NRU :: Browsing by Author "Nsangi, Allen"

Browsing by Author "Nsangi, Allen"

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Can an educational podcast improve the ability of parents of primary school children to assess the reliability of claims made about the benefits and harms of treatments: study protocol for a randomised controlled trial
(Trials, 2017-01-21) Semakula, Daniel; Nsangi, Allen; Kaseje, Margaret; Sewankambo, Nelson K.
Claims made about the effects of treatments are very common in the media and in the population more generally. The ability of individuals to understand and assess such claims can affect their decisions and health outcomes. Many people in both low- and high-income countries have inadequate aptitude to assess information about the effects of treatments. As part of the Informed Healthcare Choices project, we have prepared a series of podcast episodes to help improve people’s ability to assess claims made about treatment effects. We will evaluate the effect of the Informed Healthcare Choices podcast on people’s ability to assess claims made about the benefits and harms of treatments. Our study population will be parents of primary school children in schools with limited educational and financial resources in Uganda.
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.
Development of mass media resources to improve the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about the effects of treatments: a human-centred design approach
(Pilot and Feasibility Studies, 2019-12-29) Semakula, Daniel; Nsangi, Allen; Kaseje, Margaret; Sewankambo, Nelson Kaulukusi
Claims about what we need to do to improve our health are everywhere. Most interventions simply tell people what to do, and do not empower them to critically assess health information. Our objective was to design mass media resources to enable the public to critically appraise the trustworthiness of claims about the benefits and harms of treatments and make informed health choices.
Does the use of the Informed Healthcare Choices (IHC) primary school resources improve the ability of grade-5 children in Uganda to assess the trustworthiness of claims about the effects of treatments: protocol for a cluster-randomised trial
(Trials, 2017-05-18) Nsangi, Allen; Semakula, Daniel; Rosenbaum, Sarah; Kaseje, Margaret; Sewankambo, Nelson K.
The ability to appraise claims about the benefits and harms of treatments is crucial for informed health care decision-making. This research aims to enable children in East African primary schools (the clusters) to acquire and retain skills that can help them make informed health care choices by improving their ability to obtain, process and understand health information. The trial will evaluate (at the individual participant level) whether specially designed learning resources can teach children some of the key concepts relevant to appraising claims about the benefits and harms of health care interventions (treatments).
Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about treatment effects: one-year follow up of a randomised trial
(Trials, 2020-02-14) Semakula, Daniel; Nsangi, Allen; Rosenbaum, Sarah; Sewankambo, Nelson K.
Earlier, we designed and evaluated an educational mass media intervention for improving people’s ability to think more critically and to assess the trustworthiness of claims (assertions) about the benefits and harms (effects) of treatments. The overall aims of this follow-up study were to evaluate the impact of our intervention 1 year after it was administered, and to assess retention of learning and behaviour regarding claims about treatments.
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, 2020-01-06) Nsangi, Allen; Semakula, Daniel; Rosenbaum, Sarah; Lewin, Simon; Sewankambo, Nelson K.
We evaluated an intervention designed to teach 10- to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report outcomes measured 1 year after the intervention. In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year 5 children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books and a teachers’ guide). The primary outcomes, measured at the end of the school term and again after 1 year, were the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n = 60 schools; 76 teachers and 6383 children) or the control group (n = 60 schools; 67 teachers and 4430 children). After 1 year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared with 53.0% for the control schools (adjusted mean difference 16.7%; 95% CI, 13.9 to 19.5; P < 0.00001). In the intervention schools, 3160 (80.1%) of 3943 children who completed the test after 1 year achieved a predetermined passing score (≥ 13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference, 39.5%; 95% CI, 29.9 to 47.5). Use of the learning resources led to a large improvement in the ability of children to assess claims, which was sustained for at least 1 year.
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, 2018-01-30) Chalmers, Iain; Oxman, Andrew D.; Sewankambo, Nelson; Semakula, Daniel; Nsangi, Allen; Heneghan, Carl; Douglas, Badenoch
Many claims about the effects of treatments, though well intentioned, are wrong. Indeed, they are sometimes deliberately misleading to serve interests other than the well-being of patients and the public. People need to know how to spot unreliable treatment claims so that they can protect themselves and others from harm. The ability to assess the trustworthiness of treatment claims is often lacking. Acquiring this ability depends on being familiar with, and correctly applying, some key concepts, for example, that’ association is not the same as causation.’ The Informed Health Choices (IHC) Project has identified 36 such concepts and shown that people can be taught to use them in decision making. A randomised trial in Uganda, for example, showed that primary school children with poor reading skills could be taught to apply 12 of the IHC Key Concepts. The list of IHC Key Concepts has proven to be effective in providing a framework for developing and evaluating IHC resources to help children to think critically about treatment claims. The list also provides a framework for retrieving, coding and organising other teaching and learning materials for learners of any age. It should help teachers, researchers, clinicians, and patients to structure critical thinking about the trustworthiness of claims about treatment effects.
