Primary School Resources

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We evaluated the effects of these resources in Uganda, where we randomly allocated half of 120 schools (over 10,000 year-five students). Teachers taught the lessons over a period of nine weeks, with one double lesson (80 minutes) per week during a single term. We compared the ability of the children in those schools to apply 12 of the Key Concepts to the ability of the children in the other schools, and found a large positive effect.

In a follow-up study, we found that this effect was sustained after one year.

We developed the resources between 2013 and 2015, using a human-centred design approach with several cycles of prototyping, pilot testing and feedback from children, teachers and other stakeholders in Uganda, Kenya, Rwanda and Norway.

The following 12 Key Concepts formed the basis of IHC resources for primary schools (10-12 year olds):

Concepts about claims:

• Messages that ignore harms
• Trust in personal experiences
• Belief that commonly-used means effective
• Belief that new is better
• Trust in expert opinions
• Trust that there are no competing interests
• Messages with no comparison
• Belief in single studies

Concepts about evidence:

• Similar comparison groups
• Participants unaware of health action
• Small studies

Concepts about choices:

• Benefits and harms

In a structured process, we identified which Key Concepts were likely relevant and teachable to primary school students. See: Prioritization of concepts for primary school.

We developed and evaluated these primary school resources in a research project funded by the Norwegian Research Council.
See the final report.

Articles from this research project

Development of the key concepts

Nsangi A, Semakula D, Oxman AD, Sewankambo NK. Teaching children in low-income countries to assess claims about treatment effects: prioritization of key concepts. J Evid Based Med. 2015;8(4):173-80

Austvoll-Dahlgren A, Oxman AD, Chalmers I, Nsangi A, Glenton C, Lewin S, et al. Key concepts that people need to understand to assess claims about treatment effects. J Evid Based Med. 2015;8(3):112-25.

Chalmers I, Oxman AD, Austvoll-Dahlgren A, Ryan-Vig S, Pannell S, Sewankambo N, et al. Key Concepts for Informed Health Choices: a framework for helping people learn how to assess treatment claims and make informed choices. BMJ Evid Based Med. 2018;23(1):29-33.

Developing evaluation tools

Austvoll-Dahlgren A, Nsangi A, Semakula D. Interventions and assessment tools addressing key concepts people need to know to appraise claims about treatment effects: a systematic mapping review. Syst Rev. 2016;5(1):215.

Austvoll-Dahlgren A, Semakula D, Nsangi A, Oxman AD, Chalmers I, Rosenbaum S, et al. Measuring ability to assess claims about treatment effects: the development of the ‘Claim Evaluation Tools’. BMJ Open. 2017;7(5):e013184.

Austvoll-Dahlgren A, Guttersrud O, Nsangi A, Semakula D, Oxman AD, Group IHC. Measuring ability to assess claims about treatment effects: a latent trait analysis of items from the ‘Claim Evaluation Tools’ database using Rasch modelling. BMJ Open. 2017;7(5):e013185.

Semakula D, Nsangi A, Oxman AD, Sewankambo NK, Guttersrud Ø, Austvoll-Dahlgren A. Measuring ability to assess claims about treatment effects in English and Luganda: evaluation of multiple-choice questions from the “Claim Evaluation Tools” database using Rasch modelling. IHC Working Paper; 2017.

Davies A, Gerrity M, Nordheim L, Okebukola P, Opiyo N, Sharples J, et al. Measuring ability to assess claims about treatment effects: establishment of a standard for passing and mastery. IHC Working Paper; 2017.

Developing learning resources

Nsangi A, Semakula D, Rosenbaum SE, Oxman AD, Oxman M, Morelli A, et al. Development of the informed health choices resources in four countries to teach primary school children to assess claims about treatment effects: a qualitative study employing a user-centred approach. Pilot Feasibility Stud. 2020;6:18.

Evaluations

Nsangi A, Semakula D, Oxman AD, Austvoll-Dahlgren A, Oxman M, Rosenbaum S, et al. Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects: a cluster-randomised controlled trial. Lancet. 2017;390(10092):374-88.  (See also protocol)

Nsangi A, Semakula D, Oxman AD, Austvoll-Dahlgren A, Oxman M, Rosenbaum S, et al. Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, 1-year follow-up: a cluster-randomised trial. Trials. 2020;21(1):27.

Nsangi A, Semakula D, Glenton C, Lewin S, Oxman AD, Oxman M, et al. Informed health choices intervention to teach primary school children in low-income countries to assess claims about treatment effects: process evaluation. BMJ Open. 2019;9(9):e030787.  (See also protocol)

PhD dissertation

Nsangi A. An educational intervention to enable children to assess claims about the benefits and harms of treatments. Oslo: Faculty of Medicine, University of Oslo; 2020.

Additional resources developed in the same project:

• Manual for preparing a test or questionnaire based on the Claim Evaluation Tools database
• Guidance for contextualising resources
• IHC Podcast for parents
• IHC Glossary