Article type
Abstract
Background: There is a massive amount of information – including lots of misinformation – about what is good or bad for our health. Many people find it difficult to make decisions about what to believe or do.
Objectives: To design and evaluate educational resources that enable lower secondary school students (age 13-15) to think critically about health claims and choices.
Methods: We used a human-centered design approach to develop an educational intervention. We evaluated the effects of the intervention in cluster-randomized trials in Kenya, Rwanda, and Uganda. The intervention included a 2-3-day teacher training workshops and ten 40-minute lessons taught over 10 weeks. The primary outcome was a passing score on a test (≥9 of 18 multiple-choice questions answered correctly). We conducted a process evaluation alongside the trial to explore implementation and perceptions of the intervention.
Results: The Be Smart about Your Health resources are free to use and include 10 lesson plans for teaching nine key concepts that can help people assess claims about the effects of treatments and make informed health choices. Teachers can access the materials from a smartphone or other device. After first time visits, the content is also automatically accessible offline. Lessons are designed to be taught in classrooms equipped either with a projector or just a blackboard.
Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score.
The intervention was delivered largely as intended in all three countries. Factors that may have facilitated implementation included teacher training and the perceived value of the intervention. Time constraints, the lessons not being included in the curricula or national examinations may have impeded implementation.
Conclusions: The intervention led to a large improvement in the ability of students to think critically about health choices, but 42% of students in intervention schools did not achieve a passing score.
Objectives: To design and evaluate educational resources that enable lower secondary school students (age 13-15) to think critically about health claims and choices.
Methods: We used a human-centered design approach to develop an educational intervention. We evaluated the effects of the intervention in cluster-randomized trials in Kenya, Rwanda, and Uganda. The intervention included a 2-3-day teacher training workshops and ten 40-minute lessons taught over 10 weeks. The primary outcome was a passing score on a test (≥9 of 18 multiple-choice questions answered correctly). We conducted a process evaluation alongside the trial to explore implementation and perceptions of the intervention.
Results: The Be Smart about Your Health resources are free to use and include 10 lesson plans for teaching nine key concepts that can help people assess claims about the effects of treatments and make informed health choices. Teachers can access the materials from a smartphone or other device. After first time visits, the content is also automatically accessible offline. Lessons are designed to be taught in classrooms equipped either with a projector or just a blackboard.
Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score.
The intervention was delivered largely as intended in all three countries. Factors that may have facilitated implementation included teacher training and the perceived value of the intervention. Time constraints, the lessons not being included in the curricula or national examinations may have impeded implementation.
Conclusions: The intervention led to a large improvement in the ability of students to think critically about health choices, but 42% of students in intervention schools did not achieve a passing score.