IntroductionAt the peak of Uganda’s first wave of SARS-CoV-2 in May 2020, one in three COVID-19 c... more IntroductionAt the peak of Uganda’s first wave of SARS-CoV-2 in May 2020, one in three COVID-19 cases was linked to the haulage sector. This triggered a mandatory requirement for a negative PCR test result at all ports of entry and exit, resulting in significant delays as haulage drivers had to wait for 24–48 hours for results, which severely crippled the regional supply chain.To support public health and economic recovery, we aim to develop and test a mobile phone-based digital contact tracing (DCT) tool that both augments conventional contact tracing and also increases its speed and efficiency.Methods and analysisTo test the DCT tool, we will use a stratified sample of haulage driver journeys, stratified by route type (regional and local journeys).We will include at least 65% of the haulage driver journeys ~83 200 on the network through Uganda. This allows us to capture variations in user demographics and socioeconomic characteristics that could influence the use and adoption of t...
Aim:The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervent... more Aim:The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervention on secondary students’ ability to assess health‐related claims and make informed choices.Methods:In a cluster‐randomized trial, we randomized 80 secondary schools (students aged 13–17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2‐day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple‐choice questions for each concept to evaluate the students’ ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly).Results:Eighty schools consented and were randomly allocated. A total of 2477 students in the 40 intervention s...
AimThe aim of this prospective meta‐analysis was to synthesize the results of three cluster‐rando... more AimThe aim of this prospective meta‐analysis was to synthesize the results of three cluster‐randomized trials of an intervention designed to teach lower‐secondary school students (age 14–16) to think critically about health choices.MethodsWe conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2‐ to 3‐day teacher training workshop, digital resources, and ten 40‐min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple‐choice questions answered correctly). We performed random effects meta‐analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers.ResultsAltogether, 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 overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; p < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score.ConclusionsThe intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score.
Background Learning to thinking critically about health information and choices can protect peopl... more Background Learning to thinking critically about health information and choices can protect people from unnecessary suffering, harm, and resource waste. Earlier work revealed that children can learn these skills, but printing costs and curricula compatibility remain important barriers to school implementation. We aimed to develop a set of digital learning resources for students to think critically about health that were suitable for use in Kenyan, Rwandan, and Ugandan secondary schools. Methods We conducted work in two phases collaborating with teachers, students, schools, and national curriculum development offices using a human-centered design approach. First, we conducted context analyses and an overview of teaching strategies, prioritised content and collected examples. Next, we developed lessons and guidance iteratively, informed by data from user-testing, individual and group interviews, and school pilots. Results Final resources include online lesson plans, teachers’ guide, a...
ObjectiveMost health literacy measures rely on subjective self-assessment. The Critical Thinking ... more ObjectiveMost health literacy measures rely on subjective self-assessment. The Critical Thinking about Health Test is an objective measure that includes two multiple-choice questions (MCQs) for each of the nine Informed Health Choices Key Concepts included in the educational resources for secondary schools. The objective of this study was to determine cut-off scores for passing (the border between having and not having a basic understanding and the ability to apply the nine concepts) and mastery (the border between having mastered and not having mastered them).DesignUsing a combination of two widely used methods: Angoff’s and Nedelsky’s, a panel judged the likelihood that an individual on the border of passing and another on the border of having mastered the concepts would answer each MCQ correctly. The cut-off scores were determined by summing up the probability of answering each MCQ correctly. Their independent assessments were summarised and discussed. A nominal group technique w...
Zenodo (CERN European Organization for Nuclear Research), Jul 21, 2022
al. Use of the Informed Health Choices digital resources for teaching lower secondary school stud... more al. Use of the Informed Health Choices digital resources for teaching lower secondary school students in Rwanda to think critically about health: protocol for a process evaluation (Version 3). IHC Working Paper. 2022.
Zenodo (CERN European Organization for Nuclear Research), May 19, 2022
Background The Informed Health Choices (IHC) Key Concepts are principles for thinking critically ... more Background The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. 1 The Key Concepts provide a framework for designing curricula, learning and teaching resources, and evaluation tools.
