A study published in The Lancet has found that improved health literacy could help children and adults make better choices about their health.

The Lancet published two articles evaluating the effectiveness of the Informed Health Choices school-based intervention aimed at primary school children and a podcast aimed at parents.

In the school-based study, which included 10,000 children in more than 120 primary schools in Uganda, the researchers used a combination of a comic book and textbook to help children make more informed decisions about health treatments and behaviours. And a linked study targeted at parents, tested the effectiveness of a podcast series on their ability to assess health claims.

With unreliable health claims becoming increasingly widespread via multiple sources such as TV, radio and social media, the ability to obtain, process, understand and judge the reliability of health information can help people make good health choices, which may benefit their health and save resources.

Most health information offers instructions or claims, but little background information about the basis for the claims that are made. Additionally, much health and science education tends to rely on children memorising facts, rather than teaching them critical thinking.

“Unreliable claims about treatments are universal and a major public health concern, but few interventions aimed at teaching people to assess these claims have been tested,” said study Co-author from the Norwegian Institute of Public Health, Dr Andy Oxman.

“Our trial found that it’s possible to teach children and their parents these important skills. While the study was conducted in Uganda, pilot testing in Kenya, Rwanda and Norway lead us to believe the findings are likely to be widely applicable,” continued Dr Oxman.

“What the children are learning is very different from what they are normally taught. As one girl put it: ‘You can study about treatments, but this book was all about how to treat yourself.’ In other words, we are teaching children how to make good choices, not just telling them what they should do,” added study Co-author from Makerere University in Uganda, Dr Daniel Semakula.

The resources focus on 12 key concepts including that anecdotes are unreliable evidence, that newer or more expensive treatments are not necessarily better, the importance of conflicting interests, and the need for fair comparisons of treatments. They also use real-world examples such as claims that cow dung can heal burns; that bed nets prevent malaria; or that antibiotics for ear infections do more good than harm.

Half of the 120 schools were randomly allocated to receive the teaching intervention. In the intervention schools, teachers attended a two-day workshop. They taught nine 80-minute lessons over the course of one school term. In the control group, there was no change to the usual curriculum. At the end of the school term, children were given a test with two multiple choice questions for each concept. The questions were scenario-based and required children to assess claims.

More than twice as many children in the intervention group achieved a passing score compared those in the control group. In the intervention schools, 69% of children who took the test had a passing score on the test, compared to 27% of children in the control schools.

In the second study, 675 parents were randomly assigned to listen to the Informed Health Choices podcast or typical public service announcements about health issues. The podcast covered nine concepts. After listening to the entire podcast series, parents were given a test with two questions per concept.

Nearly twice as many parents in the intervention group achieved a passing score compared those in the control group. In the podcast group, 70% of parents who took the tests had a passing score on the test, compared to 38% of parents in the control group.

Commenting on the study’s results, Health Systems Researcher at the South African Medical Research Council (SAMRC), Simon Lewin said: “These trials indicate that it is possible to improve the health literacy of children and parents in low income settings to enable them to better assess health claims and therefore make better health choices.”

“The findings have important implications for decision makers and other stakeholders in the health and education sectors in Africa and beyond,” concluded Lewin.

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