Effectiveness of a universal classroom-based preventive intervention (PAX GBG): A research protocol for a matched-pair cluster-randomized controlled trial.

Karin Streimann,Anne Selart,Karmen Toros,Kirsti Akkermann,Aire Trummal,Merike Sisask,Kai Klandorf

doi:10.1016/j.conctc.2017.08.013

Abstract

IntroductionThe PAX Good Behavior Game (PAX GBG) is a universal classroom-based program that promotes children's mental health. In Estonia, the intervention is delivered to first grade students (aged seven to eight) within the regular school curriculum. The current work describes a protocol for a cluster-randomized controlled trial (RCT) of the PAX GBG conducted in Estonia.Design and methodsThis is an ongoing, pragmatic, two-year, matched-pair, cluster-RCT conducted in Estonian elementary schools. Schools were matched to pairs based on their geographical location and number of students per classroom. One school in each pair was randomly selected to receive the intervention and the other placed on a wait-list as a control. 42 schools provided baseline data during the autumn of 2016. Data is collected at two more points in time – seven months and 19 months post-baseline. Outcomes of children's mental health and behavior are measured by the teacher- and parent-rated Strengths and Difficulties Questionnaire, parent-rated Swanson, Nolan, and Pelham – IV Questionnaire and the Go/No-Go task completed by children. Teachers also rate their self-efficacy and overall classroom behavior.DiscussionThis study aims to test the effectiveness of the intervention in Estonian classrooms with a newer version of the rigorously tested GBG program. To our knowledge, this study is the first to measure the effects of the intervention on children's inhibitory control, which has been associated with externalizing problems in the literature. The results from this trial will provide further understanding into how the program influences children's well-being and self-control.Trial registrationClinicalTrials.gov registry (NCT02865603).

Highlights

The PAX Good Behavior Game (PAX GBG) is a universal classroom-based program that promotes children's mental health
The aim of this paper is to present the research protocol for the study designed to evaluate the impact of PAX GBG on students' mental health and behavior as well as teacher's self-efficacy in Estonia compared with the waiting list control condition
The study's main objective is to evaluate whether PAX GBG affects children's overall mental health, as measured by the total difficulties score on the teacher-completed Strengths and Difficulties Questionnaire (SDQ) [40]

Summary

Introduction

The PAX Good Behavior Game (PAX GBG) is a universal classroom-based program that promotes children's mental health. Several universal school-based prevention programs have demonstrably reduced psychological and behavioral problems in children [5] One of these is the Good Behavior Game (GBG), a behavior management strategy that has been used for more than 40 years [6]. The PAX progress evaluation form helps mentors evaluate the overall development and use of the PAX GBG methods within the classroom. Teachers use a web-based recording system to submit the number of games they have played during each week and the duration of each game played This data is summed up across the school year and calculated into total number of games implemented and total number of minutes for which the PAX GBG was implemented

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Methods

Discussion

Conclusion