Zenodo (CERN European Organization for Nuclear Research), May 19, 2022
BRIEF NAME 1. INTERVENTION: Be smart about your health secondary school resources We will conduct... more BRIEF NAME 1. INTERVENTION: Be smart about your health secondary school resources We will conduct a cluster randomised trial to compare use of the Be smart about your health secondary school resources (intervention) to routine teaching (control) in lower secondary schools in Kenya, Rwanda, and Uganda. WHY-this educational process 2. THEORY: The Be smart about your health secondary school resources are based on the Informed Health Choices (IHC) Key Concepts framework. The framework includes concepts (principles) that people should understand and apply when deciding whether to believe a claim about the effects of health actions (things that people do to care for their health or the health of others) and what to do. 3 4 The framework is based on evidence of the importance of the included concepts, logic, feedback, other relevant frameworks, and adaptation of the IHC Key Concepts to other types of interventions such as educational, environmental, and policing interventions. 3-5
Zenodo (CERN European Organization for Nuclear Research), Jul 28, 2022
et al. Effect of the Informed Health Choices digital secondary school resources on the ability of... more et al. Effect of the Informed Health Choices digital secondary school resources on the ability of lower secondary students in Kenya to critically appraise health claims: protocol for a process evaluation (Version 5). IHC Working paper. 2022.
BackgroundThe Informed Health Choices Key Concepts are principles for thinking critically about h... more BackgroundThe Informed Health Choices Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools.ObjectivesTo prioritise which of the 49 Key Concepts to include in resources for lower-secondary schools in East Africa.MethodsTwelve judges used an iterative process to reach a consensus. The judges were curriculum specialists, teachers, and researchers from Kenya, Uganda, and Rwanda. After familiarising themselves with the concepts, they pilot tested draft criteria for selecting and ordering the concepts. After agreeing on the criteria, nine judges independently assessed all 49 concepts and reached an initial consensus. We sought feedback on the draft consensus from teachers and other stakeholders. After considering the feedback, nine judges independently reassessed the prioritised concepts and reached a consensus. The final set of concepts wa...
An overview of what is known from systematic reviews of the effects of teaching strategies can in... more An overview of what is known from systematic reviews of the effects of teaching strategies can inform the design of learning resources and decisions about which teaching strategies to use. We are undertaking this overview to inform decisions about which teaching strategies to use to teach critical thinking to primary and secondary school students.
The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healt... more The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools. The objective of this study is to prioritise which of the 49 IHC Key Concepts to include in learning resources that we are developing for lower secondary schools in East Africa, and to determine the order in which the concepts should be learned, and the competences and dispositions needed to use those Key Concepts.
Additional file 2: Table S1. Results for each concept one year after listening to the podcast. Ta... more Additional file 2: Table S1. Results for each concept one year after listening to the podcast. Table S2. Intended behaviours. Table S3. Self-efficacy. Table S4. Self-reported behaviour - awareness of treatment claims. Table S5. Self-reported behaviour - assessment of the basis of treatment claims. Table S6. Self-reported behaviour - assessment of trustworthiness of treatment claims. Table S7. Self-reported behaviour - assessment of advantages and disadvantages of treatments. Table S8. Subgroup analyses - education. Table S9. Subgroup analyses - child in school that used IHC primary school resources. Table S10. Effect of IHC primary school resources on parents.
Zenodo (CERN European Organization for Nuclear Research), May 18, 2022
Higher level IHC concepts Included Key Concepts Claims Claims about effects that are not supporte... more Higher level IHC concepts Included Key Concepts Claims Claims about effects that are not supported by evidence from fair comparisons are not necessarily wrong, but there is an insufficient basis for believing them. Assumptions that treatments are safe or effective can be misleading.
Zenodo (CERN European Organization for Nuclear Research), Aug 12, 2022
BRIEF NAME: "Informed Health Choices (IHC) secondary school intervention" 1. Intervention: Inform... more BRIEF NAME: "Informed Health Choices (IHC) secondary school intervention" 1. Intervention: Informed Health Choices (IHC) secondary school resources The intervention, use of the IHC secondary school resources will be compared to routine practice (teaching according to the national lower-secondary school curriculum without intervening). WHY this educational process 2. Theory: The IHC secondary school resources are based on the IHC Key Concepts framework. The framework includes concepts (principles) that people should understand and apply when deciding whether to believe a claim about the effects of health actions (things that people do to care for their health or the health of others) and what to do. 2, 3 The framework is based on evidence of the importance of the included concepts, 4 logic, feedback, other relevant frameworks, 5 and adaptation of the IHC Key Concepts to other types of interventions such as educational, environmental, and policing interventions. 6 The resources were developed by the investigators between 2020 and 2022 using human-centred design methods. 7 This includes cycles of idea generation and prototyping, piloting with observation, user-testing with teachers and students, and feedback from teachers, students, and curriculum developers in Kenya, Rwanda, and Uganda, and an international advisory group. The aim of the design process was to ensure that teachers and students find the resources to be engaging, useful, and easy to use. The teaching strategies used in the resources are based in part on an overview of systematic reviews of teaching strategies, 8 and draw on several educational theories. These include social constructivist theory (which postulates that learning can be
Zenodo (CERN European Organization for Nuclear Research), May 31, 2022
