Behavioral and Cognitive Outcomes of an Online Weight Loss Program for Men With Low Mood: A Randomized Controlled Trial

Abstract Background Depression and obesity are major health concerns and commonly co-exist, but men rarely seek help for these conditions. SHED-IT: Recharge was a gender-tailored eHealth program for men that generated clinically meaningful improvements in weight and depressive symptoms. Purpose To evaluate behavioral and psychological outcomes from the SHED-IT: Recharge intervention designed for overweight/obese men with low mood. Methods Overall, 125 men (18–70 years) with a BMI between 25 and 42 kg/m2 and depressive symptoms (PHQ-9 ≥ 5) were randomly allocated to SHED-IT: Recharge (n = 62) or wait-list control (n = 63) groups. The self-directed program targeted key health behaviors combined with online mental fitness modules based on cognitive behavioral therapy. Behavioral (e.g., physical activity) and psychological outcomes (e.g., cognitive flexibility) were assessed with validated measures at baseline, 3 months (post-test) and 6 months (follow-up). Intention-to-treat linear mixed models examined treatment effects, which were adjusted for covariates, and effect size estimated (Cohen’s d). Results At post-test, intervention men achieved small-to-medium improvements in several health behavior outcomes including moderate-to-vigorous physical activity, light physical activity, sedentary behavior, sleep, energy intake, portion size, and risky alcohol consumption (range, d = 0.3–0.5), when compared with the control group. Intervention effects were also observed for perceived physical self-worth, perceived physical strength, cognitive flexibility, and behavioral activation (range, d = 0.3–0.8). No effects were found for fruit and vegetable intake, or mindful attention. Most effects were maintained at follow-up. Conclusions This gender-tailored, eHealth program with integrated mental fitness support elicited meaningful improvements in health behaviors and psychological outcomes for men with low mood. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12619001209189).

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Prevention of Depressive Symptoms and Promotion of Well-being in Adolescents: A Randomized Controlled Trial of the Smile Program

Anales de Psicología ◽

10.6018/analesps.35.2.342591 ◽

2019 ◽

Vol 35 (2) ◽

pp. 300-313

Author(s):

Óscar Sánchez-Hernández ◽

Francisco X. Méndez ◽

Manuel Ato ◽

Judy Garber

Keyword(s):

Depressive Symptoms ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Behavioral Approach ◽

Control Group ◽

Post Intervention ◽

Post Test ◽

Intervention Condition

This study addressed the development and evaluation of the Smile Program whose main objective was the prevention of depression and the promotion of well-being in adolescents. The program is based on interventions that have been shown to be efficacious (a cognitive-behavioral approach). Participants were 89 adolescents (mean age = 13.88 years; SD = 0.95) recruited from a sample of 1212 students from seven schools. Results showed a significant reduction in self-reported depressive symptoms in the intervention group (n= 51) as compared to youth in the control group (n= 38). Based on parents’ report (n=56), youth in the intervention group had significantly better self-esteem at post-test as compared to youth in the control group. At four months post intervention, youth in the intervention group had higher psychological well-being than those in the control group; at the 8-month follow-up, youth in the intervention condition reported better family self-concept.

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WECHAT, WERUN: A GROUP-BASED WALKING STUDY TO ENHANCE PHYSICAL ACTIVITY AMONG COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.512 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S142-S142

Author(s):

Yujun Liu ◽

Margie E Lachman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Engagement ◽

Repeated Measures ◽

Smart Phone ◽

Community Dwelling ◽

Control Group ◽

Competition Condition ◽

Post Test

Abstract The benefits of physical activity (PA) and social engagement for older adults are well established, yet the majority of adults over age 50 in the U.S. do not engage in regular exercise. We conducted a 4-week pre-post study with a one-month follow-up using a smart phone application called WeChat WeRun to explore the mechanisms of social engagement and competition to increase PA among older adults. Participants (N=40, mean age=65.7) were randomly assigned to one of two conditions. Participants in the activity competition condition used the WeRun to track their daily walking steps and interact via text with their group members for 4 weeks. The daily walking steps were displayed to the group and the participant with the highest daily steps in the group was indicated as the champion each day. Participants in the control group only used WeRun to track their own walking steps. Outcome variables included average weekly steps, exercise self-efficacy, and social engagement. The two-way repeated measures ANOVA results revealed that participants in the competition condition had higher average weekly steps and level of social engagement at the posttest, compared to those in the control group. Post hoc tests using the Bonferroni corrections revealed that the intervention increased their average weekly steps and social engagement from pretest to post-test, while these outcomes did not change in the control group. The effects were maintained at the one-month follow up. Discussion will consider the motivational role of competition and social interactions in increasing PA among older adults.

