Event Date/s
Event Details
M.Sc. Ronald Ssenyonga at Institute of Health and Society will be defending the thesis “Improving the ability of Ugandan adolescents to think critically about health: A digital educational intervention to equip Ugandan adolescents with skills to assess claims about benefits and harms of health interventions and make informed health choices” for the degree of PhD (Philosophiae Doctor).
Time and place: , Blått auditorium, Rikshospitalet, Sognsvannsveien 20, Oslo
Click here to stream the public defence
Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Order a digital copy of the thesis here
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Steven Higgins, School of Education, Durham University, UK
- Second opponent: Associate Professor Gro Jamtvedt, Oslo Metropolitan University (OsloMet), Norway
- Third member and chair of the evaluation committee: Professor II Magne Nylenna, University of Oslo
Chair of the Defence
Associate Professor Mekdes Gebremariam, University of Oslo
Principal Supervisor
Research Director Andrew D. Oxman, Norwegian Institute of Public Health
Summary
The world is awash with claims about the effects of health actions (interventions). Many of these claims are untrustworthy because their bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Most people lack the necessary skills to assess the reliability of health claims and make choices that are well-informed. The Informed Health Choices (IHC) project aimed to equip young people in secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. The goal was to cultivate lifelong competencies and dispositions that enable people to make informed personal choices and participate in policy debates as well-informed citizens. This thesis comprises three studies conducted in Uganda as part of the IHC project.
The first study was a context analysis to explore opportunities and barriers related to demand for educational resources for thinking critically about health actions, fit with the existing curriculum, and to examine conditions in Ugandan secondary schools for accessing and using digital resources. The second study was a randomized trial to evaluate the effectiveness of the IHC secondary school intervention. The intervention included applying the digital educational resources, which included 10 lessons, and executing a teacher training workshop. The third study was a process evaluation, to document the extent to which the IHC secondary school intervention was delivered as intended, identify factors that might affect the impact and scaling up of the intervention in Uganda, and explore potential adverse and beneficial effects of the intervention.
For the context analysis, we analysed documents, conducted key informant interviews, focus group discussions, and school visits, and carried out a school survey via telephone. We also reached consensus about the appropriate number and length of IHC lessons that could be taught in a school term, using the nominal group technique. We conducted a cluster-randomized trial to evaluate the effectiveness of the IHC secondary school intervention. We randomly assigned 80 secondary schools (students aged 13–17) to the intervention or the control (usual curriculum) group in central Uganda. Alongside the trial, we conducted a process evaluation, using data from classroom observations in all 40 intervention schools, teacher training evaluation forms, and lesson evaluation forms. We conducted focus group discussions with students and parents in 10 purposively selected intervention schools and key informant interviews with teachers, head teachers, policy makers, and parents. We transparently assessed confidence in our qualitative findings using established reliable methods (modified CERQual approach).
The context analysis revealed that there was demand for IHC educational resources and that teachers can access the internet using their smart phones. However, students have little to no access to digital equipment. For example, less than half of secondary schools in Uganda have a projector. As a result, we designed digital educational resources that could be accessed by teachers using a smart phone or computer and taught in classrooms with or without a projector. The trial showed a large effect on student’s ability to think critically about health actions. The process evaluation found that all key stakeholders valued the educational resources and, consistent with the trial results, that students understood and could apply the key concepts that were taught in the lessons. However, the IHC lessons were not in the curriculum and were not subject to national exams. This may have limited the impact of the intervention and is a likely barrier to scaling it up.
The IHC secondary school intervention improved students’ ability to think critically and make informed health choices. Well-designed digital resources can improve access to educational material, even in schools without computers or other information and communication technology (ICT). This could facilitate scaling up the use of the IHC educational resources and help to address inequities associated with limited ICT access, provided the lessons are incorporated in the curriculum and national examinations.
Additional information
Contact the research support staff.
