Ialongo, N. S., Werthamer, L., Kellam, S. G., Brown, C. H., Wang, S., & Lin, Y. (1999). Proximal impact of two first-grade preventive interventions on the early risk behaviors for later substance abuse, depression, and antisocial behavior. American Journal of Community Psychology, 27(5), 599–641. https://doi.org/10.1023/A:1022137920532 

Type of Study: Randomized controlled trial
Number of Participants: 678

Population:

• Age — 6.2 years (Mean=5.3–7.7 years)
• Race/Ethnicity — 86.8% African American and 13.2% European American
• Gender — 53% Male
• Status — Participants were parents and their children in grades 6-12 or 19 years.

Location/Institution: Baltimore City, Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
This purpose of this study was to assess the immediate effects of the Good Behavior Game (GBG), a classroom-centered (CC) intervention [now called PAX Good Behavior Game (PAX GBG)], and the Family-School Partnership (FSP) two universal, first-grade preventive interventions on the proximal targets of poor achievement, concentration problems, aggression, and shy behaviors, known early risk behaviors for later substance use/abuse, affective disorder, and conduct disorder. A randomized block design was used, with schools serving as the blocking factor. Three first-grade classrooms in each of the nine urban elementary schools were randomly assigned to one of the three intervention conditions: (1) CC (GBG); (2) FSP; or (3) Standard Setting or Control. Measures utilized include the Teacher Observation of Classroom Adaptation—Revised (TOCA–R), the Parent Observation of Child Adaptation (POCA), the Peer Assessment Inventory (PAI), and the Comprehensive Test of Basic Skills (CTBS). Results indicate over the course of first and second grades, GBG yielded the greatest degree of impact on its proximal targets, whereas the FSP's impact was somewhat less. The effects were influenced by gender and by preintervention levels of risk. Analyses of implementation measures demonstrated that greater fidelity to the intervention protocols was associated with greater impact on behavior ratings and on achievement scores. Limitations include the absence of direct observations of children's behavior in the classroom and in the home, the fact that the gap between GBG and Control boys' and girls' total problem behaviors widened at the end of second grade instead of narrowing and reliance on self-reported measures.

Length of controlled postintervention follow-up: 1 year.

Ialongo, N., Poduska, J., Werthamer, L., & Kellam, S. (2001). The distal impact of two first-grade preventive interventions on conduct problems and disorder in early adolescence. Journal of Emotional and Behavioral Disorders, 9(3), 146–160. https://doi.org/10.1177/106342660100900301 

Type of Study: Randomized controlled trial
Number of Participants: 678

Population:

• Age — 6.2 years (Mean=5.3–7.7 years)
• Race/Ethnicity — 86.8% African American
• Gender — 53% Male
• Status — Participants were parents and their children in grades 6-12 or 19 years.

Location/Institution: Baltimore City, Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
This study utilizes information from Ialongo et al. (1999). The purpose of this study was to examine the impact of two universal, first-grade preventive interventions on the prevalence of conduct problems and disorder and mental health service need and use in early adolescence. The classroom-centered (CC) intervention [now called the PAX Good Behavior Game] was designed to reduce the risk for later conduct problems and disorder by enhancing teachers' behavior management in first grade, whereas the Family-School Partnership (FSP) intervention targeted improvement in parent-teacher communication and parents' child behavior management strategies. Each classroom (including the teachers and students) within a school was randomly assigned either to one of the two intervention conditions (i.e., FSP or GBG) condition, so that all three conditions were represented within each of the nine schools. Randomly assigned classrooms to one of the three conditions and balanced for student gender. Measures utilized include the Teacher Observation of Classroom Adaptation—Revised (TOCA–R), the Kaufman Test of Educational Achievement (KTEA), and the Teacher Report of Classroom Behavior Checklist. Results indicate at Grade 6, or age 12, GBG and FSP intervention children received significantly lower ratings from their teachers for conduct problems than control children. GBG and FSP children were also significantly less likely than control children to meet diagnostic criteria for conduct disorder and to have been suspended from school in the last year. In addition, the GBG intervention was associated with significantly lower rates of child mental health service need and utilization. Overall, the GBG appeared to be the more effective of the two in reducing the prevalence of conduct problems and disorder at age 12 and in reducing mental health service need and utilization. Limitations include generalizability of the findings to clinical populations, ethnic minority families and to families living in suburban and urban setting and reliance on self-reported measures.

Length of controlled postintervention follow-up: 5 years.

