Using Music to Promote Hong Kong Young People's Emotion Regulation and Reduce Their Mood Symptoms and Loneliness: Protocol for a Pilot Randomized Controlled Trial

Abstract

Background: Mental health needs in the community surged during the pandemic, with concerning reports of increased negative mood symptoms among youth. At the same time, preventive psychoeducational interventions were insufficient within frontline youth mental health services in Hong Kong, and research specifically addressing youth loneliness remained limited on an international scale. Given the association between loneliness and other mental health symptoms, psychoeducational programs that empower adolescents to cope with emotions may help address both the research gap and local demand. As such, Tuned In, a previously validated intervention program originally developed in Australia, was introduced to the local context. Cultural adaptations and an added focus on loneliness were incorporated into the project to enhance its acceptability and test its effectiveness.

Objective: This study aims to evaluate an adapted version of the Tuned In music-based psychoeducation program, designed to reduce loneliness, depression, and anxiety symptoms among young people in Hong Kong by enhancing their emotion regulation skills.

Methods: Participants aged 16-19 years will be randomly assigned to either the experimental or control group. The experimental group will receive an online, group-based psychoeducation program focused on emotion recognition and management, delivered weekly over 4 consecutive weeks. The intervention is grounded in Russell's emotion circumplex model and music psychology, and program content included: The 2D model and characteristics of emotions from different quadrants (session 1); happiness and loneliness (session 2); high-arousal and negative-valence emotions, for example, stress and anxiety (sessions 3); and anxiety, perfectionism, and a celebration of achievement (session 4). Both therapist- and participant-selected music will be used in the intervention to provide a rich repertoire for group discussion, psychoeducation, reflection, and the practice of social skills. The main outcome measures will be assessed using the Emotion Regulation Questionnaire, the Difficulties in Emotion Regulation Scale, the Depression Anxiety Stress Scale, and the De Jong Gierveld Loneliness Scale. Feedback on the project arrangement will be gathered through qualitative input. A mixed methods analysis will be conducted following data collection.

Results: The project was successfully funded in February 2023 by the Health and Medical Research Fund in Hong Kong and commenced in August 2023. As of September 16, 2024, a total of 316 completed questionnaires had been received through Qualtrics for screening purposes, with 89 participants deemed eligible for the program. The project is scheduled to conclude in August 2025, with results to be published thereafter.

Conclusions: Participants are expected to show improvements in emotion regulation, along with reductions in mood symptoms and loneliness, following the intervention.

Trial registration: ClinicalTrials.gov NCT06147297; https://clinicaltrials.gov/study/NCT06147297.

International registered report identifier (irrid): DERR1-10.2196/67764.

Keywords: Hong Kong; RCTs; adolescence; adolescents; emotion regulation; emotions; loneliness; mental disorders; mental health; mental illnesses; mood symptoms; moods; music; protocol; randomized controlled trial; teenagers; teens; youth.