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The effectiveness of positive training on happiness, aggression and hope in adolescents with leukemia in Ahvaz

Indian Journal of Positive Psychology ◽

10.15614/ijpp.v9i01.11735 ◽

2018 ◽

Vol 9 (01) ◽

Author(s):

Marzieh . Shamkhani ◽

Ali . Khalafi

Keyword(s):

Sampling Method ◽

Analysis Of Covariance ◽

Control Group ◽

Positive Attitudes ◽

Measurement Tools ◽

Post Test ◽

Aggression Questionnaire ◽

Experimental Group ◽

Period Measurement

The purpose of this study was to determine the effectiveness of positive learning on happiness, Aggression and hope for adolescents with leukemia in Ahvaz. The sample consisted of 30 people who were selected by available sampling method. 15 subjects in the experimental group and 15 in the control group were randomly assigned. The experimental design was a pre-test-post-test type with control group and follow-up period. Measurement tools included Oxford Happiness Inventory (Argyle, 1989); Ahwaz's Aggression Questionnaire (Zahedifar, Najarian, and Shokrkon, 2000); Hope Scale (Schneider, 1991). To run, at first, the pre-test was taken from both groups. Then, the experimental group was trained in 14 sessions of 90 minutes, and after each group, they were subjected to post-test. And one month later, the follow-up process was completed. Data analysis was performed using multivariate covariance analysis (MANCOVA) and one-way analysis of covariance (ANCOVA). The results showed that positive attitudes toward happiness, aggressiveness and hopefulness of adolescents with leukemia in Ahvaz were effective.

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Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126645 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6645

Author(s):

Giulia Foccardi ◽

Marco Vecchiato ◽

Daniel Neunhaeuserer ◽

Michele Mezzaro ◽

Giulia Quinto ◽

...

Keyword(s):

Physical Activity ◽

Cardiac Rehabilitation ◽

Exercise Testing ◽

Text Messages ◽

Control Group ◽

Stand Test ◽

Randomized Controlled ◽

Sit To Stand ◽

Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

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Effects of a psychosocial intervention at one-year follow-up in a PREDIMED-plus sample with obesity and metabolic syndrome

Scientific Reports ◽

10.1038/s41598-021-88298-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Núria Mallorquí-Bagué ◽

María Lozano-Madrid ◽

Cristina Vintró-Alcaraz ◽

Laura Forcano ◽

Andrés Díaz-López ◽

...

Keyword(s):

Metabolic Syndrome ◽

Depressive Symptoms ◽

Psychosocial Support ◽

Food Addiction ◽

Intervention Group ◽

Control Group ◽

Lifestyle Recommendations ◽

One Year ◽

Mediational Role

AbstractThis study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55–75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.

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Effectiveness of a psychological online training to promote physical activity among students: protocol of a randomized-controlled trial

Trials ◽

10.1186/s13063-021-05333-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lena Violetta Krämer ◽

Nadine Eschrig ◽

Lena Keinhorst ◽

Luisa Schöchlin ◽

Lisa Stephan ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Mixed Model ◽

Controlled Trial ◽

Control Group ◽

Web Based ◽

Intention To Treat ◽

Randomized Controlled ◽

Link Type

Abstract Background Many students in Germany do not meet recommended amounts of physical activity. In order to promote physical activity in students, web-based interventions are increasingly implemented. Yet, data on effectiveness of web-based interventions in university students is low. Our study aims at investigating a web-based intervention for students. The intervention is based on the Health Action Process Approach (HAPA), which discriminates between processes of intention formation (motivational processes) and processes of intention implementation (volitional processes). Primary outcome is change in physical activity; secondary outcomes are motivational and volitional variables as proposed by the HAPA as well as quality of life and depressive symptoms. Methods A two-armed randomized controlled trial (RCT) of parallel design is conducted. Participants are recruited via the internet platform StudiCare (www.studicare.com). After the baseline assessment (t1), participants are randomized to either intervention group (immediate access to web-based intervention) or control group (access only after follow-up assessment). Four weeks later, post-assessment (t2) is performed in both groups followed by a follow-up assessment (t3) 3 months later. Assessments take place online. Main outcome analyses will follow an intention-to-treat principle by including all randomized participants into the analyses. Outcomes will be analysed using a linear mixed model, assuming data are missing at random. The mixed model will include group, time, and the interaction of group and time as fixed effects and participant and university as random effect. Discussion This study is a high-quality RCT with three assessment points and intention-to-treat analysis meeting the state-of-the-art of effectiveness studies. Recruitment covers almost 20 universities in three countries, leading to high external validity. The results of this study will be of great relevance for student health campaigns, as they reflect the effectiveness of self-help interventions for young adults with regard to behaviour change as well as motivational and volitional determinants. From a lifespan perspective, it is important to help students find their way into regular physical activity. Trial registration The German clinical trials register (DRKS) DRKS00016889. Registered on 28 February 2019

