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Aim: The aim of this prospective meta‐analysis was to synthesize the results of three cluster‐randomized trials of an intervention designed to teach lower‐secondary school students (age 14–16) to think critically about health choices. Methods: We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2‐ to 3‐day teacher training workshop, digital resources, and ten 40‐min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple‐choice questions answered correctly). We performed random effects meta‐analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers. Results: Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score. The overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; p < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score. Conclusions: The intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score. [ABSTRACT FROM AUTHOR]

Aim: The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervention on secondary students' ability to assess health‐related claims and make informed choices. Methods: In a cluster‐randomized trial, we randomized 80 secondary schools (students aged 13–17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2‐day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple‐choice questions for each concept to evaluate the students' ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly). Results: Eighty schools consented and were randomly allocated. A total of 2477 students in the 40 intervention schools and 2376 students in the 40 control schools participated in this trial. In the intervention schools, 1364 (55%) of students that completed the test had a passing score compared with 586 (25%) of students in the control schools (adjusted difference 33%, 95% CI 26%–39%). Conclusions: The IHC secondary school intervention improved students' ability to think critically and make informed choices. Well‐designed digital resources may improve access to educational material, even in schools without computers or other information and communication technology (ICT). This could facilitate scaling‐up use of the resources and help to address inequities associated with limited ICT access. [ABSTRACT FROM AUTHOR]

The Evidence to Decision (EtD) framework is a tool to help groups make systematic, transparent, and adaptable healthcare recommendations or decisions. Through a detailed description of the multi‐stakeholder development of this intervention, Sarah E. Rosenbaum and co‐workers present in article number 1700081 important user and stakeholder perspectives relevant for anyone seeking to use or adapt the EtD framework, or who plans to develop similar approaches for supporting groups making evidence‐informed decisions in the context of healthcare or other domains. [ABSTRACT FROM AUTHOR]

Evidence‐informed health care decisions and recommendations need to be made systematically and transparently. Mediating technology can help manage boundaries between groups making decisions and target audiences, enhancing salience, credibility, and legitimacy for all. This article describes the development of the Evidence to Decision (EtD) framework and an interactive tool to create and use frameworks (iEtD) to support communication in decision making. Methods: Using a human‐centered design approach, we created prototypes employing a broad range of methods to iteratively develop EtD framework content and iEtD tool functionality. Results: We developed tailored EtD frameworks for making evidence‐informed decisions and recommendations about clinical practice interventions, diagnostic and screening tests, coverage, and health system and public health options. The iEtD tool provides functionality for preparing frameworks, using them in group discussions, and publishing output for implementation or adaption. EtD and iEtD are intuitive and useful for producers and users of frameworks, and flexible for use across different types of topics, decisions, and organizations. They bring valued structure to panel discussions and transparency to published output. Conclusion: EtD and iEtD can resolve some of the challenges inherent in multicriteria, multistakeholder decision systems. They are freely available online for all to use at https://ietd.epistemonikos.org/ and https://gradepro.org. The purpose of Evidence to Decision frameworks is to help groups make systematic, transparent, and adaptable health care recommendations or decisions. This article describes the development of the frameworks and digital tool, revealing key stakeholder perspectives that are relevant for anyone seeking to use the framework, the tool, or develop similar approaches for decisions in other domains. [ABSTRACT FROM AUTHOR]