Kellam, S. G., Brown, C. H., Poduska, J. M., Ialongo, N. S., Wang, W., Toyinbo, P., Petras, H., Ford, C., Windham, A., & Wilcox, H. C. (2008). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes. Drug and Alcohol Dependence, 95(Suppl. 1), S5–S28. https://doi.org/10.1016/j.drugalcdep.2008.01.004 

Type of Study: Randomized controlled trial
Number of Participants: Not specified

Population:

• Age — 6–9 years (19-21 years at postintervention follow-up)
• Race/Ethnicity — 70% African American
• Gender — Not specified
• Status — Participants were two consecutive cohorts of children of low-to-lower middle socioeconomic status that participated in the study 1985-1986.

Location/Institution: 41 classes in 19 schools in five socio-demographically distinct areas of Baltimore.

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to evaluate the Good Behavior Game (GBG) [now called PAX Good Behavior Game] in regards to reducing aggressive and disruptive behaviors, which are confirmed antecedents of later substance abuse and dependence disorders, smoking, and antisocial personality disorder. Schools were randomized to one of three conditions: (1) GBG, (2) a curriculum-and-instruction program directed at reading achievement, or (3) the standard program. Balanced assignment of children to classrooms was made, and then, within intervention schools, classrooms and teachers were randomly assigned to intervention or control. Measures utilized include the Teacher Observation of Classroom Adaptation–Revised (TOCA–R), and the Composite International Diagnostic Interview–University of Michigan (CIDI–UM). Results indicate that GBG had a significant and substantial impact among all of the externalizing behaviors. The impact of GBG was overall highest among higher aggressive, disruptive first-grade males compared with less or moderately aggressive, disruptive males. By young adulthood, significant impact was found among males, particularly those who were more aggressive and disruptive in first grade, in reduced drug and alcohol abuse/dependence disorders, regular smoking, and antisocial personality disorder. Limitations include the lack of effect on anxiety and depressive disorders and that quality of GBG implementation was not assessed.

Length of controlled postintervention follow-up: Approximately 13 to 15 years.

Bradshaw, C. P., Zmuda, J. H., Kellam, S. G., & Ialongo, N. S. (2009). Longitudinal impact of two universal preventive interventions in first grade on educational outcomes in high school. Journal of Educational Psychology, 101(4), 926-937. https://doi.org/10.1037/a0016586

Type of Study: Randomized controlled trial
Number of Participants: 678

Population:

• Age — Children: 6.2 years (Mean=5.3–7.7 years) and 19 years, Parents: Not specified
• Race/Ethnicity — Children: 87% African American, 13% European American; Parents: Not specified
• Gender — Children: 53% Male, Parents: Not specified
• Status — Participants were parents and their children in grades 6-12 and age19 years.

Location/Institution: Baltimore City, Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
This study utilizes information from Ialongo et al. (1999). The purpose of this study was to examine the longitudinal effects of 2 first-grade universal preventive interventions on academic outcomes (e.g., achievement, special education service use, graduation, postsecondary education) through age 19 in a sample of urban, primarily African American children. This study examined how exposure to either the classroom-centered [now called PAX Good Behavior Game] or the family–school partnership (FSP) intervention in first grade affected standardized test performance in high school, teacher-rated academic achievement, special education service use, high school graduation, and college attendance. A randomized block design was used, with schools serving as the blocking factor. Three first-grade classrooms in each of nine urban elementary schools were randomly assigned to one of the two intervention conditions or a control condition. Teachers and children were randomly assigned to intervention conditions with balancing for gender. Measures utilized include the Teacher Observation of Classroom Adaptation—Revised (TOCA–R), the Kaufman Test of Educational Achievement (KTEA; the Teacher Report of Classroom Behavior Checklist; and administrative data. Results indicate that, although the effects varied by gender, the classroom-centered intervention was associated with higher scores on standardized achievement tests, greater odds of high school graduation and college attendance, and reduced odds of special education service use. The intervention effects of the FSP were in the expected direction; however, only 1 effect reached statistical significance. Limitations include the differences in results by gender and the different amount of teacher training and coaching between the two interventions.

Length of controlled postintervention follow-up: Varies but approximately 12 years (age 19).