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660 Chronotype Associations with Insomnia, Depressive Symptoms, and Changes in Sleep and Health Behaviors during the COVID-19 Pandemic

SLEEP ◽

10.1093/sleep/zsab072.658 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A258-A258

Author(s):

Megan Petrov ◽

Matthew Buman ◽

Dana Epstein ◽

Shawn Youngstedt ◽

Nicole Hoffmann ◽

...

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Health Behaviors ◽

Screen Time ◽

Online Survey ◽

Light Exposure ◽

Multinomial Logistic Regression ◽

Depression Scale ◽

Time In Bed ◽

Significant Difference

Abstract Introduction Evening chronotype (i.e., night owl preference) is associated with worse insomnia and depressive symptoms, and poorer health behaviors. The aim of this study was to examine the association between chronotype and these symptoms and health behaviors during COVID-19 pandemic quarantine. Methods An online survey, distributed internationally via social media from 5/21/2020–7/1/2020, asked adults to report sociodemographic/economic information, changes in sleep (midpoint, total sleep time, sleep efficiency, time-in-bed), and health behaviors (i.e., physical activity, sedentary screen time, and outdoor light exposure patterns) from prior to during the pandemic, chronotype preference (definitely morning [DM], rather more morning [RM], rather more evening [RE], or definitely evening [DE]), and complete the Insomnia Severity Index (ISI) and the 10-item Center for Epidemiologic Studies Depression scale (CES-D-10). Multinomial logistic regression and ANCOVA models, adjusting for age and sex, examined associations of chronotype with COVID-19 pandemic related impacts on sleep, depressive symptoms, and health behaviors. Results A subsample of 579 participants (M age: 39y, range: 18–80; 73.6% female), currently under quarantine and neither pregnant nor performing shift work, represented each chronotype evenly (~25%). Participants delayed their sleep midpoint by 72.0min (SD=111.5) during the pandemic. DE chronotypes had a greater delay than morning types (M±SD DE: 91.0±9.0 vs. RM: 55.9±9.2 & DM: 66.1±9.3; p=0.046) with no significant change in other sleep patterns relative to other chronotypes. However, DE and RE chronotypes had greater odds of reporting that their new sleep/wake schedule was still not consistent with their “body clock” preference relative to morning types (Χ2[15]=54.8, p<0.001), reported greater ISI (F[3,503]=5.3, p=.001) and CES-D-10 scores (F[3,492]=7.9, p<.001), and had greater odds for increased or consistently moderate-to-high sedentary screen time (Χ2[12]=22.7, p=0.03) and decreased physical activity (Χ2[12]=22.5, p=0.03) than DM chronotype. There was no significant difference in change in outdoor light exposure by chronotype (Χ2[12]=12.1, p=0.43). Conclusion In an international online sample of adults under COVID-19 pandemic quarantine, evening chronotypes, despite taking the opportunity to delay sleep to match biological clock preference, reported their sleep/wake schedules were still inconsistent with personal preference, and reported greater insomnia and depressive symptoms, and odds of engaging in poorer health behaviors than morning chronotypes. Support (if any):

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Feasibility of Using a Mobile App for Stress in Middle-Aged Men and Women. (Preprint)

10.2196/preprints.30294 ◽

2021 ◽

Author(s):

Breanne Michelle Laird ◽

Megan Puzia ◽

Linda Larkey ◽

Diane Ehlers ◽

Jennifer Huberty

Keyword(s):

