| Literature DB >> 34625211 |
Patricio Troncoso1, Neil Humphrey2.
Abstract
This cluster randomized controlled trial (RCT) examined the impact of the Good Behavior Game (GBG) on children's developmental trajectories of disruptive behavior, concentration problems, and prosocial behavior from middle childhood (ages 6-7 years) to early adolescence (ages 10-11 years). Seventy-seven schools in England were randomly assigned to intervention and control groups. Allocation was balanced by school size and the proportion of children eligible for free school meals. Children (N = 3084) ages 6-7 years at baseline were the target cohort. Outcome measures, assessed via the Teacher Observation of Child Adaptation Checklist, were taken prior to randomization (baseline - Time 1) and annually for the next 4 years (Time 2 to Time 5). During the 2-year main trial period (Time 1 to Time 3), teachers of this cohort in intervention schools implemented the GBG, whereas their counterparts in the control group continued their usual practice. A multivariate multilevel non-linear growth curve model indicated that the GBG reduced concentration problems over time. In addition, the model also revealed that the intervention improved prosocial behavior among at-risk children (e.g., those with elevated symptoms of conduct problems at Time 1, n = 485). No intervention effects were unequivocally found in relation to disruptive behavior. These findings are discussed in relation to the extant literature, strengths and limitations are noted, and practical and methodological implications are highlighted.Entities:
Keywords: Bayes factor; Behavior management; Growth curve; Intervention; Multilvariate multilevel modeling; Randomized trial
Mesh:
Year: 2021 PMID: 34625211 PMCID: PMC8519394 DOI: 10.1016/j.jsp.2021.08.002
Source DB: PubMed Journal: J Sch Psychol ISSN: 0022-4405
Fig. 1Flow of participants through the study.
Variables used in the current study.
| Variable | Description |
|---|---|
| Disruptive behavior (standardized) | TOCA-C subscale score for disruptive behavior. Time varying continuous outcome. Original scores range 1–6, with higher scores indicating greater disruptive behavior. |
| Concentration problems (standardized) | TOCA-C subscale score for concentration problems. Time varying continuous outcome. Original scores range 1–6, with higher scores indicating greater concentration problems. |
| Prosocial behavior (standardized) | TOCA-C subscale score for prosocial behavior. Time varying continuous outcome. Original scores range 1–6, with higher scores indicating greater pro-social behavior. |
| Trial arm | Nominal time-invariant school-level covariate. Coded 0 = control; 1 = GBG |
| FSM | Nominal time-invariant pupil-level covariate. Free-school meal eligibility at T1. Coded 0 = Non-FSM; 1 = FSM |
| Conduct problems risk status | Nominal time-invariant pupil-level variable. “At risk” is defined as scoring 3 or more in the SDQ conduct problems subscale (slightly raised) at T1. Coded 0 = not at risk; 1 = at risk |
| Sex | Nominal time-invariant pupil-level covariate. Sex as registered at birth and recorded in the National Pupil Database. Coded 0 = female; 1 = male |
| School FSM | Continuous (standardized) time-invariant school-level covariate. Percentage of pupils eligible for free-school meals at T1. |
| School size | Continuous (standardized) time-invariant school-level covariate. Number of pupils on roll at T1. |
Note. FSM = eligible for free school meals.
Goodness of fit comparison across longitudinal measurement models for TOCA subscales.