Petras, H., Masyn, K., & Ialongo, N. (2011) The developmental impact of two first grade preventive interventions on aggressive/disruptive behavior in childhood and adolescence: An application of latent transition growth mixture modeling. Prevention Science, 12, 300–313. https://doi.org/10.1007/s11121-011-0216-7

Type of Study: Randomized controlled trial
Number of Participants: 666

Population:

• Age — 6.2 years (Mean=5.3–7.7 years)
• Race/Ethnicity — 87% African American and 13% European American
• Gender — 54% Female
• Status — Participants were children in grades 6-12

Location/Institution: Baltimore City, Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
This study utilizes information from Ialongo et al. (1999). The purpose of this study was to examine the impact of two universal preventive interventions in first grade on the growth of aggressive/disruptive behavior in grades 1–3 and 6–12 through the application of a latent transition growth mixture model (LT-GMM). A randomized block design was used, with schools serving as the blocking factor. Three first-grade classrooms in each of the nine urban elementary schools were randomly assigned to one of the three intervention conditions: (1) classroom-centered (CC) [now called PAX Good Behavior Game]; (2) family–school partnership (FSP); or (3) standard setting/control. Measures utilized include the Teacher Observation of Classroom Adaptation-Revised (TOCA-R) and the Teacher Report of Classroom Behavior-Checklist Form (TRCB-CF). Results indicate for males, both the classroom-centered and family-centered interventions had significant direct effects on trajectory class membership in grades 6–12, whereas only the classroom-centered intervention had a significant effect on class membership in grades 1–3. Significant direct effects for females were confined to grades 1–3 for the classroom-centered intervention. Further analyses revealed that both the classroom-centered and family-centered intervention males were significantly more likely than control males to transition from the high trajectory class in grades 1–3 to a low class in grades 6–12. Effects for females in classroom-centered interventions went in the hypothesized direction but did not reach significance. Limitations include the absence of direct observations of children's behavior in the classroom and in the home, the fact that the gap between classroom-centered and control group boys' and girls' total problem behaviors widened at the end of second grade instead of narrowing, reliance on self-reported measures, and lack of follow-up.

Length of controlled postintervention follow-up: Varies — 3–11 years.

Kellam, S. G., Wang, W., Mackenzie, A. C. L., Brown, C. H., Ompad, D. C., Or, F., Ialongo, N. S., Poduska, J. M., & Windham, A. (2014) The impact of the Good Behavior Game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood. Prevention Science, 15, 6–18. https://doi.org/10.1007/s11121-012-0296-z

Type of Study: Randomized controlled trial
Number of Participants: 407

Population:

• Age — Mean=20.3 years
• Race/Ethnicity — 75% African American, 23% White, 2% American Indian, 0.2% Hispanic, and 0.2% Asian
• Gender — 50% Female and 49% Male
• Status — Participants were first and second graders in public schools.

Location/Institution: Baltimore City, Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine the impact of the Good Behavior Game (GBG) [now called PAX Good Behavior Game] on the courses and interrelationships among aggressive, disruptive behavior 3through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19–21. Six schools across the five urban areas were assigned to the GBG intervention, and then within each school GBG classrooms were randomly selected. Students in the six GBG schools were randomly assigned to either the eight GBG classrooms (N=238) or the six internal control classrooms (N=169). Measures utilized include the Teacher Observation of Classroom Adaptation-Revised (TOCA-R) and the Composite International Diagnostic Interview (CIDI-UM). Results indicate that by young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive and disruptive. Limitations include reliance on retrospective self-reported measures collected via telephone interview, which may be subject to recall bias and socially desirable responding.

Length of controlled postintervention follow-up: : 13–15 years.

Jiang, D., Santos, R., Josephson, W., Mayer, T., & Boyd, L. (2018). A comparison of variable- and person-oriented approaches in evaluating a universal preventive intervention. Prevention Science, 19, 738–747. https://doi.org/10.1007/s11121-018-0881-x

Type of Study: Randomized controlled trial
Number of Participants: 3,393

Population:

• Age — 6–9 years (Mean=7 years)
• Race/Ethnicity — Not specified
• Gender — 50.4% Female
• Status — Participants were students enrolled in 1st grade in participating schools.

