Impact of PAX Good Behavior Game on Elementary School Students in Estonia

Not Applicable

Completed

• Conditions: Mental Disorders; Mental Health Wellness 1
• Interventions: Behavioral: PAX Good Behavior Game

• Registration Number: NCT02865603
• Lead Sponsor: National Institute for Health Development, Estonia

Brief Summary

The aim of this study is to measure the impact of the intervention (PAX GBG) in Estonian-language 1st grade classrooms on students' mental health and behaviour, and teacher's self-efficacy.

Detailed Description

2-year, matched-pair, cluster-randomized controlled trial with a intervention and wait-list control arm is conducted during school years 2016/17 and 2017/18. 42 volunteering schools were matched to pairs. One school in each pair was randomly selected to receive the PAX GBG or continue their normal activities without intervention. After a post-test assessment in spring 2018 the control group teachers are trained and supported to implement PAX GBG.

Study Timeline

• Study Start: 2016-05
• Study First Submitted: 2016-08-04
• Study First Submitted QC: 2016-08-11
• Study First Posted: 2016-08-12
• Primary Completion: 2018-06
• Study Completion: 2018-06
• Status Verified: 2018-11
• Last Update Submitted: 2018-11-01
• Last Update Posted: 2018-11-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 708

Inclusion Criteria

All schools with first grade classrooms and Estonian-language as instruction language in Estonia were qualified to take part of the study if they did fit the inclusion criteria.

Schools were suitable to participate if they:

• Had equal to or more than 13 pupils in the first grade classroom in 2016/17 school term;
• Did not implement any other evidence-based program in basic school stage 1 (grades 1-3), (for example KiVa bullying prevention program);
• Did not already implement PAX GBG;
• Had at least one first grade teacher who volunteers to participate for the whole study period of two years.

Exclusion Criteria

• Schools for children with special educational needs and schools with Russian language as instruction language were excluded.
• Schools with single-sex classrooms were excluded.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PAX Good Behavior Game	PAX Good Behavior Game	The intervention is delivered by teachers within the normal school curriculum. Teachers from intervention classes completed 3-day training and were supported by the mentor, who visited their class during the 2016/17 school year and provided counseling via e-mail and phone. During the second year (2017/18) teachers could use the PAX GBG methods, but they did not receive additional support from the mentors.

Primary Outcome Measures

Name	Time	Method
Change in children's social and emotional well-being	Baseline, 7 months post-baseline and 19 months post-baseline	Children's social and emotional well-being will be measured by the teacher-completed Strengths and Difficulties Questionnaire with impact supplement (SDQ; Goodman, 1999) and parent-rated Strengths and Difficulties Questionnaire (Goodman, 1997).

Secondary Outcome Measures

Name	Time	Method
Change in symptoms of attention deficit hyperactivity disorder (ADHD) among the children	Baseline, 7 months post-baseline and 19 months post-baseline	The Swanson, Nolan and Pelham-IV Questionnaire (SNAP-IV) (Swanson et al., 2001) is an 18-item instrument for rating ADHD-related symptoms and will be completed by parents.
Change in teachers' sense of efficacy	Baseline, 7 months post-baseline and 19 months post-baseline	Teachers' efficacy will be measured with The Teachers' Sense of Efficacy Scale (TSES; Tschannen-Moran \& Hoy, 2001). It is a self-reported measure for teachers that consists of 24 items and assesses the teacher's perception of their sense of effectiveness as a teacher.
Change in children's behavioral inhibition	Baseline, 7 months post-baseline	The effects of the intervention on inhibitory control will be measured using cognitive task (Go/No-Go task). The task will be developed specially for this research and completed by children.
Change in classroom behavior	Baseline, 7 months post-baseline and 19 months post-baseline	Teacher-rated 4-item measure will be used to assess classroom behavior. The measure originates from Organisation for Economic Co-operation and Development (OECD) Teaching and Learning International Survey (TALIS) 2013 teacher's questionnaire (question nr 41) and asks to indicate how strongly does the teacher agree or disagree with statements about the classroom behavior.