| Outcome | Model | CFI | TLI | RMSEA | AIC | BIC | Chi-squared | df | SRMR |
|---|---|---|---|---|---|---|---|---|---|
| Concentration problems | Configural | 0.974 | 0.967 | 0.045 | 194,240.1 | 195,352.3 | 3376.9 | 480 | 0.034 |
| Weak | 0.973 | 0.968 | 0.044 | 194,281.9 | 195,249.9 | 3466.8 | 504 | 0.037 | |
| Strong | 0.970 | 0.967 | 0.045 | 194,559.0 | 195,358.6 | 3799.8 | 532 | 0.039 | |
| Strict | 0.967 | 0.965 | 0.047 | 194,935.1 | 195,566.4 | 4232.0 | 560 | 0.039 | |
| Disruptive behavior | Configural | 0.939 | 0.929 | 0.048 | 237,696.2 | 239,109.0 | 6619.0 | 845 | 0.031 |
| Weak | 0.935 | 0.927 | 0.048 | 238,042.1 | 239,262.5 | 7028.9 | 877 | 0.044 | |
| Strong | 0.928 | 0.922 | 0.050 | 238,709.4 | 239,713.4 | 7768.2 | 913 | 0.046 | |
| Strict | 0.922 | 0.919 | 0.051 | 239,191.0 | 239,978.6 | 8321.8 | 949 | 0.047 | |
| Prosocial behavior | Configural | 0.947 | 0.926 | 0.059 | 157,868.7 | 158,680.3 | 2435.6 | 215 | 0.045 |
| Weak | 0.945 | 0.929 | 0.057 | 157,917.9 | 158,633.3 | 2516.8 | 231 | 0.048 | |
| Strong | 0.940 | 0.929 | 0.057 | 158,112.2 | 158,707.4 | 2751.1 | 251 | 0.050 | |
| Strict | 0.937 | 0.930 | 0.057 | 158,238.6 | 158,713.6 | 2917.5 | 271 | 0.052 |
Note. CFI = Comparative Fit Index; TLI = Tucker Lewis Index; RMSEA = Root Mean Square Error of Approximation; AIC = Akaike Information Criterion; BIC = Bayesian Information Criterion; df = degrees of freedom; SRMR = Standardized Root Mean Square Residual.
Summary of descriptive statistics of the observed outcomes over time.
| Time | Concentration problems | Disruptive behavior | Prosocial behavior | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Control | GBG | Control | GBG | Control | GBG | |||||||
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |
| 1 | 2.548 | 1.146 | 2.602 | 1.130 | 1.612 | 0.812 | 1.709 | 0.810 | 4.946 | 0.917 | 4.893 | 0.875 |
| 2 | 2.657 | 1.134 | 2.576 | 1.126 | 1.644 | 0.745 | 1.761 | 0.798 | 4.910 | 0.920 | 4.844 | 0.924 |
| 3 | 2.495 | 1.129 | 2.548 | 1.133 | 1.647 | 0.837 | 1.740 | 0.856 | 4.932 | 0.952 | 4.808 | 0.930 |
| 4 | 2.432 | 1.135 | 2.437 | 1.178 | 1.706 | 0.789 | 1.747 | 0.854 | 4.917 | 0.963 | 4.915 | 0.960 |
| 5 | 2.392 | 1.174 | 2.352 | 1.148 | 1.740 | 0.863 | 1.732 | 0.840 | 4.842 | 0.981 | 4.916 | 0.953 |
Note. SD = standard deviation.
Unconditional means multivariate multilevel model for concentration problems, disruptive behavior, and prosocial behavior (standardized).
| Fixed part | Post. mean | SD |
|---|---|---|
| Intercept concentration | 0.026 | 0.028 |
| Intercept disruptive | 0.038 | 0.032 |
| Intercept prosocial | −0.017 | 0.033 |
Note. Deviance information criterion = 97,603.35.
Variance partitioning of the unconditional means model for concentration problems, disruptive behavior, and prosocial behavior.
| Outcome | Within children | Between children | Between schools |
|---|---|---|---|
| Concentration problems | 39.88% | 56.23% | 3.88% |
| Disruptive behavior | 38.81% | 55.72% | 5.47% |
| Prosocial behavior | 55.12% | 38.05% | 6.82% |
Fig. 2Predicted standardized scores for concentration problems, disruptive behavior and prosocial behavior by trial arm.
Fixed-effects parameters of the full multivariate multilevel non-linear growth curve model for concentration problems, prosocial behavior, and disruptive behavior (standardized).
