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使用《明智医疗选择》(IHC)小学资源是否能提高乌干达五年级儿童评估有关治疗效果说法的可信度的能力:一项整群随机试验方案

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.

作者信息

Nsangi Allen, Semakula Daniel, Oxman Andrew D, Oxman Matthew, Rosenbaum Sarah, Austvoll-Dahlgren Astrid, Nyirazinyoye Laetitia, Kaseje Margaret, Chalmers Iain, Fretheim Atle, Sewankambo Nelson K

机构信息

Makerere University, College of Health Sciences New Mulago Hospital Complex, PO Box 7072, Kampala, Uganda.

University of Oslo, Postboks 1130, Blindern, 0318, Oslo, Norway.

出版信息

Trials. 2017 May 18;18(1):223. doi: 10.1186/s13063-017-1958-8.

Abstract

BACKGROUND

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).

METHODS

This is a two-arm, cluster-randomised trial with stratified random allocation. We will recruit 120 primary schools (the clusters) between April and May 2016 in the central region of Uganda. We will stratify participating schools by geographical setting (rural, semi-urban, or urban) and ownership (public or private). The Informed Healthcare Choices (IHC) primary school resources consist of a textbook and a teachers' guide. Each of the students in the intervention arm will receive a textbook and attend nine lessons delivered by their teachers during a school term, with each lesson lasting 80 min. The lessons cover 12 key concepts that are relevant to assessing claims about treatments and making informed health care choices. The second arm will carry on with the current primary school curriculum. We have designed the Claim Evaluation Tools to measure people's ability to apply key concepts related to assessing claims about the effects of treatments and making informed health care choices. The Claim Evaluation Tools use multiple choice questions addressing each of the 12 concepts covered by the IHC school resources. Using the Claim Evaluation Tools we will measure two primary outcomes: (1) the proportion of children who 'pass', based on an absolute standard and (2) their average scores.

DISCUSSION

As far as we are aware this is the first randomised trial to assess whether key concepts needed to judge claims about the effects of treatment can be taught to primary school children. Whatever the results, they will be relevant to learning how to promote critical thinking about treatment claims. Trial status: the recruitment of study participants was ongoing at the time of manuscript submission.

TRIAL REGISTRATION

Pan African Clinical Trial Registry, trial identifier: PACTR201606001679337 . Registered on 13 June 2016.

摘要

背景

评估有关治疗益处和危害的说法的能力对于明智的医疗保健决策至关重要。本研究旨在使东非小学(群组)的儿童获得并保留相关技能,通过提高他们获取、处理和理解健康信息的能力,帮助他们做出明智的医疗保健选择。该试验将(在个体参与者层面)评估专门设计的学习资源是否能教会儿童一些与评估医疗保健干预措施(治疗)的益处和危害相关的关键概念。

方法

这是一项双臂、群组随机试验,采用分层随机分配。我们将于2016年4月至5月在乌干达中部地区招募120所小学(群组)。我们将根据地理环境(农村、半城市或城市)和所有权(公立或私立)对参与学校进行分层。明智医疗保健选择(IHC)小学资源包括一本教科书和一本教师指南。干预组的每个学生将获得一本教科书,并在一学期内参加由教师授课的九节课程,每节课持续80分钟。这些课程涵盖12个与评估治疗说法和做出明智医疗保健选择相关的关键概念。另一组将继续使用当前的小学课程。我们设计了索赔评估工具来衡量人们应用与评估治疗效果说法和做出明智医疗保健选择相关关键概念的能力。索赔评估工具使用多项选择题,涉及IHC学校资源涵盖的12个概念中的每一个。我们将使用索赔评估工具测量两个主要结果:(1)根据绝对标准“通过”的儿童比例;(2)他们的平均分数。

讨论

据我们所知,这是第一项评估是否可以向小学生传授判断治疗效果所需关键概念的随机试验。无论结果如何,它们都将与学习如何促进对治疗说法的批判性思维相关。试验状态:在提交手稿时,研究参与者的招募正在进行中。

试验注册

泛非临床试验注册中心,试验标识符:PACTR201606001679337。于2016年6月13日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e7/5437593/9f5e9b239dff/13063_2017_1958_Fig1_HTML.jpg

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