Secondary school resources

Anyone can use these resources for free.

We created them be easy to use in any setting. The learning goals are based on explicit, transparent principles for assessing health claims and thinking critically about choices (a set of IHC Key Concepts), and can therefore be mapped onto existing curricula. We’ve embedded examples of conditions and treatments that are relevant for young people in general, and added an Example collection so teachers can easily find other examples.

All IHC resources are free to adapt for non-commercial use under the following Creative Commons license: Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)

Contact us if you want to produce an adaptation or translation.

We evaluated the effect of the resources in randomised trials in Kenya, Rwanda, and Uganda in 2022, and analysed the combined results from these three trials. The research shows that these resources demonstrated a clear effect on students ability to assess claims and use that knowledge to make informed choices.

Follow-up studies will explore students’ knowledge and experience after one year. We are also exploring transfer of learning, potential for adverse effects, and issues related to implementation and scaling up in process evaluations (manuscripts under development).

We developed these secondary school resources between 2019 and 2022, using a human-centred design approach with several cycles of prototyping, pilot testing and feedback from students, teachers, curriculum developers and other stakeholders in Kenya, Rwanda, and Uganda.

See video about how we work when developing resources.

The following 9 Key Concepts formed the basis of the Be Smart About Your Health resources for secondary schools:

Concepts about claims:

• Messages that ignore harms
• Messages that exaggerate effects
• Trust in personal experiences
• Belief that commonly-used means effective
• Belief that new is better
• Messages with no comparison

Concepts about evidence:

• Similar comparison groups
• Small studies

Concepts about choices:

• Benefits and harms

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

We developed and evaluated these educational resources for secondary school in a research project funded by the Norwegian Research Council (Project number 284683). See project overview: Enabling sustainable public engagement in improving health and health equity (CHOICE) – Overview

Research articles

Stakeholder engagement (pending, expected in late 2024)

Context analyses

Chesire F, Ochieng M, Mugisha M, Ssenyonga R, Oxman M, Nsangi A, et al. Contextualizing critical thinking about health using digital technology in secondary schools in Kenya: a qualitative analysis. Pilot Feasibility Stud. 2022;8(1):227.  (See also protocol)

Ssenyonga R, Sewankambo NK, Mugagga SK, Nakyejwe E, Chesire F, Mugisha M, et al. Learning to think critically about health using digital technology in Ugandan lower secondary schools: a contextual analysis. PLoS One. 2022;17(2):e0260367.

Mugisha M, Uwitonze AM, Chesire F, Senyonga R, Oxman M, Nsangi A, 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):e0248773.

Prioritisation of key concepts

Agaba JJ, Chesire F, Mugisha M, Nandi P, Njue J, Nsangi A, et al. Prioritisation of Informed Health Choices (IHC) Key Concepts to be included in lower-secondary school resources: a consensus study. PLoS One. 2023;18(4):e0267422.  (See also protocol)

Teaching strategies

Oxman AD, Dahlgren A, Garcia Marti S, Kaseje M, Nsangi A, Rosenbaum S, et al. The effects of teaching strategies on learning to think critically in primary and secondary schools: protocol for an overview of systematic reviews. IHC Working Paper. 2019.

Development of the intervention (educational resources)

Rosenbaum S, Moberg J, Chesire F, Mugisha M, Ssenyonga R, et al. Teaching critical thinking about health information and choices in secondary schools: human-centred design of digital resources. F1000Research. 2023 May 11;12:481.  (See also protocol)

Evaluation of the intervention

Chesire F, Kaseje M, Ochieng M, Ngatia B, Mugisha M, Ssenyonga R, et al. Effects of the informed health choices secondary school intervention on the ability of students in Kenya to think critically about health choices: A cluster-randomized trial. J Evid Based Med. 2023

Mugisha M, Nyirazinyoye L, Simbi CMC, Chesire F, Senyonga R, Oxman M, et al. 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. J Evid Based Med. 2023

Ssenyonga R, Oxman AD, Nakyejwe E, Chesire F, Mugisha M, Nsangi A, et al. Use of the informed health choices educational intervention to improve secondary students’ ability to think critically about health interventions in Uganda: A cluster-randomized trial. J Evid Based Med. 2023

Chesire F, Mugisha M, Ssenyonga R, Rose CJ, Nsangi A, Kaseje M, et al. Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis. J Evid Based Med. 2023:1-11.

Process evaluations

Chesire F, Kaseje M, Ochieng M, Mugisha M, Ssenyonga R, Oxman M, et al. Effect of the Informed Health Choices digital secondary school resources on the ability of lower secondary students in Kenya to critically appraise health claims: protocol for a process evaluation. IHC Working Paper; 2022.

Mugisha M, Nyirazinyoye L, Oxman AD, Simbi CMC, Chesire F, Ssenyonga R, et al. Use of the Informed Health Choices digital resources for teaching lower secondary school students in Rwanda to think critically about health: protocol for a process evaluation. IHC Working Paper; 2022.

Ssenyonga R, Lewin S, Nakyejwe E, Nsangi A, Semakula D, Chesire F, et al. Informed heath choices intervention to teach secondary school adolescents in Uganda to assess claims about treatment effects: a process evaluation protocol. IHC Working Paper; 2022.

Adverse effects

Oxman M, Oxman AD, Fretheim A, Lewin S. Participants’ and investigators’ experiences and views of potential adverse effects of an educational intervention: Protocol for a qualitative evidence synthesis. IHC Working Paper. 2023.

Key concepts for informed health choices

Oxman AD, Chalmers I, Dahlgren A. Key Concepts for Informed Health Choices: a framework for enabling people to think critically about health claims (Version 2022). IHC Working Paper; 2022.

One-year follow-up (pending, expected in late 2024)

PhD theses (pending, expected in late 2024)

Final report (pending, coming March 2024)