Working paper Open Access

Does the use of the Informed Health Choices teaching resources improve the secondary students' ability to critically think about health in Uganda? A cluster randomised trial protocol

Ssenyonga, Ronald; Oxman, Andrew D.; Nakyejwe, Esther; Mugagga, Solomon K.; Nsangi, Allen; Semakula, Daniel; Chesire, Faith; Mugisha, Michael; Lewin, Simon; Rosenbaum, Sarah; Oxman, Matt; Kaseje, Margaret; Sewankambo, Nelson K.


To make well-informed choices, people must possess skills to assess the trustworthiness of health-related claims. It is important that young people learn to assess the reliability of claims to inform decisions, both when making their own choices and as citizens participating in a democracy. This trial aims to evaluate the effect of the Informed Health Choices (IHC) teaching resources on secondary school students’ ability to assess health-related claims and make informed choices.


This will be a two-arm cluster-randomised trial. We will randomise 80 lower secondary schools to evaluate the IHC secondary school digital teaching resources. The resources for teachers include 10 lessons to be delivered in a single school term, using lesson plans developed for classrooms equipped with only a blackboard or with a projector. Teachers in the intervention arm will be invited to a three-day teacher training workshop. Teachers in the control schools will continue teaching the national curriculum. Uganda’s National Curriculum Development Centre introduced a new competence-based curriculum in 2020. This curriculum has critical thinking as one of seven generic skills to be taught across all subjects. The curriculum does not explicitly include critical thinking about health. The IHC lessons address nine prioritised key concepts. We will use multiple choice questions – two for each key concept - to evaluate the student’s ability to assess claims and make informed choices. We will measure the proportion of students with a passing score at the end of the school term, and again after one year to assess retention of what was learned.

Expected results

Based on previous work done in Ugandan primary schools, we anticipate that the use of the teaching resources will lead to a large improvement in the lower secondary school students’ ability to assess claims and make informed health choices.

Files (2.0 MB)
Name Size
_Ugandan randomised trial protocol.pdf
370.3 kB Download
Additional file 01. Prioritised IHC concepts.pdf
57.0 kB Download
Additional file 02. Description of the intervention.pdf
172.4 kB Download
Additional file 03. Critical Thinking about Health Test.pdf
402.0 kB Download
Additional file 04. Determination of cut-offs for passing and mastery scores(1).pdf
106.6 kB Download
Additional file 05. Development and evaluation of the Critical Thinking about Health Test.pdf
117.7 kB Download
Additional file 06. Evaluating far transfer of learning, and monitoring potential harms.pdf
111.5 kB Download
Additional file 07. Safety monitoring and adverse events form.pdf
11.6 kB Download
Additional file 08. Informed consent form for head teachers.pdf
93.6 kB Download
Additional file 09. Informed consent form for teachers.pdf
91.3 kB Download
Additional file 10. Teacher training workshop.pdf
225.4 kB Download
Additional file 11. SPIRIT checklist.pdf
118.9 kB Download
Additional file 12. Schedule of trial events.pdf
73.6 kB Download
All versions This version
Views 8585
Downloads 152152
Data volume 21.0 MB21.0 MB
Unique views 7878
Unique downloads 9999


Cite as