Open Access Journal

ISSN: 2183-2803

Article | Open Access

An Exploratory, Cluster Randomised Control Trial of the PAX Good Behaviour Game

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Abstract:  This article presents the findings of an exploratory randomised controlled trial of the PAX Good Behaviour Game (PAX GBG) in Northern Ireland. The PAX GBG is an evidence‐based universal prevention programme designed to improve mental health by increasing self‐regulation, academic engagement, and decreasing disruptive behaviour in children. The study was designed in line with the Medical Research Council guidance on the development of complex interventions and is based on the Medical Research Council framework, more specifically within a Phase 2 exploratory trial. The study used a cluster randomised controlled trial design with a total of 15 schools (19 classes) randomised to intervention and control. This article reports specifically on the outcome of self‐regulation with 355 elementary school pupils in year 3 (age M = 7.40, SD = 0.30). Participating schools in the trial were located in areas of socio‐economic disadvantage. The teachers in the intervention group received training in the delivery of the PAX GBG and implemented the PAX GBG intervention for 12 weeks. A range of pre‐ and post‐test measures, including child reported behaviours, were undertaken. After the 12 weeks of implementation, this exploratory trial provided some evidence that the PAX GBG may help improve self‐regulation (d = .42) in participating pupils, while the findings suggest that it may offer a feasible mental health prevention and early intervention approach for Northern Ireland classrooms. However, a larger definitive trial would be needed to verify the findings in this study.

Keywords:  elementary school; good behaviour game; mental health; primary school; self‐regulation; students behaviour; universal prevention


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© Joanne O'Keeffe, Allen Thurston, Allen Thurston, Frank Kee, Frank Kee, Liam O'Hare, Liam O'Hare, Katrina Lloyd, Katrina Lloyd. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 license (, which permits any use, distribution, and reproduction of the work without further permission provided the original author(s) and source are credited.