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RecruitingNCT07138664MyHeRoUpdated Aug 24, 2025

Promoting Mental Health Among At-risk Adolescents in Malaysia

An interventional study of Super Skills for Life program and Study-Skills program in Depression in Adolescence and Anxiety, sponsored by University of Roehampton. Recruiting at 5 sites in Malaysia. Open to participants aged 12 Years to 14 Years. Per ClinicalTrials.gov, last updated 2025-08-24.

Primary conditionDepressionRegistry: Anxiety DisordersReclassifiedWhy we changed it
Registry
Anxiety Disorders — the first condition term the registry derived for this study.
ClinicalTrials.gg
Depression
Why
  1. The registry often attaches Anxiety Disorders to studies about something else, and this study's title and listed conditions do not name it.
  2. The study's listed conditions name Depression.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by University of Roehampton · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
428
Allocation
Randomized
Ages
12 Years to 14 Years
Sex
All
01

Study summary

The primary objective of this trial is to evaluate a school-based intervention designed to promote mental health among at-risk adolescents from low-income communities in Malaysia. The study will employ a two-arm, cluster randomised controlled trial design, comparing a school-based intervention to a control condition. Adolescents will be recruited from at least 20 secondary schools located in economically disadvantaged rural and urban areas of Malaysia. Assessments will take place at multiple time points: during screening, at baseline (pre-intervention), immediately after the intervention (8 weeks), and at two follow-up points-6 and 12 months post-intervention. The primary outcomes are a reduction in anxiety and depressive symptoms, along with improved mental wellbeing at the 12-month follow-up.

Read the detailed description

The overall aim of this trial is to use a school-based intervention to promote mental health among at-risk adolescents from low-income communities in Malaysia. Our primary aim is to evaluate the effectiveness and cost-effectiveness of a school-based intervention ("Super Skills for Life"; SSL) in reducing anxiety and depression, and in improving mental wellbeing in adolescents aged 12-14 years. We also aim to identify contextual factors related to the successful implementation of SSL in Malaysian schools.

This study will use a two-arm, cluster randomised controlled trial design with a 1:1 allocation ratio to compare a school-based intervention (Super Skills for Life; SSL) to a control condition (Study Skills Programme; SSP). Three stratification factors will be used for randomisation: school size, classes/forms and school location (urban vs rural). These adolescents will be invited to complete a screening questionnaire (i.e., Depression Anxiety and Stress Scale-21; DASS-21).

Based on power calculations, a total of 428 adolescents (214 per arm) with moderate to severe symptoms of anxiety and depression will be recruited to participate in the trial. Classrooms will be randomly assigned to either the intervention or control group, and eligible adolescents within each class will receive the intervention assigned to their group. Assessments will be conducted at screening, baseline (pre-intervention), immediately after the intervention (8 weeks), and at two follow-up points-6 and 12 months post-intervention. The primary outcomes will include reductions in anxiety and depressive symptoms, along with improvements in mental wellbeing at the 12-month follow-up.

Findings of this trial will determine if delivering a group school-based intervention by school staff for adolescents at risk of anxiety and depression is effective and cost-effective.

02

Conditions studied

  • Depression in Adolescence
  • Anxiety

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Keywords

  • Anxiety
  • Depression
  • Adolescents
  • School-based intervention
03

In context

Depression Reclassified

8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.

This study's planned enrollment of 428 is above the median of 81 across 7,063 interventional studies indexed under Depression.

Browse Depression studies →

Lead sponsor

University of Roehampton is the lead sponsor of 24 studies on the registry; 5 are open to participants now.

Compared within Depression, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Anxiety Disorders. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
12 Years to 14 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Adolescent (aged 12-14) who are in the first two years (Form 1 and Form 2, equivalent to year 7 and 8 in the United Kingdom school system, respectively) in lower secondary schools.
  2. Adolescents score moderate to severe levels of anxiety and/or depression on the Depression Anxiety and Stress Scale-21 (DASS-21) based on the original cut-off norms (DASS-21 Anxiety scale ≥ 10 and/or DASS-21 Depression scale ≥ 14).
  3. Adolescent's parent/carer provides written consent.

Exclusion criteria

Exclusion Criteria:

(1) Being diagnosed with neurodevelopmental disorders. (2) Being diagnosed with intellectual disability.

-

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
428 participants (estimated)

Study arms

  • Experimental
    Super Skills for Life program

    A manualized psychosocial program for preventing anxiety and depression and for promoting healthy lifestyles (called "Super Skills for Life; SSL"). SSL focuses on: (1) teaching about healthy lifestyles; (2) building emotional resilience through stress management; (3) encouraging peer learning and building peer networks; and (4) promoting self-confidence and social skills. These key elements are organized over 8 weekly sessions in a group format (45-60 minutes per session).