Background: Many people find it difficult to make decisions about what to believe or do regarding... more Background: Many people find it difficult to make decisions about what to believe or do regarding "health actions" (things that they can do to care for their health or the health of others). To avoid being misled by unreliable information and to make good choices, people must be able to understand and apply some basic principles (concepts). The Informed Health Choices (IHC) secondary school resources are designed to help students learn and use nine of these concepts. This is a protocol for a prospective meta-analysis of three cluster-randomized trials in Kenya, Rwanda, and Uganda. Objective: To estimate the effect of using the IHC secondary school resources in addition to the standard curriculum compared to the standard curriculum in the context where the trial is conducted) on students' ability to think critically about health actions. Methods: The participants are lower secondary school students (age 14-16) and their teachers. The intervention is a 2-3-day teacher training workshop, a teachers' guide, and 10 40-minute lessons taught to the students during a single school term. The comparison is the standard curriculum in each country. The primary outcome measure is the Critical Thinking about Health (CTH) Test. The test is a measure of an individual's ability to understand and apply the nine key critical thinking concepts included in the lessons. It includes two multiplechoice questions for each concept. The primary outcome is the proportion of students with a passing score on the test. Secondary outcomes include the average score on the test, the proportion of students with a score that indicates mastery of the nine concepts, retention of what the students learned after one year, self-efficacy, intended behaviours, performance on standard, end-of-term examinations, and teachers' ability to understand and apply the nine concepts measured using the CTH Test. Overall effects will be estimated using inverse variance methods. We will use mixed effects models with individual student data to estimate variation in effects for the primary and first two secondary outcomes in relation to three potential effect modifiers: use of a projector version compared to a blackboard version of the lessons, class size, and student performance on end-of-term examinations prior to the intervention. Strengths and limitations: Strengths of this meta-analysis are that it is prospective, allowing for collaboration on the design of the trials and certainty that all eligible trials have been included. A limitation is that the review authors are both developing and evaluating the intervention, although there are efforts to minimise bias. * Missing values will be pooled with dislike a lot and dislike, very unhelpful and unhelpful, very difficult and difficult, or very little trust and little trust.
IntroductionAt the peak of Uganda’s first wave of SARS-CoV-2 in May 2020, one in three COVID-19 c... more IntroductionAt the peak of Uganda’s first wave of SARS-CoV-2 in May 2020, one in three COVID-19 cases was linked to the haulage sector. This triggered a mandatory requirement for a negative PCR test result at all ports of entry and exit, resulting in significant delays as haulage drivers had to wait for 24–48 hours for results, which severely crippled the regional supply chain.To support public health and economic recovery, we aim to develop and test a mobile phone-based digital contact tracing (DCT) tool that both augments conventional contact tracing and also increases its speed and efficiency.Methods and analysisTo test the DCT tool, we will use a stratified sample of haulage driver journeys, stratified by route type (regional and local journeys).We will include at least 65% of the haulage driver journeys ~83 200 on the network through Uganda. This allows us to capture variations in user demographics and socioeconomic characteristics that could influence the use and adoption of t...
Aim:The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervent... more Aim:The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervention on secondary students’ ability to assess health‐related claims and make informed choices.Methods:In a cluster‐randomized trial, we randomized 80 secondary schools (students aged 13–17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2‐day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple‐choice questions for each concept to evaluate the students’ ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly).Results:Eighty schools consented and were randomly allocated. A total of 2477 students in the 40 intervention s...
AimThe aim of this prospective meta‐analysis was to synthesize the results of three cluster‐rando... more AimThe aim of this prospective meta‐analysis was to synthesize the results of three cluster‐randomized trials of an intervention designed to teach lower‐secondary school students (age 14–16) to think critically about health choices.MethodsWe conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2‐ to 3‐day teacher training workshop, digital resources, and ten 40‐min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple‐choice questions answered correctly). We performed random effects meta‐analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers.ResultsAltogether, 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 overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; p < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score.ConclusionsThe intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score.
Background Learning to thinking critically about health information and choices can protect peopl... more Background Learning to thinking critically about health information and choices can protect people from unnecessary suffering, harm, and resource waste. Earlier work revealed that children can learn these skills, but printing costs and curricula compatibility remain important barriers to school implementation. We aimed to develop a set of digital learning resources for students to think critically about health that were suitable for use in Kenyan, Rwandan, and Ugandan secondary schools. Methods We conducted work in two phases collaborating with teachers, students, schools, and national curriculum development offices using a human-centered design approach. First, we conducted context analyses and an overview of teaching strategies, prioritised content and collected examples. Next, we developed lessons and guidance iteratively, informed by data from user-testing, individual and group interviews, and school pilots. Results Final resources include online lesson plans, teachers’ guide, a...
