Evidence map›Paper›PMID 40197504›Full record

Trial reportTrials2025

Effects of the Informed Health Choices secondary school intervention on the ability of lower secondary students in Kenya to think critically about health choices: 1-year follow-up of a cluster-randomized trial.

Faith Chesire, Margaret Kaseje, Violet Gisore, Michael Mugisha, Ronald Ssenyonga, Matt Oxman, Allen Nsangi, Daniel Semakula, Christopher James Rose, Laetitia Nyirazinyoye and 5 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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 ChesireTropical Institute of Community Health and Development, P.O. Box 4074 - 40103, Kondele, Kisumu, Kenya. faithchelagat@gmail.com.ORCID http://orcid.org/0000-0002-2806-9267
Margaret KasejeTropical Institute of Community Health and Development, P.O. Box 4074 - 40103, Kondele, Kisumu, Kenya.
Violet GisoreTropical Institute of Community Health and Development, P.O. Box 4074 - 40103, Kondele, Kisumu, Kenya.
Michael MugishaInstitute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Ronald SsenyongaInstitute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Matt OxmanCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.
Allen NsangiMakerere University, College of Health Sciences, Kampala, Uganda.
Daniel SemakulaMakerere University, College of Health Sciences, Kampala, Uganda.
Christopher James RoseCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.
Laetitia NyirazinyoyeSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Simon LewinCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.
Nelson K SewankamboMakerere University, College of Health Sciences, Kampala, Uganda.
Sarah RosenbaumCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.
Jenny MobergCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.
Andrew D OxmanCentre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway.

Funding

Norwegian Institute of Public Health 284683
6 · The paper itself

Abstract

introductionThe Informed Health Choices (IHC) secondary school intervention aimed to teach students to assess claims about treatments. This follow-up of a cluster randomized trial assessed the retention of knowledge and the application of the nine prioritized IHC key concepts 1 year after the intervention.

methodsWe conducted a random assignment of 80 secondary schools in Western Kenya into either the intervention (n = 40) or control (n = 40) group. Both groups adhered to the standard curriculum. Teachers from the intervention group were invited to participate in a 2-day training workshop and were granted access to "Be Smart About Your Health" digital resources, comprising 10 lessons. These lessons, focused on nine prioritized IHC concepts, delivered over a single school term from May to August 2022. The digital resources were accessible online via smartphones or computers and could also be downloaded for offline use. The primary outcome measure, assessed at the end of the school term and again after 1 year, was the percentage of students achieving a passing score (defined as ≥ 9 out of 18 correct answers) on the "Critical Thinking about Health" test.

resultsOut of the total 3360 students involved in the trial, 2446 (72.8%) completed the test after 1 year. Within the intervention group, 728 out of 1369 students (53.2%) achieved a passing score after 1 year, compared to 61.7% immediately post-intervention. In contrast, in the control group, 347 out of 1077 students (32.2%) had a passing score after 1 year. The adjusted difference in passing rates between the intervention and control groups after 1 year was 20.8% (with a 95% confidence interval of 13.6 to 28.0%), compared to 27.3% (with a 95% confidence interval of 19.6 to 34.9%) immediately after the intervention.

conclusionThis study demonstrates that students were able to retain knowledge and the ability to apply the IHC key concepts, 1 year after the intervention. But fewer students in the intervention group had a passing score after 1 year compared to just after the intervention. Highlighting follow-up training is likely necessary to reinforce these skills over time.

trial registrationPan African Clinical Trial Registry, trial identifier: PACTR202204883917313. Registered on 05/04/2022.

Indexed as

Adolescent BehaviorChoice BehaviorHealth EducationHealth Knowledge, Attitudes, PracticeSchool Health ServicesStudentsThinkingAdolescentFemaleFollow-Up StudiesHumansKenyaMaleSchoolsTime FactorsCritical health literacyCritical thinkingHealth informationKenyaSecondary school curriculumTreatment claims

Identifiers

PMID40197504
PMCPMC11978177

What OpenQuestion holds

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Registered trials

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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.