“明智健康选择”中学干预措施对肯尼亚初中学生批判性思考健康选择能力的影响：一项整群随机试验的1年随访

Effects of the Informed Health Choices secondary school intervention on the ability of lower secondary students in Kenya to think critically about health choices: 1-year follow-up of a cluster-randomized trial.

作者信息

Chesire Faith, Kaseje Margaret, Gisore Violet, Mugisha Michael, Ssenyonga Ronald, Oxman Matt, Nsangi Allen, Semakula Daniel, Rose Christopher James, Nyirazinyoye Laetitia, Lewin Simon, Sewankambo Nelson K, Rosenbaum Sarah, Moberg Jenny, Oxman Andrew D

机构信息

Tropical Institute of Community Health and Development, P.O. Box 4074 - 40103, Kondele, Kisumu, Kenya.

Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.

出版信息

Trials. 2025 Apr 7;26(1):125. doi: 10.1186/s13063-025-08810-0.

DOI:10.1186/s13063-025-08810-0

PMID:40197504

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11978177/

Abstract

INTRODUCTION

The Informed Health Choices (IHC) secondary school intervention aimed to teach students to assess claims about treatments. This follow-up of a cluster randomized trial assessed the retention of knowledge and the application of the nine prioritized IHC key concepts 1 year after the intervention.

METHODS

We conducted a random assignment of 80 secondary schools in Western Kenya into either the intervention (n = 40) or control (n = 40) group. Both groups adhered to the standard curriculum. Teachers from the intervention group were invited to participate in a 2-day training workshop and were granted access to "Be Smart About Your Health" digital resources, comprising 10 lessons. These lessons, focused on nine prioritized IHC concepts, delivered over a single school term from May to August 2022. The digital resources were accessible online via smartphones or computers and could also be downloaded for offline use. The primary outcome measure, assessed at the end of the school term and again after 1 year, was the percentage of students achieving a passing score (defined as ≥ 9 out of 18 correct answers) on the "Critical Thinking about Health" test.

RESULTS

Out of the total 3360 students involved in the trial, 2446 (72.8%) completed the test after 1 year. Within the intervention group, 728 out of 1369 students (53.2%) achieved a passing score after 1 year, compared to 61.7% immediately post-intervention. In contrast, in the control group, 347 out of 1077 students (32.2%) had a passing score after 1 year. The adjusted difference in passing rates between the intervention and control groups after 1 year was 20.8% (with a 95% confidence interval of 13.6 to 28.0%), compared to 27.3% (with a 95% confidence interval of 19.6 to 34.9%) immediately after the intervention.

CONCLUSION

This study demonstrates that students were able to retain knowledge and the ability to apply the IHC key concepts, 1 year after the intervention. But fewer students in the intervention group had a passing score after 1 year compared to just after the intervention. Highlighting follow-up training is likely necessary to reinforce these skills over time.

TRIAL REGISTRATION

Pan African Clinical Trial Registry, trial identifier: PACTR202204883917313. Registered on 05/04/2022.

摘要

引言

明智健康选择（IHC）中学干预项目旨在教导学生评估有关治疗方法的说法。这项整群随机试验的随访评估了干预一年后学生对知识的保留情况以及九个优先IHC关键概念的应用情况。

方法

我们将肯尼亚西部的80所中学随机分为干预组（n = 40）或对照组（n = 40）。两组都遵循标准课程。干预组的教师被邀请参加为期两天的培训工作坊，并可使用“明智对待你的健康”数字资源，该资源包含10节课。这些课程聚焦于九个优先的IHC概念，于2022年5月至8月的一个学期内授课。数字资源可通过智能手机或电脑在线获取，也可下载以供离线使用。主要结局指标在学期末和一年后再次评估，是学生在“健康批判性思维”测试中获得及格分数（定义为18道正确答案中≥9道）的百分比。

结果

在参与试验的3360名学生中，2446名（72.8%）在一年后完成了测试。在干预组中，1369名学生中有728名（53.2%）在一年后获得及格分数，而干预后立即获得及格分数的比例为61.7%。相比之下，在对照组中，1077名学生中有347名（32.2%）在一年后获得及格分数。干预组和对照组一年后的及格率调整差异为20.8%（95%置信区间为13.6%至28.0%），而干预后立即的差异为27.3%（95%置信区间为19.6%至34.9%）。