Browsing by Author "Chesire, Faith"

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    Contextualizing critical thinking about health using digital technology in secondary schools in Kenya: a qualitative analysis
    (Pilot and Feasibility Studies, 2022-10-06) Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Sewankambo, Nelson K.; Rosenbaum, Sarah
    Good health decisions depend on one’s ability to think critically about health claims and make informed health choices. Young people can learn these skills through school-based interventions, but learning resources need to be low-cost and built around lessons that can fit into existing curricula. As a first step to developing and evaluating digital learning resources that are feasible to use in Kenyan secondary schools, we conducted a context analysis to explore interest in critical thinking for health, map where critical thinking about health best fits in the curriculum, explore conditions for introducing new learning resources, and describe the information and communication technology (ICT) infrastructure available for teaching and learning.
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    One-year follow-up efects of the informed health choices secondary school intervention on students’ ability to think critically about health in Uganda: a cluster randomized trial
    (Trials, 2025) Ssenyonga, Ronald; Andrew, D. Oxman; Nakyejwe, Esther; Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Matt, Oxman; Christopher, James Rose; Sarah, E. Rosenbaum; Jenny, Moberg; Kaseje, Margaret; Nyirazinyoye, Laetitia; Astrid, Dahlgren; Simon, Lewin; Sewankambo, Nelson K.
    We assessed the effects of the Informed Health Choices (IHC) secondary school intervention on students’ ability to think critically about choices 1 year after the intervention. Methods We randomized eighty secondary schools to the intervention or control (usual curriculum). The schools were randomly selected from the central region of Uganda and included rural and urban, government, and privately-owned schools. One randomly selected class of year-2 students (ages 14–17) from each school participated in the trial. The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in classrooms during one school term (May–August 2022). The lessons addressed nine prioritized IHC concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to think critically about choices at both the end of the school term and again after 1 year. The primary outcome was the proportion of students with a passing score (≥ 9 of 18 questions answered correctly) on the “Critical Thinking about Health” (CTH) test. Results After 1-year, 71% (1749/2477) of the students in the intervention schools and 71% (1684/2376) of the students in the control schools completed the CTH test. In the intervention schools, 53% (934/1749) of students who completed the test had a passing score compared to 33% (557/1684) of students in the control schools (adjusted difference 22%, 95% CI 16–28). Conclusions The effect of the IHC secondary school intervention on students’ ability to assess health-related claims was largely sustained for at least 1 year.
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    Open Access Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Kenya: A Mixed Methods Study
    (Global Health: Science and Practice, 2024-01-20) Chesire, Faith; Kaseje, Margaret; Ssenyonga, Ronald; Simon, Lewin
    We evaluated the Informed Health Choices secondary school intervention to help students in Kenya think critically about health choices. We conducted this process evaluation to explore if the intervention was implemented as planned, identify factors that facilitated or hindered implementation, potential benefits of the intervention, and how to scale up the intervention beyond the trial This was a mixed methods process evaluation nested in a cluster-randomized trial of the Informed Health Choices intervention. We analyzed quantitative data from teacher training evaluation forms completed by 39 teachers, 10 lesson evaluation forms completed by 40 teachers allocated to the intervention, and 72 structured classroom observation forms. We conducted a framework analysis of qualitative data from 14 group interviews (with 96 students, 23 teachers, and 18 parents) and 22 individual interviews (with 8 teachers, 5 school principals, 6 curriculum developers, and 3 policymakers). We assessed confidence in our findings from the qualitative analysis using a modified version of Confidence in the Evidence from Reviews of Qualitative Research. Lesson objectives were achieved with minimal adaptations. Factors that might have facilitated the implementation of the intervention include teacher training; perceived value of the intervention by students, teachers, and policymakers; and support from school administration. Time constraints, teachers’ heavy workloads, and the lessons not being included in the curriculum or national examination are factors that might have impeded implementation. Both students and teachers demonstrated the ability to apply key concepts that were taught to health choices and other choices. However, they experienced difficulties with 2 of the lessons. Scale-up of this intervention in Kenyan schools is feasible but may depend on adjusting the time allocated to teaching the lessons, modifying the 2 lessons that teachers and students found difficult, and including the lesson objectives and assessment in the national curriculum.