Evidence map›Paper›PMID 39478569›Full record

SynthesisTrials2024

Effects of the informed health choices secondary school intervention after 1 year: a prospective meta-analysis using individual participant data.

Faith Chesire, Michael Mugisha, Ronald Ssenyonga, Christopher J Rose, Allen Nsangi, Margaret Kaseje, Nelson K Sewankambo, Matt Oxman, Sarah E Rosenbaum, Jenny Moberg and 5 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Faith Chesire *Tropical Institute of Community Health and Development, Kisumu, Kenya.
Michael Mugisha *School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Ronald Ssenyonga *College of Health Sciences, Makerere University, Kampala, Uganda.
Christopher J RoseCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Allen NsangiCollege of Health Sciences, Makerere University, Kampala, Uganda.
Margaret KasejeTropical Institute of Community Health and Development, Kisumu, Kenya.
Nelson K SewankamboCollege of Health Sciences, Makerere University, Kampala, Uganda.
Matt OxmanCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Sarah E RosenbaumCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Jenny MobergCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Astrid DahlgrenFaculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Simon LewinCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Mahima VenkateswaranGlobal Health Cluster, Norwegian Institute of Public Health, Oslo, Norway.
Eleni PapadopoulouGlobal Health Cluster, Norwegian Institute of Public Health, Oslo, Norway.
Andrew D OxmanCentre for Epidemic Interventions Research, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway. oxman@online.no.ORCID http://orcid.org/0000-0002-5608-5061

Funding

Norges Forskningsråd 69006
6 · The paper itself

Abstract

backgroundCritical thinking about health choices is essential to avoid being misled by unreliable information and to use reliable information appropriately. The aim of this prospective meta-analysis was to synthesize the results of 1-year follow-up data from three cluster-randomized trials of an intervention designed to teach lower secondary school students to think critically about health choices. Only one other randomized trial has evaluated a school-based intervention to teach adolescents to think critically about health choices. That trial compared two teaching strategies to teach statistical reasoning. It did not assess long-term learning-retention.

methodsWe conducted the trials in Kenya, Rwanda, and Uganda. The intervention included providing a 2-3-day teacher training workshop and digital resources for ten lessons. The intervention 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 intervention effects. We calculated learning retention as the test results in the intervention schools after 1 year relative to just after the intervention, adjusted for chance.

resultsAltogether, 244 schools (11,344 students) took part in the three trials. Follow-up data was collected for 8298 students (73%). The overall odds ratio for the primary outcome after 1 year was 3.6 (95% CI: 1.9-7.1; p = 0.0001) in favor of the intervention, whereas it was 5.5 (95% CI: 3.0-10.2) just after the intervention. This corresponds to 25.6% (95% CI: 21.1-30.0%) more students in the intervention schools passing the test after 1 year versus 33.3% (95% CI: 28.7-37.8%) just after the intervention. Overall, 2273 (52.6%) of 4324 students in intervention schools had a passing score after 1 year compared to 3397 (58.1%) of 5846 students just after the intervention, indicating 88.3% learning retention.

conclusionsOne year after the intervention, we still found a positive effect on the ability of students to think critically about health choices, but 5.5% fewer students in the intervention schools had a passing score. The certainty of the evidence was also lower due to 27% of students being lost to follow-up.

trial registrationThe protocol for this prospective meta-analysis was registered with PROSPERO May 31, 2022, ID 336580. The three randomized trials were registered in the Pan African Clinical Trial Registry February 15, 2022, PACTR202203880375077; April 5, 2022, PACTR20220488391731; and April 14, 2022, PACTR202204861458660.

Indexed as

Choice BehaviorHealth EducationHealth Knowledge, Attitudes, PracticeAdolescentAdolescent BehaviorChildFemaleHumansKenyaMaleProspective StudiesRandomized Controlled Trials as TopicRetention, PsychologyRwandaSchool Health ServicesSchoolsAdolescentsCritical health literacyCritical thinkingHealth educationIndividual participant-level data meta-analysisProspective meta-analysisSecondary school

Identifiers

PMID39478569
PMCPMC11523815

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.