Location/Institution: 197 schools from 34 Manitoba public school divisions and 4 others

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to present both variable-oriented and person-oriented statistical approaches, to evaluate the PAX Good Behavior Game (PAX) with multilevel, longitudinal multivariate outcomes. Schools were randomly assigned within school divisions to implement PAX in either the 2011–2012 school year (PAX schools) or the following school year (waitlist control schools). Measures utilized include the Strengths and Difficulties Questionnaire (SDQ). Results from the variable-oriented analytic approach show that students in the PAX schools had significantly greater increases in prosocial behavior and decreases in difficulties from pretest to posttest than students in the control schools, although the effect size was small. Using a clinically informed set of cut-offs suggested by the SDQ’s developer, higher risk children benefited more from PAX than lower risk children on all the outcome variables. Results from the person-oriented approach showed that the net effect of the PAX program for moderate-risk and high-risk children over time were both significant. There was a moderate-risk class of children who benefited even more from the PAX program than those children who were most at risk. The most high-risk children may have additional problems that require more extended exposure to PAX or additional support. Also, socioeconomic status (SES) is a moderator of PAX effects, raising the possibility that some of those problems may be socioeconomic. In high-SES neighborhoods, high- and moderate-risk children benefited similarly from PAX. In low-SES neighborhoods, high-risk children benefited significantly less from PAX than moderate-risk children did, although both risk groups made significant gains from the program. High-risk children whose families and neighborhoods lack resources appear to be helped by PAX, but they may need more support to offset the multiple ways in which poverty undermines children’s mental, emotional, and behavioral well-being. Limitations include missing data at both pretest and posttest, bias inherent to teacher-reported data, the lack of other objective measurement methods, and the lack of postintervention follow-up.

Length of controlled postintervention follow-up: None.

Smith, E. P., Osgood, D. W., Oh, Y., & Caldwell, L. C. (2018). Promoting afterschool quality and positive youth development: Cluster randomized trial of the PAX Good Behavior Game. Prevention Science, 19, 159–173. https://doi.org/10.1007/s11121-017-0820-2

Type of Study: Randomized controlled trial
Number of Participants: 811

Population:

• Age — 5–12 years
• Race/Ethnicity — 48.2% White, 28.7% African American, 16.4% Other, and 6.7% Hispanic/Latino/a
• Gender — 50.1% Female and 49.9% Male
• Status — Participants were youth in afterschool programs.

Location/Institution: 76 afterschool programs

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine the PAX Good Behavior Game (PAX GBG), among 76 afterschool programs, serving youth who were diverse in race-ethnicity, socioeconomic status, and geographic locale. Demographically matched pairs of afterschool programs were randomized to PAX GBG or treatment-as-usual. Measures utilized include the Caregiver Interaction Scale (CIS), the Promising Practices Rating Scale (PPRS), the Youth Program Quality Assessment (YPQA), the Strengths and Difficulties Questionnaire (SDQ), and the Problem Behaviors and Substance Use (PBSU). Results indicate that the experimental programs evidencing higher implementation fidelity demonstrated better program quality than controls, (i.e., less harshness, increased appropriate structure, support, and engagement), as well as reduced child-reported hyperactivity and intent-to-treat effects on prosocial behavior. Limitations include that the study did not detect effects upon youth emotional symptoms (e.g., worry and anxiety), conduct problems (e.g., lying, aggression), or problem behaviors (e.g., theft, vandalism, and experimentation with substances), the sample was more limited in terms of representing Latino youth, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Ialongo, N. S., Domitrovich, C., Embry, D., Greenberg, M., Lawson, A., Becker, K. D., & Bradshaw, C. (2019). A randomized controlled trial of the combination of two school-based universal preventive interventions. Developmental Psychology, 55(6), 1313–1325. https://doi.org/10.1037/dev0000715

Type of Study: Randomized controlled trial
Number of Participants: 5,942 (5,611 students and 331 teachers)

Population:

• Age — Children: Not specified - mean grade level was 2.36 grade; Teachers: Not specified
• Race/Ethnicity — Children: 89.6% African American; Teachers: Not specified
• Gender — Children: 50.4% Male; Teachers: 88% Female
• Status — Participants were students enrolled in K-5 classrooms in participating schools.

Location/Institution: 27 elementary schools

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine whether the combination of PAX Good Behavior Game (PAX GBG) and the Promoting Alternative Thinking Strategies (PATHS) Curriculum would yield significantly greater impact on aggressive/disruptive and off-task behavior than the PAX GBG alone. Twenty-seven schools were randomly assigned to one of 3 conditions, (a) the PAX GBG alone, (b) PATHS to PAX (that is, the PAX GBG PATHS), or (c) a standard setting (control) condition. Measures utilized include the Teacher Observation of Classroom Adaptation-Revised (TOCA-R) and the Social Health Profile Social Competence Scale (SHP SCS). Results showed no main effects for the PAX GBG versus Control contrasts; however, the PAX GBG versus Control intervention x pretest level of the outcome for the classroom observation Total Problem Behavior Scale score was significant. PAX GBG also resulted in a significant reduction in the Total Problem Behavior scale score at posttest for those students whose pretest scores on the Total Problem Behaviors scale were at the upper end of the distribution. Limitations include the breadth, frequency, and duration of the assessments, and the lack of postintervention follow-up.

