Effects of using the Informed Health Choices digital secondary school resources on the ability of Rwandan students to think critically about health: protocol for a cluster-randomised trial

Background: Young people are exposed to many claims about the effects of things they can do to protect or improve health. To make good health choices, they need the ability to assess the reliability of those claims critically. Critical thinking is a core competence in the Rwandan secondary school curriculum and in many countries. However, critical thinking about health is rarely taught in Rwanda. Digital secondary school resources for critical thinking about health can potentially address this gap and if published be widely disseminated at low cost. The objective of the planned study is to evaluate the effects of using digital secondary school resources to help students learn to think critically about health.

Methods: We will conduct a two-arm cluster-randomized trial. We will randomly select 84 lower secondary schools from 10 districts representing all five provinces of Rwanda. Using stratified random allocation, we will assign 84 schools to the intervention or control arm. Schools in the intervention arm will teach 10-lessons after teacher training on the content of the secondary school resources. Schools in the control arm will not receive any training and resources. They will carry on with teaching the national curriculum. The primary outcome will be the proportion of students with a predetermined passing score on a test with multiple-choice questions from the Claim Evaluation Tools item bank. The questions measure the ability to apply key concepts related to assessing health claims and making informed health choices. The test will include two questions addressing each of the nine concepts covered by the secondary school resources.

Discussion: This is one of three randomized trials to assess the effects of the Informed Health Choices secondary school resources in Rwanda, Kenya, and Uganda.  The findings will inform decisions about how to promote critical thinking about health. Trial registration: Pan African Clinical Trial Registry, trial identifier: PACTR202203880375077, Registered on 15th February 2022.