A Gamified Instrumental Musical Training to Enhance Resilience of Underprivileged School-aged Children at Risk of Mental Health Problems: A Randomised Controlled Trial

Background: Child poverty is a prominent global health issue owing to its detrimental impact on a child's physical and psychosocial well-being. Nearly 356 million children lived in extreme poverty globally before the pandemic and this is estimated to worsen significantly. children growing up in poverty are more vulnerable to its effect and have an increased risk of psychosocial and developmental problems than children from affluent families. The impact of poverty is not only immediate during childhood but can persist into adulthood. Previous studies have shown that Chinese children from low-income families reported significantly higher levels of depressive symptoms, lower levels of self-esteem, quality of life, and life satisfaction than children from affluent families.

Therefore, there is an urgent need to design and implement promising and novel approaches for this vulnerable population to prevent children from developing mental health problems.

Growing evidence indicates the importance of fostering children's resilience to enable them to cope with adversity. Research found that resilience exerts a protective effect on the mental well-being of individuals facing adversity (i.e. exposure to poverty).

Emerging evidence reveals the promising effects of musical training of music-based interventions on enhancing resilience and psychosocial outcomes in paediatric populations. Yet, whether music-based interventions can enhance resilience in underprivileged school-aged children remains unclear.

If the proposed instrumental musical training programme is proven to be effective and sustainable, it can be recommended as usual care in the community care service for underprivileged children.