ObjectiveMost health literacy measures rely on subjective self-assessment. The Critical Thinking ... more ObjectiveMost health literacy measures rely on subjective self-assessment. The Critical Thinking about Health Test is an objective measure that includes two multiple-choice questions (MCQs) for each of the nine Informed Health Choices Key Concepts included in the educational resources for secondary schools. The objective of this study was to determine cut-off scores for passing (the border between having and not having a basic understanding and the ability to apply the nine concepts) and mastery (the border between having mastered and not having mastered them).DesignUsing a combination of two widely used methods: Angoff’s and Nedelsky’s, a panel judged the likelihood that an individual on the border of passing and another on the border of having mastered the concepts would answer each MCQ correctly. The cut-off scores were determined by summing up the probability of answering each MCQ correctly. Their independent assessments were summarised and discussed. A nominal group technique w...
Zenodo (CERN European Organization for Nuclear Research), Jul 21, 2022
al. Use of the Informed Health Choices digital resources for teaching lower secondary school stud... more al. Use of the Informed Health Choices digital resources for teaching lower secondary school students in Rwanda to think critically about health: protocol for a process evaluation (Version 3). IHC Working Paper. 2022.
Zenodo (CERN European Organization for Nuclear Research), May 19, 2022
Background The Informed Health Choices (IHC) Key Concepts are principles for thinking critically ... more Background The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. 1 The Key Concepts provide a framework for designing curricula, learning and teaching resources, and evaluation tools.
Zenodo (CERN European Organization for Nuclear Research), May 19, 2022
BRIEF NAME 1. INTERVENTION: Be smart about your health secondary school resources We will conduct... more BRIEF NAME 1. INTERVENTION: Be smart about your health secondary school resources We will conduct a cluster randomised trial to compare use of the Be smart about your health secondary school resources (intervention) to routine teaching (control) in lower secondary schools in Kenya, Rwanda, and Uganda. WHY-this educational process 2. THEORY: The Be smart about your health secondary school resources are based on the Informed Health Choices (IHC) Key Concepts framework. The framework includes concepts (principles) that people should understand and apply when deciding whether to believe a claim about the effects of health actions (things that people do to care for their health or the health of others) and what to do. 3 4 The framework is based on evidence of the importance of the included concepts, logic, feedback, other relevant frameworks, and adaptation of the IHC Key Concepts to other types of interventions such as educational, environmental, and policing interventions. 3-5
Zenodo (CERN European Organization for Nuclear Research), Jul 28, 2022
et al. Effect of the Informed Health Choices digital secondary school resources on the ability of... more et al. Effect of the Informed Health Choices digital secondary school resources on the ability of lower secondary students in Kenya to critically appraise health claims: protocol for a process evaluation (Version 5). IHC Working paper. 2022.
BackgroundThe Informed Health Choices Key Concepts are principles for thinking critically about h... more BackgroundThe Informed Health Choices Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools.ObjectivesTo prioritise which of the 49 Key Concepts to include in resources for lower-secondary schools in East Africa.MethodsTwelve judges used an iterative process to reach a consensus. The judges were curriculum specialists, teachers, and researchers from Kenya, Uganda, and Rwanda. After familiarising themselves with the concepts, they pilot tested draft criteria for selecting and ordering the concepts. After agreeing on the criteria, nine judges independently assessed all 49 concepts and reached an initial consensus. We sought feedback on the draft consensus from teachers and other stakeholders. After considering the feedback, nine judges independently reassessed the prioritised concepts and reached a consensus. The final set of concepts wa...
An overview of what is known from systematic reviews of the effects of teaching strategies can in... more An overview of what is known from systematic reviews of the effects of teaching strategies can inform the design of learning resources and decisions about which teaching strategies to use. We are undertaking this overview to inform decisions about which teaching strategies to use to teach critical thinking to primary and secondary school students.
The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healt... more The Informed Health Choices (IHC) Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools. The objective of this study is to prioritise which of the 49 IHC Key Concepts to include in learning resources that we are developing for lower secondary schools in East Africa, and to determine the order in which the concepts should be learned, and the competences and dispositions needed to use those Key Concepts.
