Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;16(3):264-274.
doi: 10.1111/jebm.12551. Epub 2023 Sep 21.

Effects of the Informed Health Choices secondary school intervention on the ability of students in Rwanda to think critically about health choices: A cluster-randomized trial

Michael Mugisha  1   2 , Laetitia Nyirazinyoye  1 , Clarisse Marie Claudine Simbi  1 , Faith Chesire  2   3 , Ronald Senyonga  2   4 , Matt Oxman  5   6 , Allen Nsangi  4 , Daniel Semakula  4 , Christopher James Rose  5 , Jenny Moberg  5 , Astrid Dahlgren  6 , Margaret Kaseje  3 , Simon Lewin  5   7   8 , Nelson K Sewankambo  4 , Sarah Rosenbaum  5 , Andrew D Oxman  5
Affiliations

Effects of the Informed Health Choices secondary school intervention on the ability of students in Rwanda to think critically about health choices: A cluster-randomized trial

Michael Mugisha et al. J Evid Based Med. 2023 Sep.

Abstract

Aim: The aim of this trial was to evaluate the effects of the Informed Health Choices intervention on the ability of students in Rwandan to think critically and make Informed Health Choices.

Methods: We conducted a two-arm cluster-randomized trial in 84 lower secondary schools from 10 districts representing five provinces of Rwanda. We used stratified randomization to allocate schools to the intervention or control. One class in each intervention school had ten 40-min lessons taught by a trained teacher in addition to the usual curriculum. Control schools followed the usual curriculum. The primary outcome was a passing score (≥ 9 out of 18 questions answered correctly) for students on the Critical Thinking about Health Test completed within 2 weeks after the intervention. We conducted an intention-to-treat analysis using generalized linear mixed models, accounting for the cluster design using random intercepts.

Results: Between February 25 and March 29, 2022, we recruited 3,212 participants. We assigned 1,572 students and 42 teachers to the intervention arm and 1,556 students and 42 teachers to the control arm. The proportion of students who passed the test in the intervention arm was 915/1,572 (58.2%) compared to 302/1,556 (19.4%) in the control arm, adjusted odds ratio 10.6 (95% CI: 6.3-17.8), p < 0.0001, adjusted difference 37.2% (95% CI: 29.5%-45.0%).

Conclusions: The intervention is effective in helping students think critically about health choices. It was possible to improve students' ability to think critically about health in the context of a competence-based curriculum in Rwanda, despite challenging postpandemic conditions.

Keywords: Informed Health Choices; Rwanda; adolescents; critical health literacy; health literacy.

PubMed Disclaimer

References

REFERENCES

    1. Park E, Kwon M. Health-related internet use by children and adolescents: systematic review. J Med Internet Res. 2018;20(4):e120.
    1. Oxman M, Larun L, Pérez Gaxiola G, et al. Quality of information in news media reports about the effects of health interventions: systematic review and meta-analyses. F1000Research. 2021;10:433.
    1. Haber N, Smith ER, Moscoe E, et al. Causal language and strength of inference in academic and media articles shared in social media (CLAIMS): a systematic review. PLoS One. 2018;13(5):1-21.
    1. Dahlgren A, Furuseth-Olsen K, Rose CJ, Oxman AD. The Norwegian public's ability to assess treatment claims: results of a cross-sectional study of critical health literacy. F1000Research. 2021;9:179.
    1. Mugisha M, Uwitonze AM, Chesire F, et al. Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: a qualitative context analysis. PLoS One. 2021;16(3):1-18.