Key concepts that people need to understand to assess claims about treatment effects
(Journal of evidence-based medicine, 2015-11-11) Austvoll-Dahlgren, Astrid; Nsangi, Allen; Semakula, Daniel; Sewankambo, Nelson
People are confronted with claims about the effects of treatments and health policies daily. Our objective was to develop a list of concepts that may be important for people to understand when assessing claims about treatment effects. An initial list of concepts was generated by the project team by identifying key concepts in literature and tools written for the general public, journalists, and health professionals, and consideration of concepts related to assessing the certainty of evidence for treatment effects. We invited key researchers, journalists, teachers and others with expertise in health literacy and teaching or communicating evidence-based health care to patients to act as the project's advisory groups. Twenty-nine members of the advisory group provided feedback on the list of concepts and judged the list to be sufficiently complete and organised appropriately. The list includes 32 concepts divided into six groups: (i) Recognising the need for systematic reviews of fair tests, (ii) Judging whether a comparison of treatments is fair comparison, (iii) Understanding the role of chance, (iv) Considering all the relevant fair comparisons, (v) Understanding the results of fair comparisons of treatments, (vi) Judging whether fair comparisons of treatments are relevant. The concept list provides a starting point for developing and evaluating resources to improve people's ability to assess treatment effects. The concepts are considered to be universally relevant, and include considerations that can help people assess claims about the effects of treatments, including claims that are found in mass media reports, in advertisements and in personal communication.
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, 2017-05-17) Austvoll-Dahlgren, Astrid; Nsangi, Allen; Semakula, Daniel; Oxman, Andrew D.
The Claim Evaluation Tools database contains multiple-choice items for measuring people’s ability to apply the key concepts they need to know to be able to assess treatment claims. We assessed items from the database using Rasch analysis to develop an outcome measure to be used in two randomised trials in Uganda. Rasch analysis is a form of psychometric testing relying on Item Response Theory. It is a dynamic way of developing outcome measures that are valid and reliable. To assess the validity, reliability and responsiveness of 88 items addressing 22 key concepts using Rasch analysis. We administrated four sets of multiple-choice items in English to 1114 people in Uganda and Norway, of which 685 were children and 429 were adults (including 171 health professionals). We scored all items dichotomously. We explored summary and individual fit statistics using the RUMM2030 analysis package. We used SPSS to perform distractor analysis. Most items conformed well to the Rasch model, but some items needed revision. Overall, the four item sets had satisfactory reliability. We did not identify significant response dependence between any pairs of items and, overall, the magnitude of multidimensionality in the data was acceptable. The items had a high level of difficulty. Most of the items conformed well to the Rasch model’s expectations. Following revision of some items, we concluded that most of the items were suitable for use in an outcome measure for evaluating the ability of children or adults to assess treatment claims.
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.
Prioritisation of Informed Health Choices (IHC) key concepts to be included in lower secondary school resources: A consensus study
(PLoS One, 2023-04-07) Agaba, Joseph Jude; Mugisha, Michael; Nsangi, Allen; Oxman, Andrew David
The Informed Health Choices Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools.
Priority setting for resources to improve the understanding of information about claims of treatment effects in the mass media
(Journal of Evidence-Based Medicine, 2015-05-08) Semakula, Daniel; Nsangi, Allen; Oxman, Andrew D.; Sewankambo, Nelson K.
