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Meta-Analysis
. 2023 Sep;16(3):321-331.
doi: 10.1111/jebm.12552. Epub 2023 Sep 21.

Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis

Faith Chesire  1   2 , Michael Mugisha  3   2 , Ronald Ssenyonga  4   2 , Christopher J Rose  5 , Allen Nsangi  4 , Margaret Kaseje  1 , Nelson K Sewankambo  4 , Matt Oxman  5 , Sarah E Rosenbaum  5 , Jenny Moberg  5 , Astrid Dahlgren  6 , Simon Lewin  5   7   8 , Andrew D Oxman  5
Affiliations
Meta-Analysis

Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis

Faith Chesire et al. J Evid Based Med. 2023 Sep.

Abstract

Aim: The 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.

Methods: We 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.

Results: 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 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.

Conclusions: The 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.

Keywords: adolescents; critical health literacy; critical thinking; health education; individual participant-level data meta-analysis; prospective meta-analysis; secondary school.

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References

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