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. 2023 Oct 24;2023(10):CD014722. doi: 10.1002/14651858.CD014722.pub2

Risk of bias for analysis 4.4 Psychological functioning and impairment at 1‐6 months.

Study Bias
Randomisation process Deviations from intended interventions Missing outcome data Measurement of the outcome Selection of the reported results Overall
Authors' judgement Support for judgement Authors' judgement Support for judgement Authors' judgement Support for judgement Authors' judgement Support for judgement Authors' judgement Support for judgement Authors' judgement Support for judgement
Huang 2017 Low risk of bias 1a.1: PY; 1a.2: PY. 1.1 Quote: "the study of effectiveness outcomes applies a cluster randomized wait‐list controlled design in 10 Ugandan schools". 1.2: Randomization was done by a researcher that was unfamiliar with the study schools
1.3: NI. Note: No useful information is reported to evaluate this element
1b.1: N: participants were recruited after cluster allocation to intervention or control;
1b.2: NI ‐ No evidence to suggest that selection was influenced by knowledge of the assigned intervention (93% of elegible teachers participated) for teachers, but teachers selected children for inclusion in a non‐random fashion;
1b.3: PN: there were no significant differences for intervention groups. Overall: Some concerns		 Low risk of bias 2.1a: NI; 2.1b: PY; 2.2: PY. Note: No information provided on whether participants knew that they were in a trial, due to the nature of the intervention they (as those delivering the intervention) were most likely aware of intervention allocation.
2.3: PN. Note: No evidence to suggest deviations from the intended intervention that arose because of the trial context
2.4: NA.
2.5: NA.
2.6: Y. Note: Data was analysed on an intention‐to‐treat basis.
2.7: NA.		 Low risk of bias 3.1a: PY ‐ all clusters were analyzed;
3.1b: PN: data was available for almost all teachers (84/86%), loss at follow‐up was greater for families/children (62‐69%)
3.2: PN. No evidence that the result was not biased by missing data
3.3: PN; 3.4: NA. Quote: "the followed and
non‐followed families did not differ by condition or on family
demographic characteristics (i.e., food insecurity status,
household size), and baseline child effectiveness outcome
measures. Therefore, we assumed data were missing
completely at random"		 Some concerns 4.1: PN. Note: The outcome measure is widely established and adapted for use in Nepal.
4.2: PN. Note: No evidence to suggest that.
4.3a: NI; 4.3b: PY. Note: no information provided on whether participants knew that they were in a trial, participants were most likely aware of the group allocation due to the nature of the intervention
4.4: PY; 4.5: PN. Note: Knowledge of the assigned intervention could influence participant‐reported outcomes, but there is no reason to believe that it did.		 Low risk of bias 5.1: PY. Note: No evidence to suggest otherwise, methods and results do not show discrepancies.
5.2: PN. Note: No evidence to suggest outcome selection. All outcomes mentioned in the methods and results were reported.
5.3: PN. Note: No evidence to suggest analyses selection. All analyses mentioned in the methods and results were reported.		 Some concerns The study is judged to raise some concerns in one domain (4), but not to be at high risk of bias for any domain.