Claims about benefits and harms of treatments are common in the media. We engaged health journalists in prioritizing concepts of evidence-based medicine that we believe the public needs to understand to be able to assess claims about treatment effects; and which could improve how journalists report such information. We conducted a three-day workshop with a group of Ugandan journalists in which we presented and explained the concepts. We asked journalists to prioritize groups of related concepts using four pre-specified criteria i.e. relevance of the concepts to journalists and their audiences; ease of comprehension; feasibility of developing resources for teaching the concepts and, whether such resources would potentially have an impact. Using a modified Delphi technique, participants ranked each group of concepts using these criteria on a scale of one to six (one = lowest; 6 = highest). We analyzed the rankings in real time using STATA statistical software. All six groups of concepts were considered relevant and comprehensible with scores of five and six on a scale of one to six. Twenty two out of 25 participants reported having understood the concepts well, with subjective scores of above 75 on a scale of one to 100. Journalists in Uganda recognize the importance of evidence-based medicine concepts in assessing claims about benefits and harms of treatments to them and their audiences. They should be empowered to use these and similar concepts in order to improve how information about effects of treatments is relayed in the media.
Protocol for assessing stakeholder engagement in the development and evaluation of the Informed Health Choices resources teaching secondary school students to think critically about health claims and choices
(PLoS One, 2020-10-12) Nsangi, Allen; Semakula, Daniel; Ssenyonga, Ronald; Mugisha, Michael; Nyirazinyoye, Leaticia; Sewankambo, Nelson Kaulukusi
As part of a five year plan (2019–2023), the Informed Health Choices Project, is developing and evaluating resources for helping secondary school students learn to think critically about health claims and choices. We will bring together key stakeholders; such as secondary school teachers and students, our main target for the IHC secondary school resources, school administrators, policy makers, curriculum development specialists and parents, to enable us gain insight about the context.
Teaching children in low-income countries to assess claims about treatment effects: prioritization of key concepts
(Journal of evidence-based medicine, 2015-09-10) Nsangi, Allen; Semakula, Daniel; Oxman, Andrew D.; Sewankambo, Nelson K.
Health-related knowledge and behaviours developed during childhood are increasingly being recognized as foundational, deeply rooted and resistant to change as children mature into adulthood. The aim of this study was to engage stakeholders in prioritizing key concepts that children need to understand when assessing claims about treatment effects.
Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: A qualitative context analysis
(PLoS One, 2021-03-22) Mugisha, Michael; Senyonga, Ronald; Nsangi, Allen; Semakula, Daniel; Rosenbaum, Sarah
Adolescents encounter misleading claims about health interventions that can affect their health. Young people need to develop critical thinking skills to enable them to verify health claims and make informed choices. Schools could teach these important life skills, but educators need access to suitable learning resources that are aligned with their curriculum. The overall objective of this context analysis was to explore conditions for teaching critical thinking about health interventions using digital technology to lower secondary school students in Rwanda. We undertook a qualitative descriptive study using four methods: document review, key informant interviews, focus group discussions, and observations. We reviewed 29 documents related to the national curriculum and ICT conditions in secondary schools. We conducted 8 interviews and 5 focus group discussions with students, teachers, and policy makers. We observed ICT conditions and use in five schools. We analysed the data using a framework analysis approach. Two major themes found. The first was demand for teaching critical thinking about health. The current curriculum explicitly aims to develop critical thinking competences in students. Critical thinking and health topics are taught across subjects. But understanding and teaching of critical thinking varies among teachers, and critical thinking about health is not being taught. The second theme was the current and expected ICT conditions. Most public schools have computers, projectors, and internet connectivity. However, use of ICT in teaching is limited, due in part to low computer to student ratios. There is a need for learning resources to develop critical thinking skills generally and critical thinking about health specifically. Such skills could be taught within the existing curriculum using available ICT technologies. Digital resources for teaching critical thinking about health should be designed so that they can be used flexibly across subjects and easily by teachers and students.
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
(Journal of Evidence‐Based Medicine, 2023-09-19) Ssenyonga, Ronald; Nakyejwe, Esther; Nsangi, Allen; Semakula, Daniel; Sewankambo, Nelson K.
The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervention on secondary students’ ability to assess health-related claims and make informed choices. In a cluster-randomized trial, we randomized 80 secondary schools (students aged 13–17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly). Eighty schools consented and were randomly allocated. A total of 2477 students in the 40 intervention schools and 2376 students in the 40 control schools participated in this trial. In the intervention schools, 1364 (55%) of students that completed the test had a passing score compared with 586 (25%) of students in the control schools (adjusted difference 33%, 95% CI 26%–39%). The IHC secondary school intervention improved students’ ability to think critically and make informed choices. Well-designed digital resources may improve access to educational material, even in schools without computers or other information and communication technology (ICT). This could facilitate scaling-up use of the resources and help to address inequities associated with limited ICT access.

Browsing by Author "Nsangi, Allen"

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