Additional file 2: Table S1. Results for each concept one year after listening to the podcast. Ta... more Additional file 2: Table S1. Results for each concept one year after listening to the podcast. Table S2. Intended behaviours. Table S3. Self-efficacy. Table S4. Self-reported behaviour - awareness of treatment claims. Table S5. Self-reported behaviour - assessment of the basis of treatment claims. Table S6. Self-reported behaviour - assessment of trustworthiness of treatment claims. Table S7. Self-reported behaviour - assessment of advantages and disadvantages of treatments. Table S8. Subgroup analyses - education. Table S9. Subgroup analyses - child in school that used IHC primary school resources. Table S10. Effect of IHC primary school resources on parents.
Zenodo (CERN European Organization for Nuclear Research), May 18, 2022
Higher level IHC concepts Included Key Concepts Claims Claims about effects that are not supporte... more Higher level IHC concepts Included Key Concepts Claims Claims about effects that are not supported by evidence from fair comparisons are not necessarily wrong, but there is an insufficient basis for believing them. Assumptions that treatments are safe or effective can be misleading.
Zenodo (CERN European Organization for Nuclear Research), Aug 12, 2022
BRIEF NAME: "Informed Health Choices (IHC) secondary school intervention" 1. Intervention: Inform... more BRIEF NAME: "Informed Health Choices (IHC) secondary school intervention" 1. Intervention: Informed Health Choices (IHC) secondary school resources The intervention, use of the IHC secondary school resources will be compared to routine practice (teaching according to the national lower-secondary school curriculum without intervening). WHY this educational process 2. Theory: The IHC secondary school resources are based on the IHC Key Concepts framework. The framework includes concepts (principles) that people should understand and apply when deciding whether to believe a claim about the effects of health actions (things that people do to care for their health or the health of others) and what to do. 2, 3 The framework is based on evidence of the importance of the included concepts, 4 logic, feedback, other relevant frameworks, 5 and adaptation of the IHC Key Concepts to other types of interventions such as educational, environmental, and policing interventions. 6 The resources were developed by the investigators between 2020 and 2022 using human-centred design methods. 7 This includes cycles of idea generation and prototyping, piloting with observation, user-testing with teachers and students, and feedback from teachers, students, and curriculum developers in Kenya, Rwanda, and Uganda, and an international advisory group. The aim of the design process was to ensure that teachers and students find the resources to be engaging, useful, and easy to use. The teaching strategies used in the resources are based in part on an overview of systematic reviews of teaching strategies, 8 and draw on several educational theories. These include social constructivist theory (which postulates that learning can be
Zenodo (CERN European Organization for Nuclear Research), May 31, 2022
Background: Many people find it difficult to make decisions about what to believe or do regarding... more Background: Many people find it difficult to make decisions about what to believe or do regarding "health actions" (things that they can do to care for their health or the health of others). To avoid being misled by unreliable information and to make good choices, people must be able to understand and apply some basic principles (concepts). The Informed Health Choices (IHC) secondary school resources are designed to help students learn and use nine of these concepts. This is a protocol for a prospective meta-analysis of three cluster-randomized trials in Kenya, Rwanda, and Uganda. Objective: To estimate the effect of using the IHC secondary school resources in addition to the standard curriculum compared to the standard curriculum in the context where the trial is conducted) on students' ability to think critically about health actions. Methods: The participants are lower secondary school students (age 14-16) and their teachers. The intervention is a 2-3-day teacher training workshop, a teachers' guide, and 10 40-minute lessons taught to the students during a single school term. The comparison is the standard curriculum in each country. The primary outcome measure is the Critical Thinking about Health (CTH) Test. The test is a measure of an individual's ability to understand and apply the nine key critical thinking concepts included in the lessons. It includes two multiplechoice questions for each concept. The primary outcome is the proportion of students with a passing score on the test. Secondary outcomes include the average score on the test, the proportion of students with a score that indicates mastery of the nine concepts, retention of what the students learned after one year, self-efficacy, intended behaviours, performance on standard, end-of-term examinations, and teachers' ability to understand and apply the nine concepts measured using the CTH Test. Overall effects will be estimated using inverse variance methods. We will use mixed effects models with individual student data to estimate variation in effects for the primary and first two secondary outcomes in relation to three potential effect modifiers: use of a projector version compared to a blackboard version of the lessons, class size, and student performance on end-of-term examinations prior to the intervention. Strengths and limitations: Strengths of this meta-analysis are that it is prospective, allowing for collaboration on the design of the trials and certainty that all eligible trials have been included. A limitation is that the review authors are both developing and evaluating the intervention, although there are efforts to minimise bias. * Missing values will be pooled with dislike a lot and dislike, very unhelpful and unhelpful, very difficult and difficult, or very little trust and little trust.
Uploads
Papers by Allen Nsangi