Prevention Science

, Volume 15, Supplement 1, pp 6-18

First online:

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

  • Sheppard G. KellamAffiliated withDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University Email author 
  • , Wei WangAffiliated withDepartment of Epidemiology & Biostatistics, College of Public Health, University of South Florida
  • , Amelia C. L. MackenzieAffiliated withDivision of Reproductive Biology, Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University
  • , C. Hendricks BrownAffiliated withCenter for Prevention Implementation Methodology, Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
  • , Danielle C. OmpadAffiliated withDepartment of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education, and Human Development, New York University
  • , Flora OrAffiliated withDepartment of Mental Health Bloomberg School of Public Health, Johns Hopkins University
  • , Nicholas S. IalongoAffiliated withDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University
  • , Jeanne M. PoduskaAffiliated withAmerican Institutes for Research
  • , Amy WindhamAffiliated withAmerican Institutes for Research

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The Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985–1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19–21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. 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, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors.


Good Behavior Game Developmental epidemiology Universal prevention programs Classroom behavior management Drug abuse Condom use Age of sex onset Number of sexual partners High-risk sexual behaviors Mixed effects modeling