Physical Activity ◽

Health Behaviors ◽

Perceived Stress ◽

Mindfulness Meditation ◽

Eating Habits ◽

Psychological Outcomes ◽

Middle Aged ◽

Men And Women ◽

General Coping ◽

Middle Aged Adults

BACKGROUND Middle-aged adults (40 to 65 years) report higher stress than most age groups. There is a need to test the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in both middle-aged men and women. OBJECTIVE Therefore, the purpose of this study was to: (1) determine the feasibility (i.e., acceptability and demand) of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults reporting elevated stress; and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness, general coping), health behaviors (i.e., physical activity, eating habits), and perceptions of COVID-19. METHODS The current study is a double-blind randomized controlled feasibility study testing a brief app-based meditation (i.e., Calm) intervention in middle-aged adults (N=83) with elevated stress levels (i.e., score greater than or equal to 15 on the Perceived Stress Scale) and limited or no previous experience with meditation. Participants were randomized to an app-based meditation intervention (Calm) or app-based education control group (POD). Participants completed self-report assessments at baseline and post-intervention (Week 4). Feasibility was measured as acceptability and demand using Bowen’s framework. Feasibility and COVID-19 perceptions data were examined via descriptive statistics. Preliminary effects were examined using repeated-measures analysis of variance. RESULTS Participants were satisfied with the meditation intervention (96.4%; 27/28) and found it appropriate/useful (92.9%; 26/28). Most reported that they were likely to continue using Calm in the future (64.3%; 18/28). More participants in the Calm group reported satisfaction, appropriateness/usefulness, and intent to continue use compared to the control. Calm participants (n=33) averaged 20.0±31.1 minutes of meditation on the days they meditated and 103±109.1 minutes of meditation per week during the study. On average there was a 70.8% adherence rate to the prescribed meditation, compared to 62.2% in POD. Recruitment of men into the study was 34.9% (29/83). Of those randomized to Calm, 55.2% (15/29) were men. Retention among men was 93.3% (14/15) compared to 60% (12/20) for women. No significant within or between group differences in stress or psychological outcomes related to stress were observed nor were significant differences in health behaviors related to stress. CONCLUSIONS A four-week, app-based mindfulness meditation intervention (i.e., Calm) may be feasible in middle-aged adults. Calm participants expressed satisfaction with the intervention and felt it was appropriate and useful. However, significant improvements in perceived stress and psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness and general coping) or health behaviors related to stress (i.e., physical activity, eating habits) were not observed. The majority of participants reported that COVID-19 negatively impacted their stress, mental health, and physical health. More research is needed for improving stress and stress related outcomes in middle-aged men and women using mindfulness meditation apps. CLINICALTRIAL ClinicalTrials.gov NCT04272138; http://clinicaltrials.gov/ct2/show/NCT04272138.

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Effectiveness of a Mobile Device–Based Resilience Training Program in Reducing Depressive Symptoms and Enhancing Resilience and Quality of Life in Parents of Children With Cancer: Randomized Controlled Trial (Preprint)

10.2196/preprints.27639 ◽

2021 ◽

Author(s):

Yuanhui Luo ◽

Wei Xia ◽

Ankie Tan Cheung ◽

Laurie Long Kwan Ho ◽

Jingping Zhang ◽

...

Keyword(s):

Depressive Symptoms ◽

Training Program ◽

Mobile Device ◽

Well Being ◽

Control Group ◽

Children With Cancer ◽

Resilience Training ◽

Experimental Group

BACKGROUND Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. OBJECTIVE The aim of this study is to examine the effectiveness of a mobile device–based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. METHODS Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device–based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor–Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. RESULTS The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=−2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38). CONCLUSIONS The mobile device–based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. CLINICALTRIAL Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242

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Effectiveness of a Mobile Device–Based Resilience Training Program in Reducing Depressive Symptoms and Enhancing Resilience and Quality of Life in Parents of Children With Cancer: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/27639 ◽

2021 ◽

Vol 23 (11) ◽

pp. e27639

Author(s):

Yuanhui Luo ◽

Wei Xia ◽

Ankie Tan Cheung ◽

Laurie Long Kwan Ho ◽

Jingping Zhang ◽

...

Keyword(s):

Depressive Symptoms ◽

Training Program ◽

Mobile Device ◽

Well Being ◽

Control Group ◽

Children With Cancer ◽

Resilience Training ◽

Experimental Group

Background Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. Objective The aim of this study is to examine the effectiveness of a mobile device–based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. Methods Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device–based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor–Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. Results The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=−2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38). Conclusions The mobile device–based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. Trial Registration Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242

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