Browsing by Author "Nyirazinyoye, Laetitia"

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    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
    (Journal of Evidence‐Based Medicine, 2023-09-21) Mugisha, Michael; Nyirazinyoye, Laetitia; Senyonga, Ronald; Semakula, Daniel; Oxman, Andrew D.
    The aim of this trial was to evaluate the effects of the Informed Health Choices intervention on the ability of students in Rwandan to think critically and make Informed Health Choices. We conducted a two-arm cluster-randomized trial in 84 lower secondary schools from 10 districts representing five provinces of Rwanda. We used stratified randomization to allocate schools to the intervention or control. One class in each intervention school had ten 40-min lessons taught by a trained teacher in addition to the usual curriculum. Control schools followed the usual curriculum. The primary outcome was a passing score (≥ 9 out of 18 questions answered correctly) for students on the Critical Thinking about Health Test completed within 2 weeks after the intervention. We conducted an intention-to-treat analysis using generalized linear mixed models, accounting for the cluster design using random intercepts. Between February 25 and March 29, 2022, we recruited 3,212 participants. We assigned 1,572 students and 42 teachers to the intervention arm and 1,556 students and 42 teachers to the control arm. The proportion of students who passed the test in the intervention arm was 915/1,572 (58.2%) compared to 302/1,556 (19.4%) in the control arm, adjusted odds ratio 10.6 (95% CI: 6.3–17.8), p < 0.0001, adjusted difference 37.2% (95% CI: 29.5%–45.0%). The intervention is effective in helping students think critically about health choices. It was possible to improve students’ ability to think critically about health in the context of a competence-based curriculum in Rwanda, despite challenging postpandemic conditions.
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    Informed health choices intervention to teach primary school children in lowincome countries to assess claims about treatment effects: process evaluation
    (BMJ open, 2019-08-02) Nsangi, Allen; Semakula, Daniel; Rosenbaum, Sarah; Nyirazinyoye, Laetitia; Kaseje, Margaret; Sewankambo, Nelson K.
    We developed the informed health choices (IHC) primary school resources to teach children how to assess the trustworthiness of claims about the effects of treatments. We evaluated these resources in a randomised trial in Uganda. This paper describes the process evaluation that we conducted alongside this trial.To identify factors affecting the implementation, impact and scaling up of the intervention; and potential adverse and beneficial effects of the intervention. All 85 teachers in the 60 schools in the intervention arm of the trial completed a questionnaire after each lesson and at the end of the term. We conducted structured classroom observations at all 60 schools. For interviews and focus groups, we purposively selected six schools. We interviewed district education officers, teachers, head teachers, children and their parents. We used a framework analysis approach to analyse the data.
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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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    Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Rwanda: A Mixed Methods Study
    (Global Health: Science and Practice, 2024-02-26) Mugisha, Michael; Nyirazinyoye, Laetitia; Ssenyonga, Ronald; Kaseje, Margaret; Lewin, Simon
    We evaluated the Informed Health Choices secondary school intervention in a cluster randomized trial in Rwanda. The intervention was effective in helping students to think critically about health. In parallel to the trial, we conducted a process evaluation to assess factors affecting the implementation, impacts, and scale-up of the intervention.
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    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
    (Zenodo, 2022-07-04) Mugisha, Michael; Nyirazinyoye, Laetitia; Simbi, Clarisse Marie Claudine; Ssenyonga, Ronald; Lewin, Simon
    The Informed Health Choices (IHC) network is a group of researchers aiming to develop the public’s critical thinking skills and help them make informed health choices. We started with young people and developed the primary and secondary school resources for teaching critical thinking about health choices. The “Be Smart about your Health” secondary school resources are designed for lower secondary students and will be evaluated in randomized trials in three countries: Kenya, Rwanda, and Uganda. This protocol is for a process evaluation that will be conducted alongside the trial in Rwanda. The aim is to assess the implementation process, impacts of the intervention, and factors affecting the impacts and scaling up use of the resources.