Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, 1-year follow-up: a cluster-randomised trial

Abstract

Introduction: We evaluated an intervention designed to teach 10-to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report outcomes measured 1 year after the intervention. Methods: In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year 5 children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books and a teachers' guide). The primary outcomes, measured at the end of the school term and again after 1 year, were the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results: We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n = 60 schools; 76 teachers and 6383 children) or the control group (n = 60 schools; 67 teachers and 4430 children). After 1 year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared with 53.0% for the control schools (adjusted mean difference 16.7%; 95% CI, 13.9 to 19.5; P < 0.00001). In the intervention schools, 3160 (80.1%) of 3943 children who completed the test after 1 year achieved a predetermined passing score (≥ 13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference, 39.5%; 95% CI, 29.9 to 47.5). Conclusion: Use of the learning resources led to a large improvement in the ability of children to assess claims, which was sustained for at least 1 year.

Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about treatment effects: one-year follow up of a randomised trial

“…When new cognitive skills are learned, it may take a A passing score for the children was 13 or more correct answers out of 24 questions, and a mastery score was 20 or more correct answers out of 24 questions. A passing score for the parents was11 or more correct answers out of 18 questions, and a mastery score was 15 or more correct answers out of 18 questions b 10,183 children completed the first test at the end of the term when the lessons were taught in the Informed Health Choices (IHC) primary school trial [44], and 6787 completed the second test after 1 year [45]. There were 561 parents who completed the first test in the IHC podcast trial after listening to the podcast and 523 completed the second test after 1 year c The intervention in the IHC primary school trial included a workshop for the teachers, a textbook, exercise book, teacher's guide, and nine 80-min lessons with reading, exercises and classroom activities.…”

“…So far as we are aware, this is the first randomised trial of the use of a podcast for non-formal education or health education, other than a podcast to aid weight loss [6,7,27,[37][38][39][40][41][42][43][44][45][46][47][48][49]. Few other interventions to improve the ability of non-health-professionals to think critically about treatments have been evaluated [35,36].…”

“…We also aimed to assess if and how parents were able to apply their newly learned key concepts in making decisions about treatments in the year following the intervention, and their intended behaviours going forward. The results of the sister studies -the 1year follow-up study of the primary school resources and process evaluations for the podcast and the primary school resources -are reported in companion articles elsewhere [45][46][47].…”

Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona

“…The first version of the "Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona" was published on 28 Nov 2019 [Martínez García 2019]. We will describe detail about preparations to adjust to the COVID19 in the publication of the results of the pilot study.…”

“…We have included relevant references to support the reasons for starting the IHC project in primary school children. The text now reads: "There are several reasons the IHC project started with primary school children: 1) children can learn about fair comparisons (controlled research) and critical appraisal (in some countries, teaching these basic capabilities is already part of the curriculum) , START 2020; 2) primary school interventions can reach a large population group, before many of them leave school [UNESCO 2019]; 3) compared to adults, children have more time to learn and show less resistance to change with regard to their beliefs, attitudes or behaviours [Vosniadou 2013]; 4) teaching children to think critically improves their academic performance [Oxman 2019]; and 5) learning how to think critically about claims about treatment effects can help them, once they become adults, to make decisions about their health and to contribute, as citizens or as health decision-makers, to develop and implement health policies . "…”