4 215 MENTAL HEALTH OUTCOMES OF APPLIED GAME MINDLIGHT Improvement in Mental Health Outcomes over Time Table 4 presents the change in secondary outcomes and 95% CIs for both intervention programs over the course of the study. It shows that noninferiority of MindLight to CBT could be demonstrated at post-test, 3-months follow-up and 6-months follow-up for social self-efficacy, emotional selfefficacy, academic self-efficacy and internalising problems. For externalising problems, non-inferiority could only be shown at 3-months follow-up. At posttest and 6-months follow-up, the CI lay entirely to the right of zero, indicating significant differences in favour of CBT. The results are visualized in Figure 2 (self-efficacy), Figure 3 (internalising problems), and Figure 4 (externalising problems). Results from these analyses in the completers only sample were similar and are available in Appendix A. To define the growth function that best reflected children’s change in social, emotional and academic self-efficacy, internalising problems, and externalising problems, we first fitted a linear growth model with intercept (i) and linear slope (s) as latent variables for all secondary outcomes separately in the intention-to-treat (ITT) sample. Most model fit indices showed acceptable fit (Appendix B), especially given our small sample size (Chen et al., 2008). The intercept and linear slope component were significant for all secondary outcomes (Table 5). This indicated that (1) children differed in their initial levels of social, emotional and academic self-efficacy, and internalising and externalising problems, (2) that their levels of social, emotional and academic self-efficacy increased (positive slope B), and that their levels of internalising and externalising problems decreased (negative slope B) significantly over time. The absence of significant variances of the slope reflects the idea that most children in our sample did change in a similar manner. Second, we added condition in the linear growth function. As expected, we did not find any differences in initial levels and rates of change of the secondary outcomes between conditions (Appendix C). Figure 5a shows the increase in emotional self-efficacy and Figure 5b shows the decrease in internalising and externalising problems separate by condition. The patterns in the other self-efficacy models were similar to the one presented in panel a. Results from the LGCM of the secondary outcomes in the completers only sample were similar and are available in Appendix D.
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