| Parameter | Concentration problems | Disruptive behavior | Prosocial behavior | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Post. mean | SD | 95% CI | Post. mean | SD | 95% CI | Post. mean | SD | 95% CI | ||||
| Intercept | −0.368 | 0.043 | −0.451 | −0.284 | −0.496 | 0.043 | −0.579 | −0.412 | 0.353 | 0.050 | 0.256 | 0.452 |
| time | 0.174 | 0.043 | 0.090 | 0.258 | 0.016 | 0.042 | −0.066 | 0.098 | −0.075 | 0.051 | −0.174 | 0.024 |
| time squared | −0.128 | 0.028 | −0.182 | −0.073 | 0.013 | 0.027 | −0.040 | 0.066 | 0.048 | 0.033 | −0.016 | 0.112 |
| time cubed | 0.020 | 0.005 | 0.011 | 0.029 | −0.001 | 0.004 | −0.010 | 0.008 | −0.010 | 0.005 | −0.020 | 0.001 |
| GBG | 0.011 | 0.061 | −0.108 | 0.131 | 0.072 | 0.061 | −0.049 | 0.192 | −0.020 | 0.072 | −0.163 | 0.120 |
| time*GBG | −0.151 | 0.061 | −0.270 | −0.033 | 0.109 | 0.059 | −0.007 | 0.224 | −0.102 | 0.071 | −0.242 | 0.038 |
| time squared*GBG | 0.096 | 0.039 | 0.019 | 0.173 | −0.073 | 0.038 | −0.148 | 0.001 | 0.051 | 0.046 | −0.039 | 0.142 |
| time cubed*GBG | −0.016 | 0.007 | −0.029 | −0.003 | 0.010 | 0.006 | −0.003 | 0.022 | −0.004 | 0.008 | −0.019 | 0.011 |
| At risk | 1.108 | 0.104 | 0.904 | 1.310 | 1.517 | 0.086 | 1.349 | 1.686 | −1.336 | 0.091 | −1.515 | −1.157 |
| FSM | 0.262 | 0.046 | 0.173 | 0.351 | 0.190 | 0.037 | 0.117 | 0.263 | −0.216 | 0.040 | −0.294 | −0.139 |
| School size | −0.041 | 0.033 | −0.105 | 0.024 | −0.062 | 0.037 | −0.134 | 0.011 | −0.001 | 0.043 | −0.086 | 0.083 |
| School FSM | 0.029 | 0.033 | −0.036 | 0.092 | −0.002 | 0.035 | −0.071 | 0.067 | −0.003 | 0.041 | −0.083 | 0.078 |
| GBG and FSM | −0.022 | 0.062 | −0.143 | 0.099 | −0.059 | 0.050 | −0.159 | 0.039 | −0.004 | 0.054 | −0.109 | 0.102 |
| GBG and at risk | −0.164 | 0.130 | −0.419 | 0.091 | −0.205 | 0.108 | −0.416 | 0.007 | 0.377 | 0.115 | 0.152 | 0.602 |
| Male | 0.390 | 0.039 | 0.313 | 0.467 | 0.232 | 0.032 | 0.169 | 0.295 | −0.184 | 0.034 | −0.251 | −0.117 |
| GBG and male | 0.002 | 0.056 | −0.107 | 0.112 | 0.013 | 0.046 | −0.077 | 0.103 | −0.036 | 0.049 | −0.132 | 0.059 |
| Male and at risk | −0.085 | 0.119 | −0.319 | 0.150 | 0.176 | 0.098 | −0.017 | 0.369 | 0.247 | 0.104 | 0.042 | 0.453 |
| GBG, male and at risk | 0.114 | 0.155 | −0.190 | 0.417 | 0.072 | 0.128 | −0.179 | 0.322 | −0.203 | 0.136 | −0.469 | 0.063 |
| GBG*school size | 0.096 | 0.054 | −0.009 | 0.203 | 0.032 | 0.061 | −0.088 | 0.153 | −0.067 | 0.071 | −0.208 | 0.071 |
| GBG*school FSM | −0.004 | 0.046 | −0.094 | 0.086 | 0.046 | 0.050 | −0.052 | 0.143 | 0.016 | 0.058 | −0.098 | 0.129 |
Note. GBG = Good Behavior Game; FSM = eligible for free school meals.
Parameters were obtained via Markov Chain Monte Carlo (MCMC) estimation with Gibbs sampling using 3 parallel chains of length 100,000 and a burn-in period of 1000 (storing all iterations). All fixed-effects parameters have an effective sample size (ESS) of at least 4000. Deviance information criterion = 73,211.344. The model uses diffuse prior distributions as described in Browne (2019). Trajectories mix well with approximately normally-distributed posteriors; however, they are not presented here as they exceed the scope of this paper. Full details are available on request.
