SWISH (See Well to Stay In ScHool: Randomised trial of spectacle distribution to decrease secondary school dropout rates in rural communities)

我们想知道的是：为中国贫困农村地区的近视儿童免费提供眼镜，并与教师一起鼓励他们在课堂上戴眼镜，是否会让更多的孩子上高中？研究类型：称为“试验”，这种研究随机选择（就像抛硬币一样）一个特定学校的所有孩子都将参加的学习小组。研究理由：中国儿童是世界上近视最严重的儿童之一，但在贫困地区，需要戴眼镜的儿童中只有五分之一戴眼镜。我们的团队在其他试验中已经证明，给孩子免费眼镜可以提高成绩，而且免费眼镜对成绩的影响比父母的教育水平和家庭财富等因素更大。戴眼镜对成绩的影响要大于学校里其他健康服务，比如提供维生素。在中国西部农村，只有大约三分之一的孩子能上普通的非职业高中。我们希望向中国政府展示眼镜可以帮助儿童继续接受教育的有力证据，以帮助说服政府实施国家计划，为有需要的儿童提供免费眼镜。研究计划：我们将在中国西部宁夏随机选择130所中学，每所学校一年级和二年级的所有孩子（每个班一个）将随机分为两组：一组获得免费眼镜，在老师的支持下推动他们戴眼镜（“干预”）；另一组只获得眼镜处方（“对照组”）。这项研究将主要关注儿童升入高中的比率，其规模足以确定我们是否使这一数字至少增加了10%。我们还会看孩子们的考试成绩，他们是否在学校戴眼镜，以及他们使用黑板（近视的孩子更难看到）或教科书学习的频率。这些其他的东西将帮助我们更好地理解戴眼镜视力更好会导致更好的成绩，然后更高的高中升学率的想法是否真的合乎逻辑。我们还将研究提供眼镜的成本和教师戴眼镜的支持，以及它给孩子们带来的好处。我们还将研究学生、老师和家长对戴眼镜和上学的看法，以确保我们的方法适合这一领域。研究小组：康登博士是一名眼科医生和公共卫生专家，能说一口流利的中文。他同时在英国（女王大学）和中国（中山大学）工作，并申请这项资助。在女王大学也有这类研究（试验）的专家，一位会说中文的专家数据分析师，一位执行研究成本和收益部分的专家，还有一位文化专家，帮助我们了解当地人对戴眼镜和留在学校的态度。与我们一起在中国工作的有中山眼科医院的工作人员和陕西师范大学的工作人员，中山眼科医院是中国最好的眼科医院，也是开展此类试验的中心。陕西师范大学与我们计划在宁夏工作的学校的管理部门有着非常密切的联系。另一个合作伙伴是美国斯坦福大学的REAP组织。他们是研究证明哪些变化有助于中国农村学校改善的专家。我们的团队已经在中国的学校里进行了很多类似的眼镜试验。

What we want to know: Will giving free glasses to short-sighted Chinese children in poor rural areas, and working with teachers to encourage them to use the glasses in class, result in more children going on to high school?Type of study: Called a "trial," this kind of study chooses at random (like flipping a coin) the study group that all children in a particular school will be in.Why the study is needed: Chinese children are some of the most short-sighted in the world, but only one in five children in poor areas who needs glasses has them. Our team has already showed in other trials that giving children free glasses leads to better grades, and that free glasses have a bigger impact on grades than factors like parents' education level and the amount of money a family has. The effect on grades from glasses is greater than from other health services in school, like giving vitamins. Only about one in three children in rural western China goes on to a regular, non-vocational high school. We would like to show the Chinese government strong evidence of what glasses can do to help children continue their education, in order to help convince the government to carry out national programs to provide free glasses for children who need them.Study Plan: We will choose 130 middle schools at random in Ningxia, western China, and all children in Years 1 and 2 (one class each) at each school will go at random into one of two groups: either a group getting free glasses, with support from teachers to push them to wear the glasses ("Intervention") or a group getting just glasses prescriptions ("Control.") The study will mainly look at the rate of children going on to high school, and is large enough to find out whether we produced at least a 10% rise in this number. We'll also look at the children's test scores, whether they wear their glasses at school, and how often they use blackboards (harder for short-sighted kids to see) or textbooks to learn from. These other things will help us to better understand whether the idea that making the vision better with glasses leads to better grades and then to higher rates of going on to high school really makes logical sense. We'll also study how much it costs to give the glasses and the teacher support to wear them, compared to how much benefit it brings to children. We will also study the thinking of students, teachers and parents about wearing glasses and staying in school, to make sure our approaches are suitable in this area.Study Team: Dr Congdon, the head of the study, is an eye doctor and public health expert who speaks fluent Chinese. He works at both the UK (Queen's) and Chinese (Zhongshan) universities seeking this grant. Also at Queen's there are specialists in this type of study (trials), an expert data analyst who speaks Chinese, an expert to carry out the part of the study looking at costs and benefits, and also a cultural expert to help us understand local attitudes about wearing glasses and staying in school. Working with us in China are staff at Zhongshan, the top eye hospital in China and a center for doing trials such as this one, and Shaanxi Normal (teacher training) University, which has very close connections to the bureau running the schools in Ningxia where we plan to work. Another partner is an American group, REAP, at Stanford University. They are experts in doing studies to prove what changes help rural Chinese schools to improve. Our team has worked together on many trials on glasses like this one in Chinese schools.