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To explore participants’ experiences of potential adverse effects of the Informed Health Choices secondary school intervention across three trial sites and to revise a framework of potential adverse effects of interventions to improve critical thinking about health choices.
This was a qualitative study. We extracted and analysed relevant data from separate process evaluations in each country. Data came from surveying teachers, observing lessons and group and individual interviews with students, teachers and other stakeholders. We modified and applied framework analysis, including five stages: (1) development of an initial framework of potential adverse effects, (2) familiarisation with the data, (3) indexing, (4) abstraction and synthesis and (5) revising the framework. We applied reflexive strategies individually and as a team.
Lower secondary school in five randomly sampled subcounties of Kisumu County in Kenya, districts representing all five provinces in Rwanda, and six districts in the central region of Uganda, between 2022 and 2024.
Students and teachers in the intervention arms of the trials, parents of students in the intervention arms and administrators at intervention schools, as well as curriculum developers and policy-makers.
The intervention involved providing teachers with a 2–3-day training workshop, and digital classroom resources, including lesson plans for 10 lessons to be delivered over the course of one semester.
We generated findings about potential increases in adverse misunderstandings, anxiety related to transfer of learning, adversely experienced cognitive dissonance, work or schoolwork-related stress, inequity, conflicts and waste. The revised framework includes the same categories of potential adverse effects as our initial framework: decision-making harms, psychological harms, equity harms, group and social harms, waste and other harms. We revised other elements of the framework, including definitions of the categories and its structure.
This study provides insight into the potential adverse effects of interventions to improve critical thinking about health choices. The findings complement those of the trials and country-level process evaluations.
To examine the extent of adherence to high-level principles in remote prescribing and investigate how medical and non-medical prescribers comply with these principles.
Scoping Review.
A systematic search of CINAHL, PubMed, Medline, the Cochrane Database of Systematic Reviews, the Web of Science, and the Ovid Emcare databases was performed. A grey literature search was conducted on relevant professional websites and Google Scholar. Literature was searched from January 2007 to March 2025.
Research results were uploaded to Raayan for management and selection of evidence. Two reviewers independently scored and appraised papers using a structured data extraction form. The ‘United Kingdom High-level Principles for Good Practice in Remote Consultations and Prescribing’ served as a coding framework for deductive manifest content analysis.
Searches identified 6870 studies. After screening the title and abstract, 54 full texts were reviewed, and 14 studies were identified for analysis. Adherence to high-level principles was limited and inconsistent. Data categories were developed into 5 themes: (1) Patient privacy and vulnerability, (2) Adequate assessment, (3) Guidelines and evidence-based prescribing, (4) Investigations and safety netting, and (5) Organisational safety and creating safe systems.
This review provided insight into the challenges that medical prescribers face when adhering to governance principles during remote prescribing practice. However, no research about how non-medical prescribers integrate remote prescribing governance into their practice was found.
Remote prescribing has become firmly embedded within the current healthcare system and robust governance is required to safeguard patient outcomes. Further research exploring how non-medical prescribers integrate the high-level principles into practice will inform prescribing governance for this group.
No patient or public contribution was sought as the scoping review focused solely on the existing literature.
FreshRSS 