Bayes factors and posterior model probabilities for the difference in outcomes between children in the trial and the control group over time.
| Outcome | Time | Control | GBG | Difference | BF1 | BF2 | BF1,2 | PMP1 | PMP2 |
|---|---|---|---|---|---|---|---|---|---|
| Concentration problems | 1 | −0.367 | −0.357 | −0.011 | 0.863 | 1.137 | 0.759 | 0.432 | 0.568 |
| 2 | −0.301 | −0.362 | 0.061 | 1.681 | 0.319 | 5.264 | 0.84 | 0.16 | |
| 3 | −0.372 | −0.407 | 0.035 | 1.441 | 0.559 | 2.58 | 0.721 | 0.279 | |
| 4 | −0.461 | −0.470 | 0.009 | 1.117 | 0.883 | 1.264 | 0.558 | 0.442 | |
| 5 | −0.451 | −0.528 | 0.077 | 1.772 | 0.228 | 7.789 | 0.886 | 0.114 | |
| Disruptive behavior | 1 | −0.495 | −0.425 | −0.07 | 0.255 | 1.745 | 0.146 | 0.127 | 0.873 |
| 2 | −0.468 | −0.352 | −0.115 | 0.064 | 1.936 | 0.033 | 0.032 | 0.968 | |
| 3 | −0.421 | −0.348 | −0.072 | 0.247 | 1.753 | 0.141 | 0.123 | 0.877 | |
| 4 | −0.359 | −0.360 | 0.001 | 1.004 | 0.996 | 1.007 | 0.502 | 0.498 | |
| 5 | −0.289 | −0.333 | 0.044 | 1.469 | 0.531 | 2.77 | 0.735 | 0.265 | |
| Prosocial behavior | 1 | 0.353 | 0.334 | 0.019 | 0.791 | 1.209 | 0.655 | 0.396 | 0.604 |
| 2 | 0.317 | 0.243 | 0.074 | 0.300 | 1.700 | 0.177 | 0.150 | 0.850 | |
| 3 | 0.318 | 0.266 | 0.053 | 0.459 | 1.541 | 0.298 | 0.230 | 0.770 | |
| 4 | 0.298 | 0.318 | −0.019 | 1.204 | 0.796 | 1.512 | 0.602 | 0.398 | |
| 5 | 0.198 | 0.312 | −0.114 | 1.862 | 0.138 | 13.524 | 0.931 | 0.069 |
Notes. Informative Hypothesis 1: Control > GBG (for concentration problems and disruptive behavior); Control < GBG (for prosocial behavior). Informative Hypothesis 2: Control ≤ GBG (for concentration problems and disruptive behavior); Control ≥ GBG (for disruptive behavior). BF1 = Bayes Factor for Informative Hypothesis 1. BF2 = Bayes Factor for Informative Hypothesis 2. BF1,2 = Bayes Factor for Informative Hypothesis 1 over Informative Hypothesis 2. PMP1 = Posterior Model Probability for Informative Hypothesis 1. PMP2 = Posterior Model Probability for Informative Hypothesis 2.
Binary logistic multilevel model of children nested within schools for missingness in the full model (Table 6).
| Fixed part | Coef. | S.E. | 95% Conf. Int. | |
|---|---|---|---|---|
| Intercept | −4.701 | 0.418 | −5.520 | −3.882 |
| Male | 0.187 | 0.363 | −0.524 | 0.899 |
| FSM | 0.890 | 0.687 | −0.456 | 2.235 |
| At risk | −0.179 | 0.510 | −1.178 | 0.821 |
| Trial (if GBG) | −0.755 | 0.610 | −1.950 | 0.441 |
| School size | 0.145 | 0.194 | −0.236 | 0.525 |
| School FSM | 0.065 | 0.211 | −0.349 | 0.479 |
| Random part | ||||
| Variance (Intercept) | 0.276 | |||
| VPC | 0.077 | |||
Note. Bayesian Information Criterion (BIC) = 3844.33. GBG = Good Behavior Game; FSM = eligible for free school meals; VPC = Variance Partitioning Coefficient. Parameters were obtained via Maximum Likelihood using Mplus version 8 (Muthén & Muthén, 2017) called from the R package “MplusAutomation” (Hallquist & Wiley, 2018).
