Moderators of an intervention on emotional and behavioural problems: household- and school-level parental education

Nil Horoz*, J. Marieke Buil, Susanne Koot, Frank J. van Lenthe, Tanja A.J. Houweling, Joost Oude Groeniger, Hans M. Koot, Pol A.C. van Lier

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Children of lower-educated parents and children in schools with a relatively high percentage of peers with lower-educated parents (lower parental education schools) are more likely to develop emotional and behavioural problems compared to children in higher-educated households and schools. Universal school-based preventive interventions, such as the Good Behaviour Game (GBG), are generally effective in preventing the development of emotional and behavioural problems, but information about potential moderators is limited. This study examined whether the effectiveness of the GBG in preventing emotional and behavioural problems differs between children in lower- and higher-educated households and schools.

METHODS: Using a longitudinal multi-level randomized controlled trial design, 731 children (Mage=6.02 towards the end of kindergarten) from 31 mainstream schools (intervention arm: 21 schools, 484 children; control arm: 10 schools, 247 children) were followed annually from kindergarten to second grade (2004-2006). The GBG was implemented in first and second grades.

RESULTS: Overall, the GBG prevented the development of emotional and behavioural problems. However, for emotional problems, the GBG-effect was slightly more pronounced in higher parental education schools than in lower parental education schools (Bhigher parental education schools =-0.281, P <0.001; Blower parental education schools =-0.140, P = 0.016). No moderation by household-level parental education was found.

CONCLUSIONS: Studies into universal school-based preventive interventions, and in particular the GBG, should consider and incorporate school-level factors when studying the effectiveness of such interventions. More attention should be directed towards factors that may influence universal prevention effectiveness, particularly in lower parental education schools.

Original languageEnglish
Pages (from-to)864-870
Number of pages7
JournalEuropean journal of public health
Volume32
Issue number6
Early online date18 Oct 2022
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
This study was supported by a grant from the Netherlands Organization for Health Research and Development (ZonMw) (project No. 531003013) and by ZonMw Grants #26200002 and #120620029.T.A.J.H. was funded through a grant awarded by the Norwegian Research Council (project number 288638) to the Centre for Global Health Inequalities Research (CHAIN) at the Norwegian University for Science and Technology (NTNU).

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.

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