Nordheim Lena V, Gundersen Malene W, Espehaug Birgitte, Guttersrud Øystein, Flottorp Signe
Faculty of Health and Social Sciences, Centre for Evidence Based Practice, Bergen University College, Bergen, Norway.
Faculty of Medicine and Dentistry, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
PLoS One. 2016 Aug 24;11(8):e0161485. doi: 10.1371/journal.pone.0161485. eCollection 2016.
Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims.
We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) to assess the certainty of the evidence.
Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low.
Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health claims. The small number of studies, their heterogeneity, and the predominantly high risk of bias inhibit any firm conclusions about their effects. None of the studies evaluated any long-term effects of interventions. Future intervention studies should adhere to high methodological standards, target a wider variety of school-based settings, and include a process evaluation.
PROSPERO no. CRD42015017936.
青少年频繁使用媒体，会从各种渠道接触到健康声明。大众媒体中充斥着相互矛盾、伪科学且往往具有误导性的健康声明，这使得对健康声明进行批判性评估成为一项必不可少的能力。学校在教育青少年对健康声明进行批判性评估方面发挥着重要作用。本系统评价的目的是评估以学校为基础的教育干预措施对提高青少年批判性评估健康声明能力的效果。
我们检索了MEDLINE、Embase、PsycINFO、AMED、Cinahl、教师参考中心、LISTA、ERIC、社会学文摘、社会服务文摘、考克兰图书馆、科学引文索引扩展版、社会科学引文索引以及灰色文献来源。纳入的研究是评估以学校为基础的教育干预措施，通过增进学生的科学知识来提高青少年对健康声明的批判性评估能力。符合条件的研究设计包括随机对照试验和非随机对照试验，以及中断时间序列分析。两位作者独立筛选研究、提取数据并评估纳入研究的偏倚风险。由于干预措施存在异质性且结果报告不充分，我们对研究进行了描述性综合分析。我们使用GRADE（推荐分级、评估、制定和评价）来评估证据的确定性。
纳入了八项研究：两项比较了不同的教学方式，其他研究则将教育干预措施与常规教学进行了比较。研究大多报告了教育干预措施在批判性评估相关知识和技能方面的短期积极效果。然而，所有比较和结果的证据确定性都非常低。
学校中的教育干预措施可能对与健康声明批判性评估相关的知识和技能产生有益的短期影响。研究数量少、异质性大以及普遍存在的高偏倚风险阻碍了我们对其效果得出任何确凿结论。没有一项研究评估干预措施的任何长期影响。未来的干预研究应遵循高方法学标准，针对更广泛的学校环境，并纳入过程评估。
PROSPERO编号CRD42015017936
