Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis.

INTRODUCTION: The world is awash with claims about the effects of health interventions. Many of these claims are untrustworthy because the bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Yet, most people lack the necessary skills to appraise the reliability of health claims. The Informed Health Choices (IHC) project aims to equip young people in Ugandan lower secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. To ensure that we create resources that are suitable for use in Uganda's secondary schools and can be scaled up if found effective, we conducted a context analysis. We aimed to better understand opportunities and barriers related to demand for the resources, how the learning content overlaps with existing curriculum and conditions in secondary schools for accessing and using digital resources, in order to inform resource development. METHODS: We used a mixed methods approach and collected both qualitative and quantitative data. We conducted document analyses, key informant interviews, focus group discussions, school visits, and a telephone survey regarding information communication and technology (ICT). We used a nominal group technique to obtain consensus on the appropriate number and length of IHC lessons that should be planned in a school term. We developed and used a framework from the objectives to code the transcripts and generated summaries of query reports in Atlas.ti version 7. FINDINGS: Critical thinking is a key competency in the lower secondary school curriculum. However, the curriculum does not explicitly make provision to teach critical thinking about health, despite a need acknowledged by curriculum developers, teachers and students. Exam oriented teaching and a lack of learning resources are additional important barriers to teaching critical thinking about health. School closures and the subsequent introduction of online learning during the COVID-19 pandemic has accelerated teachers' use of digital equipment and learning resources for teaching. Although the government is committed to improving access to ICT in schools and teachers are open to using ICT, access to digital equipment, unreliable power and internet connections remain important hinderances to use of digital learning resources. CONCLUSIONS: There is a recognized need for learning resources to teach critical thinking about health in Ugandan lower secondary schools. Digital learning resources should be designed to be usable even in schools with limited access and equipment. Teacher training on use of ICT for teaching is needed.

Analysing the impact of COVID-19 risk perceptions on route choice behaviour in train networks.

INTRODUCTION: Unlike previous pandemics, COVID-19 has sustained over a relatively longer period with cyclical infection waves and numerous variants. Public transport ridership has been hit particularly hard. To restore travellers' confidence it is critical to assess their risk determinants and trade-offs. METHODS: To this end, we survey train travellers in the Netherlands in order to: (i) quantify the impact of trip-specific, policy-based, and pandemic-related attributes on travellers' COVID-19 risk perceptions; and (ii) evaluate the trade-off between this risk perception and other travel attributes. Adopting the hierarchical information integration approach, in a two-stage stated preference experiment, respondents are asked to first rate how risky they perceive different travel situations to be, and then to choose between different travel options that include their own perceived risk rating as an attribute. Perceived risk ratings and choices between travel options are modelled using a linear regression and a mixed multinomial logit model, respectively. RESULTS: We find that on-board crowding and infection rates are the most important factors for risk perception. Amongst personal characteristics, the vulnerability of family and friends has the largest impact-nearly twice that of personal health risk. The bridging choice experiment reveals that while values of time have remained similar to pre-pandemic estimates, travellers are significantly more likely to choose routes with less COVID-19 risk (e.g., due to lower crowding). Respondents making longer trips by train value risk four times as much as their shorter trip counterparts. By combining the two models, we also report willingness to pay for mitigating factors: reduced crowding, mask mandates, and increased sanitization. CONCLUSION: Since we evaluate the impact of a large number of variables on route choice behaviour, we can use the estimated models to predict behaviour under detailed pandemic scenarios. Moreover, in addition to highlighting the importance of COVID-19 risk perceptions in public transport route choices, the results from this study provide valuable information regarding the mitigating impacts of various policies on perceived risk.

The cognitive science of COVID-19: Acceptance, denial, and belief change.

Because the spread of pandemics depends heavily on human choices and behaviors, dealing with COVID-19 requires insights from cognitive science which integrates psychology, neuroscience, computer modeling, philosophy, anthropology, and linguistics. Cognitive models can explain why scientists adopt hypotheses about the causes and treatments of disease based on explanatory coherence. Irrational deviations from good reasoning are explained by motivated inference in which conclusions are influenced by personal goals that contribute to emotional coherence. Decisions about COVID-19 can also be distorted by well-known psychological and neural mechanisms. Cognitive science provides advice about how to improve human behavior in pandemics by changing beliefs and by improving behaviors that result from intention-action gaps.