Length of controlled postintervention follow-up: None.

Ashworth, E., Humphrey, N., & Hennessey, A. (2020). Game over? No main or subgroup effects of the Good Behavior Game in a randomized trial in English primary schools. Journal of Research on Educational Effectiveness, 13(2), 298–321. https://doi.org/10.1080/19345747.2019.1689592

Type of Study: Randomized controlled trial
Number of Participants: : 77 schools (3084)

Population:

• Age — Not specified
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were first grade students.

Location/Institution: England

Summary: (To include basic study design, measures, results, and notable limitations)
This study aimed to examine the impact of a universal, school-based intervention, the Good Behavior Game (GBG) [now called PAX Good Behavior Game], on children’s behavior, and to explore any subgroup moderator effects among children at varying levels of cumulative risk (CR) exposure. Seventy-seven primary schools were randomly assigned to intervention and control groups. Measures utilized include the Teacher Observation of Classroom Adaptation (TOCA-C). Results indicated that multilevel models indicated that no main or subgroup effects were evident. These findings were largely insensitive to the modeling of CR, although a small intervention effect on disruptive behavior was found when the curvilinear trend was used. Further sensitivity analyses revealed no apparent influence of the level of program differentiation. In sum, the findings indicate that the GBG does not improve behavior when implemented in this sample of English schools. Limitations include that schools in the sample were typically larger than average and may not be representative of school overall, and that teachers were not included as a level of analysis in the model.

Length of controlled postintervention follow-up: None.

Ashworth, E., Panayiotou, M., Humphrey, N., & Hennessey, A. (2020). Game on—complier average causal effect estimation reveals sleeper effects on academic attainment in a randomized trial of the Good Behavior Game. Prevention Science, 21, 222–233. https://doi.org/10.1007/s11121-019-01074-6

Type of Study: Randomized controlled trial
Number of Participants: 77 schools (3084)

Population:

• Age — Not specified
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were first grade students.

Location/Institution: England

Summary: (To include basic study design, measures, results, and notable limitations)
This study utilizes the same sample as Ashworth et al. (2020). The purpose of this study was to examine the efficacy of the Good Behavior Game (GBG) [now called PAX Good Behavior Game] in improving children’s reading attainment, and the extent to which this varies as a function of cumulative intervention intensity (dosage) and timing of outcome measurement. Seventy-seven primary schools were randomly assigned to intervention and control groups. Measures utilized include the Hodder Group Reading Test. Results indicated that at posttest, no effects of the GBG on children’s reading attainment were found in either the intent-to-treat (ITT) or Complier Average Causal Effect (CACE) models. At 1-year follow-up, results remained null in the ITT model, but a significant intervention effect was found among moderate compliers in the CACE model. Limitations include trial schools were larger than average, the current study sample may not have been fully representative of schools and students in England and, due to the unknown classroom level information for the control schools, classroom was not modeled as a level in the multilevel CACE models.

Length of controlled postintervention follow-up: 1 year.

Streimann, K., Selart, A., & Trummal, A. (2020). Effectiveness of a universal, classroom-based preventive intervention (PAX GBG) in Estonia: A cluster-randomized controlled trial. Prevention Science, 21(2), 234–244. https://doi.org/10.1007/s11121-019-01050-0

Type of Study: Randomized controlled trial
Number of Participants: 42 schools (708 students)

Population:

• Age — 7–8 years
• Race/Ethnicity — Not specified
• Gender — 50.1% Female and 49.9% Male
• Status — Participants were first grade students.

Location/Institution: Estonia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to assess the impact of the PAX Good Behavior Game (PAX GBG) on students' mental health and behavior 7 and 19 months post-baseline. Each school from a pair was randomized into either an intervention or control group. Measures utilized include the Strengths and Difficulties Questionnaire (SDQ), the Swanson, Nolan, and Pelham – IV Questionnaire (SNAP-IV), the Teachers' Sense of Efficacy Scale (TSES), and the Teaching and Learning International Survey (TALIS). Results indicate the intervention had positive effects on children's mental health at the end of the first academic year, which lasted and strengthened during the second academic year. Moderation analysis demonstrated positive effects on mental health and prosocial behavior for high-risk students during the first year. A few positive effects extended to the home environment during the second academic year. Implementation fidelity was satisfactory. The intervention also had a positive lasting effect on teacher's self-efficacy and overall classroom behavior. Limitations include that the study was conducted as a matched-cluster randomized trial based on the implementation-related goals, that the trial had a relatively small number of clusters involved, students in the intervention schools had significantly more mental health difficulties at baseline, and matching was based on a variable that turned out to be not perfectly valid.

