinese, immigrants

    http://www.frontiersin.org/Psychology http://www.frontiersin.org/Psychology/editorialboard http://www.frontiersin.org/Psychology/editorialboard http://www.frontiersin.org/Psychology/editorialboard http://www.frontiersin.org/Psychology/editorialboard http://dx.doi.org/10.3389/fpsyg.2015.01769 http://crossmark.crossref.org/dialog/?doi=10.3389/fpsyg.2015.01769&domain=pdf&date_stamp=2015-11-27 http://www.frontiersin.org/Psychology http://www.frontiersin.org http://www.frontiersin.org/Psychology/archive https://creativecommons.org/licenses/by/4.0/ mailto:hrmrlth@hkucc.hku.hk http://dx.doi.org/10.3389/fpsyg.2015.01769 http://journal.frontiersin.org/article/10.3389/fpsyg.2015.01769/abstract http://loop.frontiersin.org/people/293527/overview http://loop.frontiersin.org/people/242619/overview http://loop.frontiersin.org/people/293721/overview

  • Yu et al. Mediation of a Resilience Intervention

    INTRODUCTION

    The identification of mechanisms of change or the processes that are responsible for the effectiveness of an intervention is crucial in the evolvement of evidence-based interventions (Kendall and Terry, 2009). However, the design that are used in most outcome studies frequently do not allow for the elucidation of such mechanisms (Kazdin and Nock, 2003; Maric et al., 2012). This paper presents a follow-up to our earlier publication that described the effectiveness of a four-session Resilience intervention to enhance adaptation in Mainland Chinese immigrants to Hong Kong (Yu et al., 2014b). Our previous publication reported a randomized controlled trial to enhance adaptation by increasing knowledge and personal resilience in two separate brief interventions with immigrants from Mainland China to Hong Kong (Yu et al., 2014b). In addition to extending the previous findings to report on the longer term effects of the interventions on the secondary outcome of personal resilience, the current analyses examined a mediation model and sustained effects to explain how changes in personal resilience occurred over time. This study will focus on two questions: (1) Were the changes that occurred in personal resilience at the end of the intervention and at follow-ups the result of the components we specified? In other words, did the intervention work because of the way it was designed to work? (2) Did changes in personal resilience following the intervention influence levels of personal resili

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