Parents of children with special needs in Hong Kong often face limited psychological support, which can negatively impact the child rehabilitation process and the well-being of parent-child relationships. To address this gap, we have developed Pai.ACT, the first deep learning-based mental health advisory system for parents.
Pai.ACT features an AI chatbot that integrates the counselling principles of Acceptance and Commitment Therapy (ACT) through natural language processing, providing parents with a human-like voice-to-text experience. Using data from chatbot interactions, the Pai.ACT platform offers assessments regarding the individual's psychological inflexibility status and delivers stratified mental health interventions by:
* Low-risk: Users access self-help ACT digital modules tailored to their specific psychological inflexibility processes. * Moderate-risk: In addition to the self-help modules, users receive 4-6 sessions of video-conferencing-based ACT interventions (45-60 minutes per session) conducted by our trained counseling team. * High-risk: Users are directed to specialized mental health services provided by collaborating units.
The study includes a regional randomised controlled trial (RCT) in Hong Kong's Sha Tin District, in collaboration with the Shatin District Office. The goal of this regional study is to evaluate the feasibility, acceptability, and potential efficacy of combining AI-driven mental health support across all of Hong Kong. Focus group interviews will also explore parents' perceptions of Pai.ACT and help identify the most effective service model for scaling its use.
Pai.ACT provides accessible and comprehensive mental health services to Chinese-speaking parents, helping to alleviate the psychological burden of caregiving. By integrating mental health support with child rehabilitation services and non-governmental organisations, Pai.ACT has the potential to enhance family caregivers' well-being, reduce stigma associated with special needs children, and promote more significant mental health awareness in Chinese-speaking communities.
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Parents diagnosed with severe mental illnesses.
Pregnant parents or those less than six months postpartum.
Parents with a developmental disability that impairs their ability to understand the program's content.
Parents with cognitive, language, communication, visual, or hearing impairments that could hinder their comprehension of the intervention content.
Parallel
Pai.ACT Group
BehavioralThe Pai.ACT mobile app is an innovative therapeutic tool that utilizes Acceptance and Commitment Therapy (ACT). It integrates a sophisticated AI algorithm to analyze self-reported data and conversation texts when the user interacts with the AI chatbot and identifies what psychological inflexibility processes are required to be the most essential to be addressed for process-matched ACT interventions. Following interactions with the AI chatbot, Pai.ACT provides a stratified mental health support, categorizing into three risk levels: * Low-risk: Users access self-help ACT digital modules tailored to their specific psychological inflexibility processes. * Moderate-risk: In addition to the self-help modules, users receive 4-6 sessions of video-conferencing-based ACT interventions (45-60 minutes per session) conducted by our trained counseling team. * High-risk: Users are directed to specialized mental health services provided by collaborating units.
Control Group
Other interventionBoth the Pai.ACT intervention group and the control group will receive standard family support through Hong Kong's family and children rehabilitation services, which are administered by government-funded units under the Social Welfare Department. Parents will participate in structured psychoeducation sessions focusing on positive parenting and will have access to peer support groups. Their children will receive individualized training plans tailored for neurodevelopmental conditions, in addition to referrals for speech and occupational therapy.
Parenting Stress
Parenting stress will be assessed using the Parental Stress Scale (PSS, 18-item, 5-point scale). The PSS evaluates parental satisfaction and strain regarding parenting roles. A higher score represents a higher level of parental stress. The Chinese PSS version, including its parenting stress, will be assessed using the Parental Stress Scale (PSS), which consists of 18 items and uses a 5-point rating system. The PSS is designed to evaluate how parents perceive their roles in terms of satisfaction and strain. A higher score indicates a greater level of parental stress. The Chinese version of the PSS, along with its subscales, has demonstrated strong validity in terms of both convergent and discriminant measures, as well as good internal consistency, with a Cronbach's alpha ranging from .79 to .88 among Chinese parents.
Child's Emotional and Behavioural Symptoms
The Strengths and Difficulties Questionnaire (SDQ) is designed to evaluate a child's emotional and behavioral symptoms. It employs a 3-point Likert scale to assess the following areas: emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, and prosocial behavior. Each of these subscales consists of five items. The Chinese version of the SDQ has demonstrated adequate test-retest reliability, with an Intraclass Correlation Coefficient ranging from .75 to .86, and has shown good discriminant validity among parents in Hong Kong.
Depressive Symptoms
Depressive symptoms will be evaluated using the Patient Health Questionnaire (PHQ-9). The PHQ-9 consists of 9 items on a 4-point Likert scale, with a total score of 10 or higher indicating potential depression.
Anxiety Symptoms
Anxiety symptoms will be evaluated using the Generalized Anxiety Disorder-7 (GAD-7) scale. The GAD-7 is a 7-item, 4-point Likert scale, where a total score of ≥10 indicates a potential anxiety disorder.
Psychological Flexibility
Psychological flexibility will be assessed using the Psyflex questionnaire and/or the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT). The Psyflex is a 6-item, 5-point Likert scale designed to measure psychological flexibility, while the CompACT measures the core processes of ACT, including openness to experience, behavioural awareness, and valued action. Each item is rated on a 7-point Likert scale, with higher scores indicating greater psychological flexibility.
Perceived usability of the mobile app
Perceived usability of the mobile app will be measured using the System Usability Scale (SUS). The SUS is a 10-item, 10-point Likert scale. The total SUS score ranges from 0 to 100. A score of at least 80 out of 100 indicates high perceived usability. This score suggests that the mobile app, integrated with the 'Pai.ACT' mental health advisory system, is highly usable for end users. These end users are primarily parents of children with Special Health Care Needs (SHCN).
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Chinese University of Hong Kong
Lead sponsor
Social Welfare Department, Hong Kong
Collaborator
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