Length of controlled postintervention follow-up: 7 months

Bradshaw, C. P., Shukla, K. D., Pas, E. T., Berg, J. K., & Ialongo, N. S. (2020). Using complier average causal effect estimation to examine student outcomes of the PAX Good Behavior Game when integrated with the PATHS Curriculum. Administration and Policy in Mental Health and Mental Health Services Research, 47, 972–986. https://doi.org/10.1007/s10488-020-01034-1

Type of Study: Randomized controlled trial
Number of Participants: 1526

Population:

• Age — Children: Not specified; Teachers: 30 years or younger
• Race/Ethnicity — Children: 93% African American, 3% Hispanic, 2% White, and 2% Other (students); Teachers: Not specified
• Gender — Children: 60% Male and 39% Female; Teachers: 88% Female
• Status — Participants were K-5 teachers of at-risk children who displayed aggressive-disruptive behavior.

Location/Institution: 27 elementary schools

Summary: (To include basic study design, measures, results, and notable limitations)
This study reports intent-to-treat (ITT) and Complier Average Causal Effect (CACE) findings from a randomized controlled trial (RCT) testing the impacts of the universal PAX Good Behavior Game (PAX GBG) integrated with Promoting Alternative Thinking Strategies (i.e., PATHS to PAX) and PAX GBG only compared to a control. Participants were randomized to either the PAX GBG only, to an integration of the PAX GBG and the PATHS program, or to a control group. Measures utilized include the Teacher Observation of Classroom Adaptation-Revised (TOCA-R). Results indicate the ITT analyses indicated improvements for students in the integrated condition on ratings of social competence compared to the control condition. The CACE analyses also indicated significant effects of the integrated intervention on social competence, as well as academic engagement and emotion regulation for students in high compliance classrooms. No iatrogenic effects of the program were observed in the current study, except for aggressive-disruptive behavior among the noncompliers for the PAX GBG-only condition. Limitations include sample size of classrooms was relatively small, and thus became even smaller when split into implementation conditions and compliance groups, missing data at either the student or teacher level, and lack of follow-up.

Length of controlled postintervention follow-up: None.

The following studies were not included in rating PAX GBG on the Scientific Rating Scale...

Koenig, A. L., Ialongo, N., Wagner, B. M., Poduska, J., & Kellam, S. (2002). Negative caregiver strategies and psychopathology in urban, African–American young adults. Child Abuse & Neglect, 26(12), 1211–1233. https://doi.org/10.1016/S0145-2134(02)00422-2

This study utilizes information from Ialongo et al. (1999). The purpose of this study was to evaluate the Good Behavior Game (GBG) [now called PAX Good Behavior Game] in regards to three aims: (1) assess the prevalence of reported exposure to negative caregiver strategies in a community-based African-American population, (2) examine the sources of variation in caregiver parenting strategies, including demographic variables and child characteristics, and (3) investigate whether mental disorders in young adulthood may differ based on reported degree of exposure to negative strategies. Schools were randomly assigned to either an intervention or control condition within a geographic area. Measures utilized include the Teacher Observation of Classroom Adaptation–Revised (TOCA–R), The Life Events Questionnaire-Adolescent Version (LEQ-A), and the Composite International Diagnostic Interview–University of Michigan (CIDI–UM). Results indicate that 54% of the sample reported some use of physical discipline by caregivers. Lower family income and younger caregiver age, as well as teacher reports of child aggression, were related to reports of caregiver’s high use of negative strategies. In addition, young adults who reported a high rate of negative caregiver strategies had a significantly increased risk for psychopathology and were over twice as likely to have experienced a history of suicidal ideation than those reporting low exposure. Limitations include that determination of mental disorder diagnoses was based on a single interview conducted over the phone by a lay interviewer, and the reliance on retrospective reports for frequency and prevalence of negative caregiver strategies, psychiatric diagnostic information, and lifetime suicidal ideation and attempts. Note: This article was not used for rating since outcomes related to the topic areas PAX Good Behavior Game are rated in were not reported.