Random part of the full multivariate multilevel non-linear growth curve model for concentration problems, prosocial behavior and disruptive behavior.
| Level | Parameter | Post. mean | S.D. | 95% Cred. Int. | ESS | |
|---|---|---|---|---|---|---|
| Between schools | Variance (Intercept concentration) | 0.028 | 0.007 | 0.017 | 0.044 | 24,749 |
| Covariance (Concentration, Disruptive) | 0.026 | 0.007 | 0.015 | 0.041 | 31,158 | |
| Variance (Intercept disruptive) | 0.040 | 0.008 | 0.026 | 0.059 | 40,698 | |
| Covariance (Concentration, Prosocial) | −0.034 | 0.008 | −0.052 | −0.021 | 35,511 | |
| Covariance (Disruptive, Prosocial) | −0.033 | 0.008 | −0.052 | −0.019 | 46,303 | |
| Variance (Intercept prosocial) | 0.058 | 0.012 | 0.039 | 0.085 | 54,959 | |
| Between children | Variance (Intercept concentration) | 0.363 | 0.017 | 0.332 | 0.397 | 11,807 |
| Covariance (Concentration, Disruptive) | 0.115 | 0.010 | 0.097 | 0.135 | 5919 | |
| Variance (Intercept disruptive) | 0.129 | 0.009 | 0.112 | 0.148 | 4066 | |
| Covariance (Concentration, Prosocial) | −0.178 | 0.012 | −0.203 | −0.155 | 6002 | |
| Covariance (Disruptive, Prosocial) | −0.100 | 0.009 | −0.118 | −0.083 | 3754 | |
| Variance (Intercept prosocial) | 0.148 | 0.012 | 0.125 | 0.172 | 3180 | |
| Covariance(Intercept concentration, time concentration) | −0.002 | 0.004 | −0.010 | 0.005 | 3970 | |
| Covariance(Intercept disruptive, time concentration) | 0.016 | 0.003 | 0.011 | 0.021 | 2668 | |
| Covariance(Intercept prosocial, time concentration) | −0.003 | 0.003 | −0.008 | 0.004 | 2455 | |
| Variance(time concentration) | 0.008 | 0.001 | 0.006 | 0.011 | 2216 | |
| Covariance(Intercept concentration, time disruptive) | 0.016 | 0.004 | 0.009 | 0.023 | 5166 | |
| Covariance(Intercept disruptive, time disruptive) | 0.027 | 0.003 | 0.021 | 0.031 | 1928 | |
| Covariance(Intercept prosocial, time disruptive) | −0.014 | 0.003 | −0.019 | −0.007 | 2576 | |
| Covariance(time concentration, time disruptive) | 0.006 | 0.001 | 0.004 | 0.008 | 2834 | |
| Variance(time disruptive) | 0.014 | 0.001 | 0.012 | 0.017 | 3267 | |
| Covariance(Intercept concentration, time prosocial) | −0.014 | 0.004 | −0.021 | −0.006 | 3923 | |
| Covariance(Intercept disruptive, time prosocial) | −0.020 | 0.003 | −0.025 | −0.014 | 2276 | |
| Covariance(Intercept prosocial, time prosocial) | 0.017 | 0.003 | 0.010 | 0.022 | 1596 | |
| Covariance(time concentration, time prosocial) | −0.005 | 0.001 | −0.008 | −0.003 | 2042 | |
| Covariance(time disruptive, time prosocial) | −0.009 | 0.001 | −0.012 | −0.007 | 2943 | |
| Variance(time prosocial) | 0.011 | 0.002 | 0.008 | 0.014 | 2222 | |
| Within children | Variance (Intercept concentration) | 0.382 | 0.006 | 0.370 | 0.394 | 12,395 |
| Covariance (Concentration, Disruptive) | 0.136 | 0.004 | 0.128 | 0.145 | 14,135 | |
| Variance (Intercept disruptive) | 0.361 | 0.006 | 0.350 | 0.372 | 14,503 | |
| Covariance (Concentration, Prosocial) | −0.251 | 0.006 | −0.262 | −0.240 | 13,504 | |
| Covariance (Disruptive, Prosocial) | −0.213 | 0.005 | −0.223 | −0.202 | 14,738 | |
| Variance (Intercept prosocial) | 0.531 | 0.008 | 0.516 | 0.547 | 16,761 | |