    Behavioral: Super Skills for Life program

  • Experimental
    Study-Skills program

    Study-Skills program will be implemented in a group format (45-60 minutes per session) in 8 weekly sessions, covering: note-taking skills, effective study strategies, and time management.

    Behavioral: Study-Skills program

Interventions

  • BehavioralSuper Skills for Life program

    Study-Skills program will be implemented in a group format (45-60 minutes per session) in 8 weekly sessions, covering: note-taking skills, effective study strategies, and time management.

    Also known as: Study-Skills program

  • BehavioralStudy-Skills program

    Study-Skills program will be used as a comparator intervention, which will be implemented in a group format (45-60 minutes per session) in 8 weekly sessions, covering: note-taking skills, effective study strategies, and time management.

06

What researchers measure

Primary outcomes

  1. Change in adolescent's anxiety and depression

    The Revised Children's Anxiety and Depression Scale will be used to identify symptoms of anxiety and depressive disorder in adolescents. It contains 6 items for measuring anxiety and 5 items for depression symptoms, which are to be rated on a 4-point Likert Scale from 0 ("never") to 3 ("always").

    Time frame: Pre-intervention, as well as at 8 weeks, and at 6 and 12 months after the intervention.

  2. Change in adolescent's wellbeing

    Short Warwick-Edinburgh Mental Well-being Scale will be used to measure mental wellbeing. All its 7 items are worded positively and cover feeling and functioning aspects of mental wellbeing. The items can be rated on a 5-point scale from 1 (none of the time) to 5 (all of the time).

    Time frame: Pre-intervention, as well as at 8 weeks, and at 6 and 12 months after the intervention.

Secondary outcomes

  1. Change in adolescent's emotion regulation strategies.

    Cognitive Emotion Regulation Questionnaire will be used to measure emotion regulation strategies. It consists of 18 items, which can be rated on a 5-point Likert scale ranging from 1 (almost never) to 5 (almost always) in response to how often each of the 9 emotion regulation strategies are used: refocus on planning, putting into perspective, acceptance, positive refocusing, positive reappraisal, self-blame, other blame, rumination, and catastrophizing.

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  2. Change in adolescent's suicidal behaviour.

    The Paykel Suicide Scale (PSS) will be used to measure suicidal behaviour. The scale consists of 5 items, with a dichotomous response system, i.e., Yes or No.

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  3. Change in adolescent's ability to carry out essential social behaviors.

    The Social Skills Questionnaire will be used to measure essential social behaviors that contribute to success in social interactions. Its 13 items can be are rated from 0 (Not true), 1 (Sometimes true) to 2 (Mostly true).

    Time frame: Pre-intervention, as well as at 8 weeks, and at 6 and 12 months after the intervention.

  4. Change in adolescent's working memory and inhibition.

    Teenage Executive Functioning Inventory will be used to measure working memory and inhibition. It contains 20 items which can be rated on a 5-point Likert scale ranging from 1 ("definitely not true") to 5 ("definitely true").

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  5. Change in adolescent's executive function.

    Executive function will also be measured using milliseconds experimental task to measure attention control and working memory.

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  6. Change in the severity of anxiety and depressive symptoms.

    Depression Anxiety and Stress Scale-21 (DASS-21) will be used to measure adolescent's severity of anxiety and depressive symptoms. The DASS-21 consists of 21 items which are divided equally across the anxiety, depressive and stress subscales, which can be rated on a 4-point Likert Scale (range from 0 \[did not apply to me at all\] to 3 \[applied to me very much or most of the time\]).

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  7. Change in adolescent's lifestyle habits.

    Lifestyle and Habits Questionnaire (LHQ-B) will be used to measure adolescent's lifestyle habits (physical activity and exercise, sleep and sleep hygiene, and type of food consumption). LHQ-B contains 16 items which ask adolescents about how frequently they perform each behaviour in the past 30 days on a 5-point scale from "never" to "always".

    Time frame: Pre-intervention, as well as at 8 weeks, and at 6 and 12 months after the intervention.

Other outcomes

  1. Changes in adolescent's self-esteem.

    Rosenberg Self-Esteem Scale (RSES) will be used to measure global self-worth. Three out of 10 items will be used in the present study, which can be rated on a 4-point Likert scale format ranging from 4 (strongly agree) to 1 (strongly disagree).

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  2. Changes in adolescent's academic stress.

    The Educational Stress Scale for Adolescents will be used to measure adolescent's perceived academic stress. Its 16 statements can be rated on a five-point Likert scale ranging from "strongly disagree" to "strongly agree".

    Time frame: Pre-intervention, as well as at 8 weeks, and at 6 and 12 months after the intervention.

  3. Changes in adolescents' feelings about their school and teachers.

    School Connectedness Scale will be used to adolescents' feelings about their school and teachers. Its 5 items can be rated on a five-point response format ranging from 0 (Strongly disagree) to 4 (Strongly agree).

    Time frame: Pre-intervention, as well as at 8 weeks, and at 12 months after the intervention.

  4. Measure facilitators' attitudes toward the adoption of evidence-based practices.

    Evidence-based Practice Attitude Scale for Teachers will be used to measure facilitators' attitudes toward the adoption of evidence-based practices (EBPs). It contains 13 items can be rated on a 5-Likert scale, ranging from "Not at All" (0) to "To a Very Great Extent" (4).

    Time frame: Pre-intervention.

  5. Changes in adolescent's health-related quality of life.

    The Child Health Utility will be used to measure health-related quality of life. It consists of 9 domains (worry, sadness, pain, tiredness, annoyance, school, sleep, daily routine and activities), and within each dimension, there are five different levels with increasing levels of severity.

    Time frame: Pre-intervention and at 12 months after the intervention.

  6. Changes in parent's quality of life, cost-utility of healthcare interventions, and computation of quality-adjusted life years.

    Self-reported European Quality of Life Five Dimension will be used to measure parent's quality of life, cost-utility of healthcare interventions, and computation of quality-adjusted life years.

    Time frame: Pre-intervention and at 12 months after the intervention.

  7. Changes in cost incurred by adolescents across healthcare, social care and community settings.

    Client Service Receipt Inventory to collect information from the parents related to cost-related data, by estimating associated costs across healthcare, social care and community settings. Parent will further be asked about adolescent's frequency and cost of using mental and physical health and social services.

    Time frame: Pre-intervention and at 12 months after the intervention.

07

Study locations

5 of 5 sites recruiting
  • Fakulti Psikologi Dan Pendidikan
    Kota Kinabalu, Sabah 88400, Malaysia
    Recruiting
    • Suwaibah Zakaria, PhD · Contactsuwaibah@ums.edu.my · +60138837732
    • Suwaibah Zakaria, PhD · Principal investigator
  • Universiti Malaysia Sarawak
    Kuching, Sarawak 94300, Malaysia
    Recruiting
    • Chuong Hock Ting, MD · Contactchting@unimas.my · +60163315598
    • Chuong Hock Ting, MD · Principal investigator
  • Universiti Kebangsaan Malaysia
    Bangi, Selangor 43600, Malaysia
    Recruiting
  • Universiti Malaya
    Kuala Lumpur, Selangor 50603, Malaysia
    Recruiting
    • Nik Daliana Nik Farid, PhD · Contactdaliana@um.edu.my · +60122779250
    • Nik Daliana Nik Farid, PhD · Principal investigator
  • Sunway University
    Subang Jaya, Selangor 47500, Malaysia
    Recruiting
    • Alvin Lai Oon Ng, PhD · Contactalvinn@sunway.edu.my · +60192808540
    • Alvin Ng Oon Ng, PhD · Principal investigator
08

References and documents

Publications

  • Essau CA, Zakaria S, Ting CH, Lee JAC, de la Torre-Luque A, Ng ALO, Majid HA, Dodd H, Nik Farid ND, Muhammad NA, Wahab S. Promoting mental health among at-risk adolescents in Malaysia (MyHeRo): study protocol for a cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of a school-based intervention compared with study skills condition for adolescents identified as at risk for anxiety and depression. Trials. 2026 Jan 28;27(1):160. doi: 10.1186/s13063-025-09368-7. PubMed 41593785 ↗

Individual participant data

Plan to share: No — Data will not be shared on an individual basis. Anonymised study data will be archived at the end of the study through the University of Roehampton data repository.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 24, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07138664
Lead sponsor
University of Roehampton
Collaborators
Universiti Malaysia Sabah, University Malaysia Sarawak, Universidad Complutense de Madrid, Sunway University, Saglik Bilimleri Universitesi, University of Exeter, University of Malaya, National University of Malaysia
Responsible party
Cecilia Essau (Professor of Developmental Psychopathology, University of Roehampton) — Principal investigator
First posted
Aug 24, 2025
Start date
Aug 2025 (estimated)
Primary completion
Sep 2026 (estimated)
Completion
Sep 2026 (estimated)
Last update
Aug 24, 2025

Study contacts

Cecilia A Essau, PhD
Contact
c.essau@roehampton.ac.uk
+442083923647

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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